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Visualization of Bacterial Resistance using Fluorescent Antibiotic Probes
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Published on: March 2, 2020

Advances in antibiotic measurement.

Amitava Dasgupta1

  • 1Department of Pathology and Laboratory Medicine, University of Texas, Houston Medical School, Houston, USA. amitava.dasgupta@uth.tmc.edu

Advances in Clinical Chemistry
|March 9, 2012
PubMed
Summary

Therapeutic drug monitoring (TDM) is crucial for certain antibiotics like aminoglycosides and vancomycin. While not routinely monitored, other antibiotics may benefit from TDM in patients with kidney issues.

Area of Science:

  • Pharmacology
  • Clinical Pharmacy
  • Drug Monitoring

Background:

  • Antibiotics are frequently prescribed, but only specific classes typically require therapeutic drug monitoring (TDM).
  • Aminoglycosides and vancomycin are commonly monitored, alongside chloramphenicol and antituberculosis agents.
  • Penicillins, cephalosporins, sulfonamides, quinolones, and macrolides generally have wide therapeutic indices and do not need routine TDM.

Purpose of the Study:

  • To outline the necessity and application of therapeutic drug monitoring for various antibiotic classes.
  • To highlight antibiotics that require routine monitoring versus those that may benefit in specific patient populations.
  • To discuss the availability of diagnostic methods for antibiotic TDM.

Main Methods:

  • Review of current clinical practices and guidelines for antibiotic TDM.

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  • Analysis of pharmacokinetic properties influencing the need for TDM across different antibiotic classes.
  • Assessment of commercially available and in-house developed assays for antibiotic drug levels.
  • Main Results:

    • Routine TDM is essential for aminoglycosides and vancomycin.
    • Chloramphenicol and antituberculosis drugs may also necessitate TDM.
    • Antibiotics with wide therapeutic indices (penicillins, macrolides, etc.) generally do not require routine TDM, but monitoring may be useful in renal impairment.
    • Immunoassays are widely available for aminoglycosides and vancomycin.
    • Tests for other antibiotics are less common and often rely on in-house methods.

    Conclusions:

    • TDM is critical for specific antibiotics to ensure efficacy and minimize toxicity.
    • The need for TDM varies significantly based on the antibiotic class and patient's clinical status, particularly renal function.
    • Diagnostic test availability influences the practical application of TDM for less commonly monitored antibiotics.