{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T10:56:37Z","timestamp":1776423397842,"version":"3.51.2"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cefepime is a key carbapenem-sparing agent due to its stability against AmpC \u03b2-lactamases. However, high plasma concentrations are associated with cefepime-induced neurotoxicity (CIN). Following 2019 EUCAST reclassification of \u2018intermediate\u2019 as \u2018susceptible, increased exposure\u2019, higher doses (6\u2005g\/day) are often recommended. Pharmacokinetic\/pharmacodynamic (PK\/PD) simulations suggest that a reduced daily dose of cefepime 4\u2005g\/day administered by continuous infusion may achieve adequate target attainment while limiting toxicity, but real-world clinical data are scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective, single-centre observational study including adult inpatients treated with cefepime administered as a 2\u2005g loading dose followed by continuous infusion of 4\u2005g\/day. Therapeutic drug monitoring was performed to assess steady-state free cefepime concentrations (\u0192Css). The primary endpoint was pharmacodynamic target attainment (100% \u0192T\u200a&amp;gt;\u200aMIC) for EUCAST \u2018susceptible, increased exposure\u2019 breakpoints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 46 included patients, median \u0192Css was 26.2\u2005mg\/L (IQR 18.4\u201333.2). Pharmacodynamic targets were achieved in 96% of patients for Enterobacterales (MIC 4\u2005mg\/L) and 93% for Pseudomonas aeruginosa (MIC 8\u2005mg\/L). Clinical efficacy was observed in 96% of cases. Signs consistent with CIN occurred in three patients (6.5%), mainly in the context of renal function deterioration or pre-existing neurological vulnerability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A reduced-dose cefepime regimen consisting of 4\u2005g\/day administered by continuous infusion achieves high pharmacodynamic target attainment with a favourable efficacy\u2013toxicity balance in real-life clinical practice. This strategy represents a promising alternative to higher-dose regimens and supports individualized dosing guided by renal function and therapeutic drug monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkag138","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T11:22:12Z","timestamp":1776079332000},"source":"Crossref","is-referenced-by-count":0,"title":["Real-world validation of a reduced-dose continuous infusion cefepime regimen: pharmacodynamic target attainment, efficacy and neurotoxicity"],"prefix":"10.1093","volume":"81","author":[{"given":"Kieffer","family":"Korvin","sequence":"first","affiliation":[{"name":"Department of Infectious and Tropical Diseases, Nimes University Hospital , Nimes ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1853-2932","authenticated-orcid":false,"given":"Sylvain","family":"Goutelle","sequence":"additional","affiliation":[{"name":"CHU de Lyon, Service de Pharmacie, Groupement Hospitalier Nord, H\u00f4pital Pierre Garraud , 136 rue du Commandant Charcot, Lyon cedex 05 69322 ,","place":["France"]},{"name":"Laboratoire de Biom\u00e9trie et Biologie \u00c9volutive, Universit\u00e9 Claude Bernard Lyon 1, UMR CNRS 5558, University of Lyon, B\u00e2t. Gr\u00e9gor Mendel , 43 bd du 11 Novembre 1918, Villeurbanne Cedex 69622 ,","place":["France"]},{"name":"ISPB\u2014Facult\u00e9 de Pharmacie de Lyon, Universit\u00e9 Claude Bernard Lyon 1, University of Lyon , 8 Avenue Rockefeller, Lyon 69003 ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Laffont-Lozes","sequence":"additional","affiliation":[{"name":"Department of Infectious and Tropical Diseases, Nimes University Hospital , Nimes ,","place":["France"]},{"name":"Department of Pharmacy, Nimes University Hospital , Nimes ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fanny","family":"Villa","sequence":"additional","affiliation":[{"name":"Department of Infectious and Tropical Diseases, Nimes University Hospital , Nimes ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aur\u00e9lie","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of 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