An HPLC assay for the therapeutic drug monitoring of cefiderocol in critically ill patients

Sir, Cefiderocol is a novel parenteral cephalosporin demonstrating potent in vitro efficacy against MDR Pseudomonas aeruginosa, Acinetobacter baumannii and Enterobacteriales, including ESBL- and carbapenemase-producing strains. Its siderophore property allows it to enter bacterial cells through active iron transporters, a mechanism that is independent from porin channels or efflux pumps.1 Cefiderocol was approved by EMA in 2020 for the treatment of infections due to aerobic Gram-negative organisms in adults with limited treatment options.2 Recently, a randomized clinical trial of cefiderocol in a heterogeneous patient population with infections caused by carbapenem-resistant Gram-negative bacteria reported 66% clinical cure and 48% microbiological eradication at the...