Antimicrobial Pharmacokinetic and Pharmacodynamic Considerations in Special Populations: A Call to Action

Pharmacokinetic (PK) and pharmacodynamic (PD) variability in special populations can impact antimicrobial efficacy and safety. This review highlights the importance of PK/PD optimization in patients known to have altered PK, including those with obesity, cystic fibrosis, renal dysfunction, critical illness, transplantation, pregnancy, and/or significant burns. Historically, PK/PD data are underrepresented in these populations, leading to suboptimal dosing recommendations and increased risks of therapeutic failure or toxicity. Herein, we discuss key physiological alterations affecting antimicrobial PK/PD, regulatory challenges, and currently available solutions. To bridge these knowledge gaps, we advocate for broader patient inclusion in clinical trials, improved PK modeling, real-world data collection, and increased investment in precision dosing strategies. Addressing these issues has the potential to enhance patient outcomes, reduce antimicrobial resistance, and improve infectious diseases management. This review serves as a call to action for researchers, clinicians, and policymakers to prioritize PK/PD research in special patient populations.