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Comment
. 2019 Mar 5;68(6):1065-1066.
doi: 10.1093/cid/ciy787.

Therapeutic Drug Monitoring: The Need for Practical Guidance

Jan-Willem C Alffenaar  1 , Scott K Heysell  2 , Stellah G Mpagama  3
Affiliations
Comment

Therapeutic Drug Monitoring: The Need for Practical Guidance

Jan-Willem C Alffenaar et al. Clin Infect Dis. .
No abstract available

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Figures

Figure 1.
Figure 1.
Levels of programmatic therapeutic drug monitoring (TDM). Screening for low drug exposure using semiquantative assays can be done at the bedside of the patient in the local healthcare facility. Patients with low drug exposure will qualify for a dose increase and TDM of the key drugs by measuring the concentrations in plasma/serum/dried blood spot. These more advanced analytical assays should be made available at a regional level. In addition, some patients may qualify immediately for TDM based on risk factors [9]. For patients with specific needs, TDM for other drugs should be made available at a central level. To reduce sample shipment costs, dried blood spot is the preferred sample material unless the drug has proven to be stable at high temperatures for a prolonged time. *Key drugs include: isoniazid, rifampicin for drug susceptible tuberculosis and levofloxacin/moxifloxacin, linezolid for multidrug resistant tuberculosis.
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References

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