Related Experiment Video
Updated: Aug 2, 2025
11:17
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
13.0K
Why is the Implementation of Beta-Lactam Therapeutic Drug Monitoring for the Critically Ill Falling Short? A
Erin F Barreto1, Pooja N Chitre2, Kathleen H Pine3
1Department of Pharmacy, Mayo Clinic, Rochester, Minnesota.
Therapeutic Drug Monitoring
|April 19, 2023
Summary
Beta-lactam therapeutic drug monitoring (BL TDM) improves critically ill patient outcomes but has low hospital adoption. Successful implementation requires focusing on individual internalization of BL TDM and organizational support.
Area of Science:
- Pharmacology and Clinical Pharmacy
- Implementation Science
- Critical Care Medicine
Background:
- Beta-lactam therapeutic drug monitoring (BL TDM) can enhance outcomes for critically ill patients.
- Despite benefits, BL TDM is implemented in only 10%-20% of hospitals.
- Understanding provider perceptions is crucial for successful BL TDM implementation.
Purpose of the Study:
- To characterize provider perceptions of BL TDM.
- To identify key considerations for implementing BL TDM in clinical practice.
- To explore barriers and facilitators to BL TDM adoption.
Main Methods:
- A sequential mixed-methods study was conducted from 2020 to 2021.
- Surveys and semistructured interviews were administered to diverse stakeholders at three academic medical centers.
- Implementation science frameworks were used to contextualize findings.
Main Results:
- Most survey respondents found BL TDM relevant, improving medication effectiveness and safety.
- Two key implementation themes emerged: individual internalization and organizational features.
- Individual internalization, influenced by evidence and expertise, was more complex for BL TDM than other antibiotics.
Conclusions:
- Provider enthusiasm for BL TDM is high.
- Implementation barriers extend beyond assay availability, encompassing individual and organizational factors.
- Focusing on individual internalization is key to improving BL TDM adoption.
Related Concept Videos
01:26Urine Studies II: Urine Culture and Sensitivity Test
67
A urine culture and sensitivity test is a diagnostic procedure used to identify urinary tract bacterial infections and determine the most effective antibiotics for treatment. This test is generally preferred when a patient shows manifestations of a urinary tract infection, such as frequent or painful urination, cloudy or foul-smelling urine, or lower abdominal pain.Purpose of the TestThe primary goals of a urine culture and sensitivity test are to:Determine the specific bacteria causing the...
67
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
22
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
22
01:25Errors occurring during blood pressure monitoring
806
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
806
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
151
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
151