４．感染症治療薬の TDM 対象の拡大は必要か

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Recently, clinical application of the pharmacokinetic (PK)-pharmacodynamic (PD) theory has progressed, and therapeutic drug monitoring (TDM) is performed actively. However, conventional TDM is insufficient in cases of serious infections, and expansion of TDM may be required. It is difficult to predict the development of toxicity of linezolid by monitoring blood drug level. The variations in blood level of beta-lactam antimicrobial agents and fluconazole are predictable based on the renal function of patients. As for the liposomal amphotericin B, blood drug level is not reliable as a marker of efficacy because of the gap between blood level and target tissue concentration. The blood level of itraconazole fluctuates due to various factors, necessitating careful monitoring. In conclusion, daily TDM is not necessary for most drugs, but is necessary for planning appropriate regimen of itraconazole. ( <I>Jpn J Clin Pharmacol Ther</I> 2012; 43(4): 229-234)
一般社団法人日本臨床薬理学会の論文