Optimal dosage regimens of cefiderocol administered by short, prolonged or continuous infusion: a PK/PD simulation study.

This article focuses on evaluating alternative dosing regimens of cefiderocol, an intravenous antibiotic used to treat multidrug-resistant Gram-negative infections, through pharmacokinetic/pharmacodynamic (PK/PD) simulations. The study compares the approved prolonged infusion (PI) of 3 hours with short infusion (SI, 1 hour) and continuous infusion (CI) regimens across different levels of renal function, assessing drug concentrations in plasma and epithelial lining fluid (ELF) relevant to bloodstream infections and pneumonia, respectively. Results indicate that while recommended PI regimens achieve adequate target attainment in plasma, higher doses and continuous infusion are necessary to reach pharmacodynamic targets in ELF, especially for patients with normal or augmented renal clearance and pneumonia. The authors suggest that SI and CI regimens may be viable alternatives to PI, with CI potentially offering advantages in pneumonia treatment, but emphasize the need for further clinical evaluation.