Revamped antibiotic may treat deadly eye infection

Key Takeaways

• New research suggests that the relatively new antibiotic cefiderocol, given in the form of eye drops, may be a way to combat a deadly eye infection linked to contaminated bottles of artificial tears.
• The researchers would like to see further development of cefiderocol as a potential weapon against corneal infections caused by highly antibiotic-resistant Pseudomonas aeruginosa. 

The relatively new antibiotic cefiderocol given in the form of eye drops may be a way to combat a type of eye infection that broke out in the U. S. last year, according to research presented at the 2024 annual meeting of the Association for Research in Vision and Ophthalmology (ARVO). The infections, linked to contaminated bottles of artificial tears, were detected in 81 patients in 18 states. The outbreak led to loss of vision in 14 patients, surgical removal of the eyeball in 4 patients, and four deaths, according to health officials.  The infection was caused by an extensively drug-resistant strain of Pseudomonas aeruginosa that had not previously been reported in this country.  Last year scientists cautioned that the bacteria potentially could spread from person to person. 

At ARVO on May 6, Eric G. Romanowski, MS, research director of the Charles T. Campbell Ophthalmic Microbiology Laboratory at the University of Pittsburgh Medical Center, described studies that his lab conducted evaluating topical cefiderocol as a potential treatment option for these infections.  Investigators found that the bacterial strain was susceptible to this medication, which was approved by the US Food and Drug Administration in 2019 for treatment for urinary tract infections. But the antibiotic had not been tested as an eye drop.

“We showed that the ‘Trojan-horse’ antibiotic, cefiderocol…was non-toxic and effective against the highly resistant outbreak strain in an experimental model of infection,” Romanowski and co–lead investigator Robert M. Q. Shanks, PhD, reported, adding that their results show that topical cefiderocol could be a new weapon for treating corneal infections caused by highly antibiotic-resistant Pseudomonas aeruginosa. The group reported that cefiderocol was well tolerated on rabbit corneas and was also effective for keratitis (inflammation or irritation of the cornea). Their paper noted that “there is no current consensus as to the most effective antimicrobial strategy to deal with” extensively drug-resistant keratitis. 

The researchers first published their findings as a preprint in September 2023 and then in Ophthalmology Science in December. “We would like to see further development of this antibiotic for potential use,” Romanowksi added. “It would be up to any individual clinician to determine whether to use this antibiotic in an emergency situation.”

Edited by Dawn Wilcox, BSN, RN and Miriam Kaplan, PhD.

Source: Jake Remaly, Medscape Medical News, May 7, 2024; see source article