Cefiderocol Red Wine Urine Syndrome in Pediatric Patients: A Multicenter Case Series

Pediatr Infect Dis J. 2023 Oct 20. doi: 10.1097/INF.0000000000004150. Online ahead of print.

Abstract

Cefiderocol is a novel cephalosporin antibiotic with activity against multidrug-resistant gram-negative bacteria and limited pediatric experience. This case series describes 3 immunocompromised children receiving blood transfusion who developed benign red or purple urine with administration of cefiderocol. Interaction with iron from blood products is a possible mechanism. It is important to recognize this phenomenon and distinguish it from hematuria to avoid unnecessary diagnostic testing.