ArticleInvestigative ophthalmology & visual science2025
Cefiderocol and Moxifloxacin Have Additive and Synergistic Activity Against Pseudomonas aeruginosa Including an Isolate of the 2023 Keratitis Outbreak.
Article in Investigative ophthalmology & visual science, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Enhanced Efficacy of Cefiderocol With PolyTrim Combination Therapy in a Rabbit Model of Extensively Drug-Resistant Pseudomonas aeruginosa Keratitis.Investigative ophthalmology & visual science · 2026Article
- Cefiderocol Is Effective In Vitro Against Numerous Gram-Negative Species Isolated from Keratitis Patients.Antibiotics (Basel, Switzerland) · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
Purpose: The 2023 outbreak of Pseudomonas aeruginosa keratitis linked to contaminated artificial tears highlighted the need for new treatments targeting ocular infections caused by multi-drug-resistant and extensively drug-resistant bacteria. This study evaluated the in vitro efficacy and potential synergy of cefiderocol and moxifloxacin against P. aeruginosa keratitis isolates. The influence of quorum-sensing defects on antibiotic efficacy was also assessed because of the increase in lasR mutant keratitis isolates. Ceftazidime, which lacks the "Trojan Horse" iron-binding-mediated bacterial entry mechanism of cefiderocol, served as a comparator. Methods: Time-kill and epsilometer (E-test) assays were used to determine minimum inhibitory concentrations and drug interactions. Fractional inhibitory concentration indices were calculated to characterize drug interactions as antagonistic, indifferent, additive, or synergistic. Quorum-sensing defective strains were identified by a characteristic colony sheen phenotype associated with LasR system defects. Results: Time-kill studies demonstrated consistent synergistic interactions between cefiderocol and moxifloxacin against seven out of seven tested P. aeruginosa keratitis isolates, including one from the 2023 outbreak. E-test-based assays showed additive or synergistic activity against 79% of isolates, although this dropped to 60% among suspected quorum-sensing defective strains. In contrast, the ceftazidime and moxifloxacin combination was less effective, particularly sheen-positive strains. The cefiderocol-moxifloxacin combination showed indifferent effects against Serratia marcescens and Staphylococcus aureus, with each antibiotic retaining individual activity. Conclusions: Cefiderocol and moxifloxacin exhibited synergy against most tested P. aeruginosa keratitis isolates in vitro, including those with suspected quorum-sensing defects. These findings support further investigation of this combination for treating highly drug-resistant ocular infections.
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Registered trials
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