Application of therapeutic drug monitoring to the treatment of bacterial central nervous system infection: a scoping review.
Paul ArkellRichard C WilsonKillian WatkinsDavid B AntcliffeMark GilchristMark WilsonTimothy M RawsonAlison HolmesPublished in: The Journal of antimicrobial chemotherapy (2022)
Despite increasing observational data showing low CNS penetration of various antibiotics, there are few clinical studies describing practical implementation of TDM in management of CNS infection. Lack of consensus around clinically relevant CSF PK-PD targets and protocols for dose-adjustment may contribute. Standardised investigation of TDM as a tool to improve treatment is required, especially as innovative drug concentration-sensing and PK-PD modelling technologies are emerging. Data generated at different centres offering TDM should be open access and aggregated to enrich understanding and optimize application.