High-priority and challenging pathogens are highly susceptible to Fetroja in vitro1,2

Susceptibility of >40,000 Gram-negative clinical isolates from multiple countries was tested against Fetroja1

In vitro activity does not necessarily correlate with clinical efficacy.

In vitro susceptibility rates of clinical strains from North America and Europe (2014-2019)a
Fetroja
(cefiderocol)		 Ceftazidime/
avibactam		 Ceftolozane/
tazobactam		 Imipenem/
relebactamb		 Colistinc
Enterobacterales (n=31,896)1,2 99.8% 99.2% 91.7% 85.0%
(n=6093)		 96.8%
Carbapenem-NSd (n=1021) 96.7% 77.0% 7.8% 54.1%
(n=220)		 80.5%
Ceftazidime/avibactam-NS (n=263) 91.6% 0.0% 3.8% 9.2%
(n=65)		 90.9%
Ceftolozane/tazobactam-NS (n=2658) 97.7% 90.5% 0.0% 76.9%
(n=511)		 88.7%
P aeruginosa (n=7700)1,2 99.9% 93.8% 94% 83.9%
(n=1487)		 99.3%
Carbapenem-NSd (n=1759) 99.8% 75.0% 76.1% 32.9%
(n=343)		 98.5%
Ceftazidime/avibactam-NS (n=477) 100% 0.0% 24.3% 11.6%
(n=86)		 99.2%
Ceftolozane/tazobactam-NS (n=463) 99.8% 22.0% 0.0% 11.0%
(n=82)		 98.1%
A baumannii complexe (n=5226)3 96.0% 43.6% 47.0%
(n=4185)		 51.4%
(n=1041)		 92.7%
Carbapenem-NSd (n=2811) 94.2% 13.7% 8.8%
(n=2274)		 5.8%
(n=537)		 87.2%
S maltophilia (intrinsically carbapenem-resistant) (n=2031)3-5 98.6% 40.0% 32.5%
(n=1565)		 1.9%
(n=466)		 68.7%
Swipe table for more
NS=non-susceptible.

No cross resistance with other classes of antibacterials has been identified for Fetroja6

100% of Carb-NS P aeruginosa isolates, 91.5% of Carb-NS Enterobacterales isolates, and 60% of Carb-NS A baumannii complex isolates expressing MBLs were susceptible to Fetroja7,8

In vitro susceptibility study design1

Over 40,000 clinical isolates of Gram-negative pathogens (Enterobacterales, P aeruginosa, A baumannii complex, and S maltophilia*) were collected over 5 consecutive years (from November 2014 to December 2019) by the SIDERO-WT surveillance studies conducted in North America and Europe. Gram-negative isolates from patients with intra-abdominal, urinary tract, lower respiratory tract, skin and soft tissue, or bloodstream infections were collected by clinical laboratories and were tested centrally (IHMA Inc., Schaumburg, IL, USA). Fetroja MICs were determined by microbroth dilution using iron-depleted cation-adjusted Mueller-Hinton broth (ID-CAMHB) as approved by the Clinical and Laboratory Standards Institute (CLSI) subcommittee on antimicrobial susceptibility testing in January 2016.1

a
Ratios (%) of susceptible strains were calculated by using the following MIC criteria established by the CLSI. If no CLSI criteria met the combinations of drugs and species, the CLSI criteria for closely related species or the criteria established by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) were applied: Fetroja MIC ≤4 μg/mL for Enterobacterales, P aeruginosa, and Acinetobacter complex (CLSI); ≤1 μg/mL for S maltophilia (CLSI); ceftazidime/avibactam MIC ≤8 μg/mL for Enterobacterales and P aeruginosa (CLSI) (and the same criteria were applied for non-fermenters, except for P aeruginosa); ceftolozane/tazobactam MIC ≤2 μg/mL for Enterobacterales (CLSI); ≤4 μg/mL for P aeruginosa (CLSI) and other non-fermenters. Colistin MIC ≤2 μg/mL intermediate criteria for all Gram-negative isolates (CLSI) were used as the susceptible breakpoint. Imipenem/relebactam MIC ≤1 μg/mL for Enterobacterales (CLSI), and ≤2 μg/mL for P aeruginosa (CLSI) and other non-fermenters.1,3
b
Imipenem/relebactam was only tested in SIDERO-WT-2019.3
c
Proteus spp, Providencia spp, Morganella morganii, and Serratia marcescens were excluded because they are intrinsically resistant to colistin.3
d
Carbapenem-non-susceptible strain was defined as the strain that shows non-susceptibility to meropenem (CLSI).3,9
e
A baumannii complex consists of A baumannii, A calcoaceticus, A dijkshoorniae, A nosocomialis, A pittii, A seifertii, and A baumannii complex, nonspeciated.3
*
The efficacy of Fetroja in treating clinical infections caused by S maltophilia has not been established in adequate and well-controlled clinical trials.

Even carbapenem-non-susceptible pathogens remain susceptible to Fetroja in vitro1