TDM for beta-lactams in critical care: You know my name (Look up the number)

Given we traditionally only monitored particular antibiotics to spare toxicity, and that beta lactams were widely considered such safe drugs, it was once difficult to imagine this drug class would become important TDM candidates. A bit more than a decade ago we started to see the first reports about augmented renal clearance in critically ill patients, often in situations in which antibiotic treatment was crucial, such as sepsis. TDM of beta lactams in the critical care is now recognised as a valuable tool to ensure adequate drug exposure and optimise therapeutic outcomes for these vulnerable patients. But the space is full of nuances and unanswered questions remain.

We are joined today by two big names in this space, Professors Birgit Koch and Jason Roberts, who we are fortunate to have help us navigate this complex therapeutic domain.

In this episode we'll hear about:

• TDM for beta-lactams in intensive care is growing, but are we doing it well?

• The long (and winding) road to practice change.

• Exposure targets: our experts' approach and some helpful advice.

• How much of a barrier do compatibility issues pose for continuous infusions?

• Jason's Venn diagram to consider patient outcomes

• Augmented renal clearance - not just in ICU patients: other settings where it ought to be considered.

• Spot the difference: our experts describe their services.

Eight Drugs a Week is supported by the International Association of Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT). The personal views of the hosts and guests do not necessarily reflect the position of the Association.

To join IATDMCT, visit: https://iatdmct.org/join-us/

Subscribe to Eight Drugs a Week on your preferred podcast platform.

About our guests:

Birgit is a Hospital Pharmacist and Clinical Pharmacologist at Erasmus University Medical Centre, in Rotterdam, Netherlands, where she leads the Clinical Pharmacometrics group. She is director of the education program for Clinical Pharmacology residents and director of Research & Teaching in Pharmacy.

Jason is Director of the University of Queensland Centre for Clinical Research and an Australian National Health and Medical Research Council Leadership Fellow at The University of Queensland. He is a Clinical Pharmacist at Royal Brisbane and Women's Hospital, where he leads the Centre of Research Excellence RESPOND.