![]() ![]() However, there are some major drawbacks to TDM. In 2015, a survey of centres around the world found only 6–7% were tracking beta-lactam levels, but a more recent study put the figure at 40% . However, increasingly intensive care units are also tracking concentrations of beta-lactam antibiotics, such as penicillins and cephalosporins. Therapeutic drug monitoring (TDM) already does this to a certain extent and there is a growing global trend of using TDM in critically ill patients to track levels of drugs, such as vancomycin and aminoglycosides, where there is a narrow therapeutic window. Teams around the world are working on the best way to deliver this ‘precision dosing’ to achieve the perfect therapeutic concentrations. ![]() Yet there is plenty of evidence to suggest a more personalised approach would increase efficacy, reduce toxicity and help tackle antimicrobial resistance (AMR) . They may be a bit more careful about when they deploy antibiotics, selecting for the right ones and trying to avoid overuse but, essentially, they prescribe a one-size-fits-all dose and hope for the best. The way in which prescribers approach the use of antibiotics has changed very little in the past few decades. Journal of Pharmaceutical Health Services Research.International Journal of Pharmacy Practice.Antimicrobial resistance and stewardship.
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