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Shipkova M, Jamoussi H. Therapeutic Drug Monitoring of Antibiotic Drugs: The Role of the Clinical Laboratory. Ther Drug Monit. 2022;44(1):32-49doi: 10.1097/FTD.0000000000000934.
Shipkova, M., & Jamoussi, H. (2022). Therapeutic Drug Monitoring of Antibiotic Drugs: The Role of the Clinical Laboratory. Therapeutic drug monitoring, 44(1), 32-49. https://doi.org/10.1097/FTD.0000000000000934
Shipkova, Maria, and Jamoussi, Hedi. "Therapeutic Drug Monitoring of Antibiotic Drugs: The Role of the Clinical Laboratory." Therapeutic drug monitoring vol. 44,1 (2022): 32-49. doi: https://doi.org/10.1097/FTD.0000000000000934
Shipkova M, Jamoussi H. Therapeutic Drug Monitoring of Antibiotic Drugs: The Role of the Clinical Laboratory. Ther Drug Monit. 2022 Feb 01;44(1):32-49. doi: 10.1097/FTD.0000000000000934. PMID: 34726200.
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Ther Drug Monit. 2022 Feb 01;44(1):32-49. doi: 10.1097/FTD.0000000000000934.

Therapeutic Drug Monitoring of Antibiotic Drugs: The Role of the Clinical Laboratory.

Therapeutic drug monitoring

Maria Shipkova, Hedi Jamoussi

Affiliations

  1. Competence Center for Therapeutic Drug Monitoring, SYNLAB Holding Germany GmbH, SYNLAB MVZ Leinfelden-Echterdingen GmbH, Leinfelden-Echterdingen, Germany.

PMID: 34726200 DOI: 10.1097/FTD.0000000000000934

Abstract

BACKGROUND: Therapeutic drug monitoring (TDM) of anti-infective drugs is an increasingly complex field, given that in addition to the patient and drug as 2 usual determinants, its success is driven by the pathogen. Pharmacodynamics is related both to the patient (toxicity) and bacterium (efficacy or antibiotic susceptibility). The specifics of TDM of antimicrobial drugs stress the need for multidisciplinary knowledge and expertise, as in any other field. The role and the responsibility of the laboratory in this interplay are both central and multifaceted. This narrative review highlights the role of the clinical laboratory in the TDM process.

METHODS: A literature search was conducted in PubMed and Google Scholar, focusing on the past 5 years (studies published since 2016) to limit redundancy with previously published review articles. Furthermore, the references cited in identified publications of interest were screened for additional relevant studies and articles.

RESULTS: The authors addressed microbiological methods to determine antibiotic susceptibility, immunochemical and chromatographic methods to measure drug concentrations (primarily in blood samples), and endogenous clinical laboratory biomarkers to monitor treatment efficacy and toxicity. The advantages and disadvantages of these methods are critically discussed, along with existing gaps and future perspectives on strategies to provide clinicians with as reliable and useful results as possible.

CONCLUSIONS: Although interest in the field has been the driver for certain progress in analytical technology and quality in recent years, laboratory professionals and commercial providers persistently encounter numerous unresolved challenges. The main tasks that need tackling include broadly and continuously available, easily operated, and cost-effective tests that offer short turnaround times, combined with reliable and easy-to-interpret results. Various fields of research are currently addressing these features.

Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

Conflict of interest statement

The authors declare no conflict of interest.

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