The stereoselectivity of the reaction of imines of benzaldehyde and cinnamaldehyde with ketenes generated by the reaction of optically active oxazolidinone acid chlorides with triethylamine and complexed ketenes generated by photolysis of optically active oxazolidine-and oxamlidinonechromium-carbene complexes in the presence and absence of added triethylamine was compared. The absolute stereochemistry was determined primarily by the structure of the chiral auxiliary. The relative (cis-trans) stereochemistry was determined primarily by the structure of the imine and the free or bound character of the ketene. Triethylamine addition to reactions of carbene complexes afforded results that closely paralleled that of acid chloride generated ketenes. A mechanistic scheme accounting for these results and the general trends observed in other ketenelimine cyclizations is provided.

The objectives of this study were to characterize the concentration‐time profiles of total radioactivity equivalent and unchanged cefiderocol, the route(s) of elimination and mass balance, and safety of cefiderocol after intravenous administration of a single 1000‐mg (100 μCi) dose of [ 14 C]‐cefiderocol as a 1‐hour infusion in healthy adult male subjects. Unchanged cefiderocol accounted for the majority of total radioactivity in plasma, and the partitioning of total radioactivity into red blood cells was negligible. The recovery of total radioactivity was complete in all subjects within 120 hours after initiation of the infusion (101.5% of the administered dose). Cefiderocol‐related material was primarily excreted into urine, with 98.7% of the administered dose of [ 14 C]‐cefiderocol excreted as total radioactivity into urine and negligible excretion into feces. Based on the results of metabolite profiling, cefiderocol accounted for 92.3% of area under the concentration‐time curve of total radioactivity in plasma and accounted for 90.6% of the administered dose excreted into urine. Metabolism was a minor route of elimination for cefiderocol. Cefiderocol was generally safe and well tolerated in healthy adult male subjects. In conclusion, unchanged cefiderocol represents the majority of total radioactivity in plasma. Cefiderocol is primarily excreted as unchanged drug into urine. This study indicates that cefiderocol and drug‐related material did not remain in the body.

Purpose: Cefiderocol is a novel siderophore cephalosporin with potent activity against gramnegative bacteria, including multidrug-resistant strains. This Phase I study was conducted to assess the tolerability of single-ascending doses of cefiderocol (part 1) and the effect of cefiderocol on cardiac repolarization, assessed using the electrocardiographic corrected QT interval (QTcF) and other ECG parameters (part 2), in healthy adult subjects. Methods: Part 1 was a randomized, double-blind, placebo-controlled, single-ascending dose study in healthy adult male and female subjects. Part 2 was a 4-period crossover study in which subjects received a single 2-g dose of cefiderocol (therapeutic dose), a single 4-g dose of cefiderocol (supratherapeutic dose), or saline (placebo), each infused over 3 hours, and a single oral 400-mg dose of moxifloxacin. In each treatment period, continuous cardiac monitoring was used to assess the effects of cefiderocol on ECG parameters. The QT interval corrected using the Fridericia formula (QTcF) was the primary ECG parameter; the time-matched placebo-and baselineadjusted (dd)-QTcF interval was the primary end point. The plasma pharmacokinetic properties of cefiderocol were calculated on the basis of concentrationetime profiles in all evaluable subjects. Findings: All point estimates for the ddQTcF interval were <5 ms and the upper bound of the 90% CIs were <10 ms at each timepoint after the initiation of the cefiderocol 3-hour infusion. Concentration-effect modeling showed a slightly negative slope and predicted modestly negative values of the ddQTcF interval at the C max of cefiderocol. Both doses of cefiderocol were well tolerated. All adverse events were mild in severity, with no deaths or serious adverse events reported. Implications: Overall, therapeutic and supratherapeutic doses of cefiderocol had no apparent clinically significant effect on the QTcF.

Cefiderocol has no clinically significant DDI potential via drug transporters.

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