{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T03:35:52Z","timestamp":1769744152755,"version":"3.49.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000762","name":"Imperial College Healthcare","doi-asserted-by":"publisher","award":["NIHR200646"],"award-info":[{"award-number":["NIHR200646"]}],"id":[{"id":"10.13039\/501100000762","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Notwithstanding 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\u2013pharmacodynamics (PK\u2013PD) 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study was a prospective, observational, pilot PK\u2013PD 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\u2013PD was interpreted according to EUCAST rationale documents and other published guidance. Doses were not adjusted except for linezolid and teicoplanin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 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\u2013PD target attainment was acceptable for all drugs and dose regimens, and all \u03b2-lactam-based treatments met conservative PK\u2013PD targets.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We 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\u2013PD target attainment. Our findings provide an initial step towards supporting TDM in OPAT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkaf484","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:43:07Z","timestamp":1765888987000},"source":"Crossref","is-referenced-by-count":0,"title":["Exploring the opportunity for therapeutic drug monitoring (TDM) and precision dose antimicrobials in an outpatient antimicrobial therapy (OPAT) service: a prospective observational study"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3275-6932","authenticated-orcid":false,"given":"R C","family":"Wilson","sequence":"first","affiliation":[{"name":"Centre for Antimicrobial Optimisation, Imperial College London , London ,","place":["UK"]},{"name":"Pharmacy Department, Imperial College Healthcare NHS Trust , London ,","place":["UK"]},{"name":"National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London , London ,","place":["UK"]},{"name":"David Price Evans Infectious Diseases & Global Health Group, The University of Liverpool , Liverpool ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0625-3535","authenticated-orcid":false,"given":"M J","family":"Gilchrist","sequence":"additional","affiliation":[{"name":"Centre for Antimicrobial Optimisation, Imperial College London , London ,","place":["UK"]},{"name":"Pharmacy Department, Imperial College Healthcare NHS Trust , London ,","place":["UK"]},{"name":"National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London , London ,","place":["UK"]},{"name":"OPAT Service, Imperial College Healthcare NHS Trust , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R","family":"Cele","sequence":"additional","affiliation":[{"name":"OPAT Service, Imperial College Healthcare NHS Trust , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S","family":"d\u2019Arc","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Imperial College London , Charing Cross Hospital Campus, London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E A","family":"Mills","sequence":"additional","affiliation":[{"name":"Department of Infectious Disease, Imperial College London , Charing Cross Hospital Campus, London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C","family":"Ndhlovu","sequence":"additional","affiliation":[{"name":"OPAT Service, Imperial College Healthcare NHS Trust , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B","family":"Balancio","sequence":"additional","affiliation":[{"name":"OPAT Service, Imperial College Healthcare NHS Trust , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Arkell","sequence":"additional","affiliation":[{"name":"Centre for Antimicrobial Optimisation, Imperial College London , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L","family":"Read","sequence":"additional","affiliation":[{"name":"Antimicrobial Reference Laboratory, Infection Sciences, North Bristol NHS Trust , Bristol ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Bayliss","sequence":"additional","affiliation":[{"name":"Antimicrobial Reference Laboratory, Infection Sciences, North Bristol NHS Trust , Bristol ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A R","family":"Noel","sequence":"additional","affiliation":[{"name":"Antimicrobial Reference Laboratory, Infection Sciences, North Bristol NHS Trust , Bristol ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A P","family":"MacGowan","sequence":"additional","affiliation":[{"name":"Antimicrobial Reference Laboratory, Infection Sciences, North Bristol NHS Trust , Bristol ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A H","family":"Holmes","sequence":"additional","affiliation":[{"name":"Centre for Antimicrobial Optimisation, Imperial College London , London ,","place":["UK"]},{"name":"National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London , London ,","place":["UK"]},{"name":"David Price Evans Infectious Diseases & Global Health Group, The University of Liverpool , Liverpool ,","place":["UK"]},{"name":"Fleming Initiative, Fleming Centre, Imperial College London and Imperial College Healthcare NHS Trust , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T M","family":"Rawson","sequence":"additional","affiliation":[{"name":"Centre for Antimicrobial Optimisation, Imperial College London , London ,","place":["UK"]},{"name":"National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London , London ,","place":["UK"]},{"name":"Fleming Initiative, Fleming Centre, Imperial College London and Imperial College Healthcare NHS Trust , London 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