Therapeutic drug monitoring (TDM) of β-lactam/β-lactamase inhibitor (BL/BLI) drug combinations: insights from a pharmacometric simulation study
2024

Therapeutic Drug Monitoring of β-lactam/β-lactamase Inhibitor Combinations

publication Evidence: moderate

Author Information

Author(s): O’Jeanson Amaury, Nielsen Elisabet I, Friberg Lena E

Primary Institution: Uppsala University

Hypothesis

Can therapeutic drug monitoring (TDM) of β-lactamase inhibitors (BLIs) improve their effectiveness at infection sites?

Conclusion

The study suggests that relying solely on TDM of β-lactams may lead to suboptimal BLI concentrations, indicating the need for dose adjustments based on BLI levels.

Supporting Evidence

  • Therapeutic drug monitoring (TDM) is increasingly recommended for optimizing β-lactam exposure.
  • Low probability of target attainment (PTA) was observed for certain β-lactamase inhibitors.
  • Adjustments based on BLI concentrations could improve treatment outcomes.

Takeaway

This study looks at how well certain antibiotics work when combined with inhibitors and suggests that we might need to check the levels of these inhibitors to make sure they are effective.

Methodology

Population pharmacokinetic models were used to simulate drug concentrations at infection sites based on approved dosing regimens.

Potential Biases

Potential biases may arise from using separate pharmacokinetic models for BLs and BLIs without accounting for correlations between them.

Limitations

The study's findings may not fully reflect real-world patient variability and the models used were based on pooled data from controlled settings.

Digital Object Identifier (DOI)

10.1093/jac/dkae375

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