Importance and Reality of TDM for Antibiotics Not Covered by Insurance in Japan

Ebihara, Fumiya; Hamada, Yukihiro; Kato, Hideo; Maruyama, Takumi; Kimura, Toshimi

doi:10.3390/ijerph19052516

Cited by 3 publications

(3 citation statements)

References 81 publications

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“…However, the use of dosages tailored to renal function does not always limit the risk of over- and underexposure to antimicrobial treatments, as revealed by a recent study conducted in older hospitalized patients treated with appropriate doses of levofloxacin [ 108 ]. In this context, implementation of therapeutic drug monitoring (TDM) in an acute care setting when dealing with older patients with CKD may be useful to approach antimicrobial dosage adjustment and prevent antimicrobial adverse effects and toxicity [ 109 ].…”

Section: Clinical Profile Of Older Patients At Risk Of Adverse Events...mentioning

confidence: 99%

Safety and Tolerability of Antimicrobial Agents in the Older Patient

et al. 2023

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Older patients are at high risk of infections, which often present atypically and are associated with high morbidity and mortality. Antimicrobial treatment in older individuals with infectious diseases represents a clinical challenge, causing an increasing burden on worldwide healthcare systems; immunosenescence and the coexistence of multiple comorbidities determine complex polypharmacy regimens with an increase in drug–drug interactions and spread of multidrug-resistance infections. Aging-induced pharmacokinetic and pharmacodynamic changes can additionally increase the risk of inappropriate drug dosing, with underexposure that is associated with antimicrobial resistance and overexposure that may lead to adverse effects and poor adherence because of low tolerability. These issues need to be considered when starting antimicrobial prescriptions. National and international efforts have been made towards the implementation of antimicrobial stewardship (AMS) interventions to help clinicians improve the appropriateness and safety of antimicrobial prescriptions in both acute and long-term care settings. AMS programs were shown to decrease consumption of antimicrobials and to improve safety in hospitalized patients and older nursing home residents. With the abundance of antimicrobial prescriptions and the recent emergence of multidrug resistant pathogens, an in-depth review of antimicrobial prescriptions in geriatric clinical practice is needed. This review will discuss the special considerations for older individuals needing antimicrobials, including risk factors that shape risk profiles in geriatric populations as well as an evidence-based description of antimicrobial-induced adverse events in this patient population. It will highlight agents of concern for this age group and discuss interventions to mitigate the effects of inappropriate antimicrobial prescribing.

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Section: Clinical Profile Of Older Patients At Risk Of Adverse Events...mentioning

confidence: 99%

Safety and Tolerability of Antimicrobial Agents in the Older Patient

et al. 2023

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“…It helps to avoid adverse effects caused by inadequate drug dosage or drug overdose. Drugs that need to be monitored by TDM include antipsychotics [4][5][6], antimicrobials [7,8], and chemotherapeutics [9].…”

Section: Introductionmentioning

confidence: 99%

A Rapid Therapeutic Drug Monitoring Strategy of Carbamazepine in Serum by Using Coffee-Ring Effect Assisted Surface-Enhanced Raman Spectroscopy

Zhu

et al. 2022

Molecules

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Carbamazepine (CBZ) has a narrow therapeutic concentration range, and therapeutic drug monitoring (TDM) is necessary for its safe and effective individualized medication. This study aims to develop a procedure for CBZ detection in serum using coffee-ring effect assisted surface-enhanced Raman spectroscopy (SERS). Silver nanoparticles deposited onto silicon wafers were used as the SERS-active material. Surface treatment optimization of the silicon wafers and the liquid–liquid extraction method were conducted to eliminate the influence of impurities on the silicon wafer surface and the protein matrix. The proposed detection procedure allows for the fast determination of CBZ in artificially spiked serum samples within a concentration range of 2.5–40 μg·mL−1, which matches the range of the drug concentrations in the serum after oral medication. The limit of detection for CBZ was found to be 0.01 μg·mL–1. The developed method allowed CBZ and its metabolites to be ultimately distinguished from real serum samples. The developed method is anticipated to be a potential tool for monitoring other drug concentrations.

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“…Therapeutic drug monitoring (TDM) helps to adjust dosage and achieve an optimal therapeutic effect while avoiding subtherapeutic and toxic drug levels. Drugs that typically warrant TDM include antipsychotics [4][5][6], chemotherapeutics [7], and antimicrobials [8,9].…”

Section: Introductionmentioning

confidence: 99%

A rapid therapeutic drug monitoring method of carbamazepine in serum by using coffee ring effect-based surface-enhanced Raman spectroscopy

Zhu

et al. 2022

Preprint

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Carbamazepine (CBZ) has a narrow therapeutic concentration range, and therapeutic drug monitoring (TDM) is necessary for its safe and effective administration. This study aims to develop a procedure for CBZ detection in plasma using coffee ring effect-based surface-enhanced Raman spectroscopy (SERS). Silver nanoparticles deposited onto silicon wafers were used as the SERS-active material. Surface treatment optimization of the silicon wafers and the liquid–liquid extraction method were conducted to eliminate the influence of impurities on the silicon wafer surface and the protein matrix. The proposed detection procedure allows for the fast determination of CBZ in artificially spiked serum samples within a concentration range of 2.5–40 μg·mL–1, which matches the range of the drug concentrations in the serum after oral medication. The limit of detection for CBZ was found to be 0.01 μg·mL–1. The developed method allowed CBZ and its metabolites to be ultimately distinguished from real serum samples. It is anticipated that the developed method will have great potential for monitoring other drug concentrations.

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Importance and Reality of TDM for Antibiotics Not Covered by Insurance in Japan

Cited by 3 publications

References 81 publications

Safety and Tolerability of Antimicrobial Agents in the Older Patient

Safety and Tolerability of Antimicrobial Agents in the Older Patient

A Rapid Therapeutic Drug Monitoring Strategy of Carbamazepine in Serum by Using Coffee-Ring Effect Assisted Surface-Enhanced Raman Spectroscopy

A rapid therapeutic drug monitoring method of carbamazepine in serum by using coffee ring effect-based surface-enhanced Raman spectroscopy

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