Anest. intenziv. Med. 2025;36(2):84-90 | DOI: 10.36290/aim.2025.015

Therapeutic drug monitoring - a path to more effective antibiotic therapyReview Article

Juhás V.^{1, 4}, Šudáková A.^{2, 4}, Harazim M.^{3, 4}

¹ Úsek klinické farmacie, Nemocniční lékárna Fakultní nemocnice Brno

² Oddělení klinické biochemie Fakultní nemocnice Brno

³ Interní gastroenterologická klinika Fakultní nemocnice Brno

⁴ Lékařská fakulta Masarykovy univerzity Brno

Therapeutic drug monitoring (TDM) is a key tool in optimizing antibiotic therapy in critically ill patients. The variability of pharmacokinetics and pharmacodynamics (PK/PD) in this population often requires an individualized approach that goes beyond standard dosing schedules. Early implementation of TDM, especially during the first 48 hours of treatment, is essential to achieve target therapeutic antibiotic concentrations. The correct administration strategy, using prolonged or continuous infusions of the administered antibiotics, plays a significant role in achieving optimal PK/PD parameters. At our institution, we have observed a high variability in the concentrations achieved for β-lactam antibiotics over the years, which supports the wider implementation of TDM in routine clinical practice.

Keywords: therapeutic drug monitoring (TDM), antibiotic therapy, piperacillin/tazobactam, meropenem, cefepime, linezolid.

Received: February 10, 2025; Revised: April 7, 2025; Accepted: April 10, 2025; Published: June 27, 2025  Show citation