Cefiderocol (Fetroja®) is a siderophore cephalosporin that results in an iron-depleted environment of Gram-negative bacteria via the “Trojan horse” strategy.

Cefiderocol has demonstrated time-dependent bactericidal activity against Gram-negative bacteria, especially those with multidrug-resistant organisms, including carbapenem-resistant Enterobacteriaceae (CRE).

Cefiderocol has received the US Food and Drug Administration approval for the treatment of complicated urinary tract infections (cUTIs) from Gram-negative bacteria, especially in patients who have limited or no alternative treatment options.

Due to an increase in all-cause mortality in patients treated with cefiderocol compared to those treated with best available therapy, cefiderocol is reserved for cUTIs in carbapenem-resistant Gram-negative bacterial infections.