Table 5 Overview of recently approved beta-lactam–beta-lactamase inhibitors and cefiderocol with activity against carbapenem-resistant Gram-negative bacilli
| Â | |||||
|---|---|---|---|---|---|
Antibacterial coverage | Enterobacterales Acinetobacter Pseudomonas Stenotrophomonas Achromobacter Burkholderia | Enterobacterales Pseudomonas | Pseudomonas | Enterobacterales Pseudomonas Anaerobic Gram-negative and Gram-positive bacteria | Enterobacterales |
Coverage of beta-lactamase producers | Serine-carbapenemases (Class A and Class D [including CRAB producing class D carbapenemases), AmpC enzyme, certain extended-spectrum beta-lactamase, metallo-carbapenemases | Serine-carbapenemases (Class A and Class D), Amp C enzyme, certain extended-spectrum beta-lactamase | Amp C enzyme, certain extended-spectrum beta-lactamase | Serine-carbapenemases (Class A), Amp C enzyme, certain extended-spectrum beta-lactamase | Serine-carbapenemases (Class A), Amp C enzyme, certain extended-spectrum beta-lactamase |
Dosing recommendations | Normal, mild, moderate, severe renal impairment, ARC | Normal, mild, moderate, severe renal impairment | Normal, mild, moderate, severe renal impairment | Normal, mild, moderate, severe renal impairment | Normal, mild, moderate, severe renal impairment |
Drug–drug interaction | Monitoring may be required | Monitoring may be required | Monitoring may be required | Monitoring may be required | Monitoring may be required |
Compatibility | Yes | Yes | Yes | Yes | Yes |
Clinical efficacy and safety | Pneumonia, UTI, sepsis, bacteremia, and infections with limited treatment options | Pneumonia, UTI, IAI, bacteremia, and infections with limited treatment options | Pneumonia, UTI, IAI | Pneumonia, UTI, IAI, bacteremia, and infections with limited treatment options | Pneumonia, UTI, IAI, bacteremia, and infections with limited treatment options |
Lung penetration | Yes | Yes | Yes | Yes | Yes |
Considerations | ACM was numerically increased with cefiderocol in the CREDIBLE–CR study in pneumonia, BSI, sepsis caused by Acinetobacter spp. On-therapy resistance | Decreased clinical efficacy in adult patients with IAI and moderate renal impairment On-therapy resistance | Decreased clinical efficacy in adult patients with IAI and moderate renal impairment On-therapy resistance | Monitoring of liver function, particularly in patients with liver disease Alternative therapies for patients with ARC On-therapy resistance | On-therapy resistance |