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Study Finds Variability in Cefiderocol Pharmacokinetics

Investigators say they consider cefiderocol a candidate for therapeutic drug monitoring.

Cefiderocol was one of the most notable US Food and Drug Administration (FDA) approvals of 2019.

The FDA approved cefiderocol, a novel cephalosporine that shows efficacy against various gram-negative bacteria, for the treatment of complicated urinary tract infections.

Pharmacokinetic characteristics of cefiderocol in patients are not fully understood. New research from French investigators that was slated to be presented at the 2020 European Congress on Clinical Microbiology and Infectious Diseases (ECCMID) was conducted in order to explore the pharmacokinetics of cefiderocol after multiple administrations in patients hospitalized in intensive care unit.

ECCMID’s in-person and virtual components were cancelled due to coronavirus disease 2019 (COVID-19), but the congress organizers have released a book of abstracts which were accepted for the conference.

The study included patients treated with 3-hour intravenous infusions of cefiderocol in the intensive care unit. There were 9 blood samples drawn from each patient over the course of the infusion.

Cefiderocol plasma concentration was determined by an ultra-performance liquid chromatography system coupled with mass tandem spectrometry, developed and validated in the team’s laboratory.

A total of 7 patients were included in the study. They were treated for Pseudomonas aeruginosa, Achromobacter xylosidans, Klebsiella pneumoniae, or Acinetobacter baumannii infection only susceptible to cefiderocol.

Ventilator associated pneumonia was the site of infection in 6 of 7 patients. The median age of patients was 53 years old out of a range from 23-73.

The gender distribution was 4 women and 3 men.

“Our results suggest that there is significant inter-individual pharmacokinetic variability in this patient population; this argue to consider cefiderocol a candidate for therapeutic drug monitoring,” abstract authors wrote.

This is the first prospective pharmacokinetic study of cefiderocol in intensive care unit patients.

The abstract, “Pharmacokinetics study of cefiderocol in intensive care unit patients,” was released May 5, 2020, as part of the ECCMID Abstract Book 2020.