[Measurement and data analysis of drug concentrations at the target site--potentials, limitations and fields of...

Drug measurements in the blood are only surrogates for drug concentrations in peripheral tissues, which often represent the target sites of the drug. Due to drug specific and physiological characteristics, however, blood and target site concentrations may differ. For this reason, methods to measure drug concentrations at the target site have been developed during the last years. During the last decade, microdialysis has become the method of choice for the continuous study of unbound tissue concentrations of drugs. In order to fully exploit these measurements to quantify the concentration-time profile of the investigated drug, different tools of data analysis can be applied. The aim is to contribute to decision-making in selecting the optimal dose 1) for dosing schedules during the development program of new drugs and 2) for therapeutic usage for physicians and pharmacists. For these aims, the so called ,,nonlinear mixed effect (NLME) modelling approach" presents the method of choice as it determines the typical concentration-time profile of a drug as well as the variability within the investigated study population. Additionally, between-patient variability can be explained by patient-specific characteristics e.g. weight enabling dose individualisation within the whole investigated population. A systematic literature research in Pubmed for the use of antiinfectives in humans shows that the preferable methods of measuring concentrations at the target site (microdialysis) and data analysis (NLME) have rarely been used simultaneously. Hence, in future the benefit of linking both methods of choice should be further exploited in order to improve knowledge gain, to optimise antiinfective dosing regimens and to increase medication safety.