ID Consultant: Laboratory monitoring during long-term use of oral antimicrobials in pediatric patients.

Oral antimicrobials remain the mainstay of long-term treatment for many infections. Meanwhile, the use of oral agents is becoming commonplace for treatment of several pediatric infections once managed exclusively with parenteral therapies. Unfortunately, antimicrobials are associated with several laboratory toxicities, particularly when high doses or combination therapies are used, but there is a paucity of data on optimal laboratory monitoring strategies. In this ID Consultant piece, we offer a summary of the three most common lab-based toxicities seen with long-term use of oral antimicrobials - drug-induced kidney injury, liver injury, and hematological toxicities - and we provide our recommended approach to monitoring.