Comment on “evaluation of high dose post-dialytic versus daily beta-lactam dosing in hemodialysis patients using Monte Carlo simulation”

This correspondence acknowledges the authors' efforts in addressing an important clinical question and evaluating a practical dosing approach for patients undergoing hemodialysis. We highlight several methodological assumptions within the simulation model that may limit the clinical interpretability of the results, including the extrapolation of PK/PD targets from individuals with normal kidney function, the use of non-standard avibactam thresholds, and the unvalidated implications of prolonged sub-MIC intervals in hemodialysis populations. We further emphasize the need for dedicated PK/PD investigations and supporting clinical outcome data before these dosing strategies can be confidently integrated into practice.