Fetroja
Fetroja Uses, Dosage, Side Effects, Food Interaction and all others data.
Fetroja is a cephalosporin antibacterial drug and exerts a mechanism of action similar to other β-lactam antibiotics. Unlike other agents in this category, cefiderocol is a siderophore able to undergo active transport into the bacterial cell through iron channels. It represents a significant addition to antibacterial treatment option as it has proven to be effective in vitro against multidrug resistant strains including extended spectrum β-lactamase producers and carbapenemase producing bacteria.
Fetroja was granted designation as a Qualified Infectious Disease Product and granted priority review status by the FDA on November 14, 2019. It is indicated for use in complicated urinary tract infections in patients with limited or no alternative treatments available. This indication was supported by a positive clinical trial composed of 448 patients with complicated urinary tract infections which demonstrated a 72.6% rate of symptom resolution and bacterial eradication with cefiderocol compared to 54.6% with the comparator, imipenem/cilastatin. A concern noted in the trial was a 0.3% higher rate of all cause mortality, the cause of which has not been determined.
Similarly to other cephalosporins, cefiderocol exerts bactericidal activity against a range of bacterial species. Fetroja has primarily shown efficacy against aerobic Gram negative bacteria including Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa.
| Trade Name | Fetroja |
| Availability | Prescription only |
| Generic | Cefiderocol |
| Cefiderocol Other Names | Cefiderocol |
| Related Drugs | amoxicillin, doxycycline, ciprofloxacin, ceftriaxone, levofloxacin, Augmentin, vancomycin, Levaquin, meropenem |
| Weight | 1g, |
| Type | Intravenous powder for injection |
| Formula | C30H34ClN7O10S2 |
| Weight | Average: 752.21 Monoisotopic: 751.1497104 |
| Protein binding | Cefiderocol is 40-60% bound to plasma proteins, predominantly to albumin. |
| Groups | Approved, Investigational |
| Therapeutic Class | |
| Manufacturer | |
| Available Country | United States, |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Fetroja is a cephalosporin antibiotic used in complicated urinary tract infections.
Fetroja is indicated for the treatment of complicated urinary tract infections with or without pyelonephritis.
Fetroja is also used to associated treatment for these conditions: Complicated Urinary Tract Infection, Nosocomial Pneumonia, Pyelonephritis, Ventilator-associated Bacterial Pneumonia
How Fetroja works
Fetroja acts by binding to and inhibiting penicillin-binding proteins (PBPs), preventing cell wall synthesis and ultimately causing death of the bacterial cell. Like other β-lactam antibiotics cefiderocol is able to enter bacterial cells via passive diffusion through porins. Unlike other β-lactams, cefiderocol contains a chlorocatechol group which allows it to chelate iron. Once bound to ferric iron cefiderocol is able to undergo active transport into bacterial cells through iron channels in the outer cell membrane such as those encoded by the cirA and fiu genes in E. coli or the PiuA gene in P. aeruginosa. Once inside the cell, cefiderocol binds to and inhibits PBP3 with high affinity thereby preventing the linking of peptodoglycan layers via the pentapeptide bridge. PBP1a, 1b, 2,and 4 are also bound and inhibited by cefiderocol but with a lesser potency than PBP3 and are therefore expected to contribute less to its antibacterial effect.
Toxicity
Information on cefiderocol toxicity is not yet available. In case of overdose supportive care is recommended. Hemodialysis has proven effective in removing cefiderocol with a 3-4 hour session removing 60% of circulating drug.
Food Interaction
No interactions found.Fetroja Disease Interaction
Major: colitisModerate: renal dysfunction, seizure disorders
Volume of Distribution
Fetroja has a mean volume of distribution of 18 L.
Elimination Route
A single intravenous dose of 2 g of cefiderocol in healthy patients produces a Cmax of 89.7 mg/L and an AUC of 386 mg*h/L. In patients with complicated urinary tract infections and a creatinine clearance of at least 60 mL/min, doses of 2 g cefiderocol every 8 hours produced an AUC of 394.7 mg*h/L and a Cmax of 138 mg/L. However the infusion rate for this chronic dosing was 3 times the recommended rate. Cmax and AUC are known to increase proportionally with dosage.
Half Life
The terminal elimination half-life of cefiderocol is 2-3 h.
Clearance
Fetroja has a mean clearance of 5.18 L/h.
Elimination Route
98.6% of cefiderocol is eliminated in the urine with 90.6% as the unchanged parent drug. The remaining 8% is eliminated as metabolites. 2.8% is eliminated in the feces. Less than 10% of cefiderocol is metabolized.
Innovators Monograph
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