scholarly journals Role of therapeutic drug monitoring in pulmonary infections: use and potential for expanded use of dried blood spot samples

Bioanalysis ◽  
2015 ◽  
Vol 7 (4) ◽  
pp. 481-495 ◽  
Author(s):  
Susan Hofman ◽  
Mathieu S Bolhuis ◽  
Remco A Koster ◽  
Onno W Akkerman ◽  
Sander van Assen ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Dried Blood Spot ◽  
Therapeutic Drug ◽  
Pulmonary Infections ◽  
Blood Spot

scholarly journals Dried Blood Spot Analysis Suitable for Therapeutic Drug Monitoring of Voriconazole, Fluconazole, and Posaconazole

2013 ◽  
Vol 57 (10) ◽  
pp. 4999-5004 ◽  
Author(s):  
Kim C. M. van der Elst ◽  
Lambert F. R. Span ◽  
Kai van Hateren ◽  
Karin M. Vermeulen ◽  
Tjip S. van der Werf ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Sampling Method ◽  
Fungal Infections ◽  
Venous Blood ◽  
Blood Sampling ◽  
Dried Blood Spot ◽  
Therapeutic Drug ◽  
Venous Blood Sampling ◽  
Blood Spot

ABSTRACTInvasive aspergillosis and candidemia are important causes of morbidity and mortality in immunocompromised and critically ill patients. The triazoles voriconazole, fluconazole, and posaconazole are widely used for the treatment and prophylaxis of these fungal infections. Due to the variability of the pharmacokinetics of the triazoles among and within individual patients, therapeutic drug monitoring is important for optimizing the efficacy and safety of antifungal treatment. A dried blood spot (DBS) analysis was developed and was clinically validated for voriconazole, fluconazole, and posaconazole in 28 patients. Furthermore, a questionnaire was administered to evaluate the patients' opinions of the sampling method. The DBS analytical method showed linearity over the concentration range measured for all triazoles. Results for accuracy and precision were within accepted ranges; samples were stable at room temperature for at least 12 days; and different hematocrit values and blood spot volumes had no significant influence. The ratio of the drug concentration in DBS samples to that in plasma was 1.0 for voriconazole and fluconazole and 0.9 for posaconazole. Sixty percent of the patients preferred DBS analysis as a sampling method; 15% preferred venous blood sampling; and 25% had no preferred method. There was significantly less perception of pain with the DBS sampling method (P= 0.021). In conclusion, DBS analysis is a reliable alternative to venous blood sampling and can be used for therapeutic drug monitoring of voriconazole, fluconazole, and posaconazole. Patients were satisfied with DBS sampling and had less pain than with venous sampling. Most patients preferred DBS sampling to venous blood sampling.

Dried Blood Spot Analysis – the next level of therapeutic drug monitoring?

2014 ◽  
Vol 47 (06) ◽  
Author(s):  
M Scherf-Clavel ◽  
M Hohner ◽  
S Unterecker ◽  
P Högger
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Dried Blood Spot ◽  
Therapeutic Drug ◽  
Blood Spot ◽  
Spot Analysis

A Simple Dried Blood Spot Assay for Therapeutic Drug Monitoring of Lamotrigine

2010 ◽  
Vol 71 (11-12) ◽  
pp. 1093-1099 ◽  
Author(s):  
Salah AbuRuz ◽  
Mutasim Al-Ghazawi ◽  
Yousef Al-Hiari
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Dried Blood Spot ◽  
Therapeutic Drug ◽  
Blood Spot

scholarly journals Dried Blood Spot Analysis for Therapeutic Drug Monitoring of Linezolid in Patients with Multidrug-Resistant Tuberculosis

2012 ◽  
Vol 56 (11) ◽  
pp. 5758-5763 ◽  
Author(s):  
D. H. Vu ◽  
M. S. Bolhuis ◽  
R. A. Koster ◽  
B. Greijdanus ◽  
W. C. M. de Lange ◽  
...  
Keyword(s):  
Therapeutic Drug Monitoring ◽  
Drug Monitoring ◽  
Drug Exposure ◽  
Multidrug Resistant ◽  
Dried Blood Spot ◽  
Therapeutic Drug ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb ◽  
Blood Spot

ABSTRACTLinezolid is a promising antimicrobial agent for the treatment of multidrug-resistant tuberculosis (MDR-TB), but its use is limited by toxicity. Therapeutic drug monitoring (TDM) may help to minimize toxicity while adequate drug exposure is maintained. Conventional plasma sampling and monitoring might be hindered in many parts of the world by logistical problems that may be solved by dried blood spot (DBS) sampling. The aim of this study was to develop and validate a novel method for TDM of linezolid in MDR-TB patients using DBS sampling. Plasma, venous DBS, and capillary DBS specimens were obtained simultaneously from eight patients receiving linezolid. A DBS sampling method was developed and clinically validated by comparing DBS with plasma results using Passing-Bablok regression and Bland-Altman analysis. This study showed that DBS analysis was reproducible and robust. Accuracy and between- and within-day precision values from three validations presented as bias and coefficient of variation (CV) were less than 17.2% for the lower limit of quantification and less than 7.8% for other levels. The method showed a high recovery of approximately 95% and a low matrix effect of less than 8.7%. DBS specimens were stable at 37°C for 2 months and at 50°C for 1 week. The ratio of the concentration of linezolid in DBS samples to that in plasma was 1.2 (95% confidence interval [CI], 1.12 to 1.27). Linezolid exposure calculated from concentrations DBS samples and plasma showed good agreement. In conclusion, DBS analysis of linezolid is a promising tool to optimize linezolid treatment in MDR-TB patients. An easy sampling procedure and high sample stability may facilitate TDM, even in underdeveloped countries with limited resources and where conventional plasma sampling is not feasible.

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