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The page below is a sample from the LabCE course Pharmacology in the Clinical Lab: Therapeutic Drug Monitoring and Pharmacogenomics. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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TDM for Antibiotics

Infection is obviously a very serious indication, and effective antibiotic levels must be achieved as soon as possible. However, many antibiotics also have nephrotoxic or ototoxic effects; thus the concentrations of these antibiotics need to be monitored. Serum concentrations that are too low or too high must be avoided.
Examples of antibiotics that are monitored by TDM include:
  • Amikacin
  • Gentamicin
  • Tobramycin
  • Vancomycin
  • Antifungals (voriconazole, posaconazole, fluconazole, flucytosine)
Antibiotics such as ampicillin that are readily cleared and have a wide therapeutic window are not usually monitored by TDM.