Id say yes….green pipe on the right, mustache face on the left. It matches up pretty perfectly to me

Unbelievable detective work….

Seems like $ will drive it. If a hospital may already have cefiderocol formulary with broader utility and/or cefta-avi w/ aztreo around it’s a small niche. I like they addressed loading, but regimen throws me in terms of dose vs vial size. Therapeutic need for load in some of those renal strata??

In their defence avibactam is a much better BLI than the 1st gen BLIs.

Lower ratios required for inhibition, less likely to encounter Rx failure through Beta lactamase hyperproduction.

We’ve done an episode on it, link to the show notes here for the interested:
idiots.notion.site/44-Beta-Lact...

And importantly, they gave NO IV LEAD IN to most patients in the oral arm. Started oral on day 1. Further busting the myth that some magical amount of IV lead in is necessary.

Not in the clinic setting, but I know of Tobra IM on some occasions for UTI in ED. With the similar PK and PD, same dosing and same concentration, seemingly shouldn’t pose major issues to sub out was how i’ve thought about it!

ID rule of thumb is to prophylax against PJP when high-dose steroids are used (i.e. 20mg or more of prednisone daily) for 4 or more weeks. Prophylactic regimens and other indications for prophylaxis are reviewed nicely in the linked JAMA article.

www.doi.org/10.1001/jama...