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Cefiderocol infusion

Updated 2 Feb 2023 | Cephalosporins


Infusion of cefiderocol.

Drugs List

  • cefiderocol 1g powder for solution for infusion
  • FETCROJA 1g powder for concentrate for solution for infusion
  • Therapeutic Indications


    Infections caused by Gram-negative bacteria

    For the treatment of infections due to aerobic Gram-negative organisms in adults with limited treatment options.


    It is recommended the cefiderocol should be used to treat patients that have limited treatment options only after consultation with a physician with appropriate experience in the management of infectious diseases.


    2g every 8 hours.

    Duration to be in accordance with the site of infection.

    Patients with Renal Impairment

    Creatinine clearance equal to or over 120mL/min (augmented renal clearance)
    2g every 6 hours.

    Creatinine clearance 60 to 120mL/min
    2g every 8 hours.

    Creatinine clearance 30 to 60mL/min
    1.5g every 8 hours.

    Creatinine clearance 15 to 30mL/min
    1g every 8 hours.

    Creatinine clearance less than 15mL/min or with intermittent haemodialysis
    0.75g every 12 hours.


    Children under 18 years
    Restricted sodium intake

    Precautions and Warnings

    Creatinine clearance equal to or above 120ml/minute
    History of seizures
    Moderate renal impairment

    Reduce dose in patients with creatinine clearance below 60ml/min
    Sodium content of formulation may be significant
    Consult national/regional policy on the use of anti-infectives
    Monitor renal function regularly
    Consider pseudomembranous colitis if patient presents with diarrhoea
    If tremors, myoclonus or convulsion occur, consider anticonvulsant therapy
    May affect results of some laboratory tests
    Discontinue at once if pseudomembranous colitis occurs
    Discontinue if overgrowth of resistant organisms occurs
    Discontinue if severe hypersensitivity reactions occur

    Cephalosporins have been implicated in triggering seizures. Patients that have seizure disorders should continue with anticonvulsant therapy. If patients develop focal tremors, myoclonus, or seizures, a neurological evaluation should be performed and placed on anticonvulsant therapy if not already instituted.

    Pregnancy and Lactation


    Cefiderocol is contraindicated during pregnancy.

    The manufacturer does not recommend using cefiderocol during pregnancy. At the time of writing, there is limited data on the use of cefiderocol during pregnancy (less than 300 pregnancy outcomes). Animal studies do not indicate direct or indirect harmful effects with respect to reproductive toxicity.


    Use cefiderocol with caution during breastfeeding.

    The manufacturer advises that the patient either discontinues cefiderocol or discontinues breastfeeding. It is unknown whether cefiderocol is excreted in human breast milk.

    Side Effects

    Abnormal liver function
    Alanine aminotransferase increased
    Altered liver function tests
    Aspartate aminotransferase increased
    Clostridium difficile diarrhoea
    Erythema at injection site
    Erythematous rash
    Gamma glutamyl transferase (GGT) increased
    Hypersensitivity reactions
    Increase of liver transaminases
    Increased susceptibility to infection
    Increases in hepatic enzymes
    Injection site reactions
    Local pain (injection site)
    Macular rash
    Maculopapular rash
    Overgrowth by non-susceptible organisms
    Phlebitis (injection site)
    Pseudomembranous colitis
    Skin reactions

    Effects on Laboratory Tests

    Cefiderocol may result in false-positive results in urine dipstick tests (urine protein, ketones, or occult blood). Alternative methods of testing should be used by the clinical laboratories to confirm positive tests.

    A positive direct or indirect Coombs test may develop during treatment with cefiderocol.


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: October 2020

    Reference Sources

    Summary of Product Characteristics: Fetcroja 1g powder. Shionogi. Revised April 2020.

    NICE Evidence Services Available at: Last accessed: 06 May 2021

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