Evidence map›Paper›PMID 41609506›Full record

Observational studyThe Journal of antimicrobial chemotherapy2026

Exploring the opportunity for therapeutic drug monitoring (TDM) and precision dose antimicrobials in an outpatient antimicrobial therapy (OPAT) service: a prospective observational study.

R C Wilson, M J Gilchrist, R Cele, S d'Arc, E A Mills, C Ndhlovu, B Balancio, P Arkell, L Read, M Bayliss and 4 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The Journal of antimicrobial chemotherapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

R C WilsonCentre for Antimicrobial Optimisation, Imperial College London, London, UK.ORCID 0000-0002-3275-6932
M J GilchristCentre for Antimicrobial Optimisation, Imperial College London, London, UK.ORCID 0009-0003-0625-3535
R CeleOPAT Service, Imperial College Healthcare NHS Trust, London, UK.
S d'ArcDepartment of Infectious Disease, Imperial College London, Charing Cross Hospital Campus, London, UK.
E A MillsDepartment of Infectious Disease, Imperial College London, Charing Cross Hospital Campus, London, UK.
C NdhlovuOPAT Service, Imperial College Healthcare NHS Trust, London, UK.
B BalancioOPAT Service, Imperial College Healthcare NHS Trust, London, UK.
P ArkellCentre for Antimicrobial Optimisation, Imperial College London, London, UK.
L ReadAntimicrobial Reference Laboratory, Infection Sciences, North Bristol NHS Trust, Bristol, UK.
M BaylissAntimicrobial Reference Laboratory, Infection Sciences, North Bristol NHS Trust, Bristol, UK.
A R NoelAntimicrobial Reference Laboratory, Infection Sciences, North Bristol NHS Trust, Bristol, UK.
A P MacGowanAntimicrobial Reference Laboratory, Infection Sciences, North Bristol NHS Trust, Bristol, UK.
A H HolmesCentre for Antimicrobial Optimisation, Imperial College London, London, UK.
T M RawsonCentre for Antimicrobial Optimisation, Imperial College London, London, UK.

Funding

Imperial College Healthcare NIHR200646
6 · The paper itself

Abstract

objectivesNotwithstanding the wide uptake of outpatient antimicrobial therapy (OPAT) in the UK, there is a paucity of data on antimicrobial exposure. We aimed to assess antimicrobial pharmacokinetic-pharmacodynamics (PK-PD) for several agents in our service with a view to understanding a potential role for therapeutic drug monitoring (TDM) and precision antimicrobial therapy in this setting.

methodsThe study was a prospective, observational, pilot PK-PD study. Adult patients receiving intravenous ceftazidime, ceftriaxone, daptomycin, ertapenem, flucloxacillin or teicoplanin, or oral treatment with linezolid were enrolled. Peak and trough blood samples were obtained. Total and unbound antibacterial concentrations were measured. Clinical details, laboratory findings and UK OPAT good practice recommendation metrics were extracted from the medical record. PK-PD was interpreted according to EUCAST rationale documents and other published guidance. Doses were not adjusted except for linezolid and teicoplanin.

resultsIn total, 39 patients were recruited to the study, predominantly on ceftriaxone (21/39, 54%) or ertapenem (6/39, 15%). Four patients received (10%) teicoplanin, three (8%) ceftazidime, three (8%) flucloxacillin, one (3%) linezolid and one (3%) daptomycin. The most common reason for OPAT was bacteraemia and endocarditis (6/39; 15% each). PK-PD target attainment was acceptable for all drugs and dose regimens, and all β-lactam-based treatments met conservative PK-PD targets.

conclusionsWe have demonstrated that drug monitoring is practicable in the OPAT setting of a large institution with no on-site analytical capability. Current dosage regimens result in acceptable PK-PD target attainment. Our findings provide an initial step towards supporting TDM in OPAT.

Indexed as

Ambulatory CareAnti-Bacterial AgentsDrug MonitoringAdultAgedAged, 80 and overBacterial InfectionsFemaleHumansMaleMiddle AgedOutpatientsPilot ProjectsProspective StudiesUnited KingdomYoung AdultAnti-Bacterial Agents

Identifiers

PMID41609506
PMCPMC12853871

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.