{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T16:33:33Z","timestamp":1789835613173,"version":"4.0.1"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Therapeutic drug monitoring (TDM) may help optimize beta-lactam antibiotic dosing in patients with deep-seated infections. However, its impact on clinical outcomes remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this review was to evaluate the existing evidence on the role of TDM and pharmacokinetic\/pharmacodynamic (PK\/PD)-guided optimization of beta-lactam antibiotic dosing in achieving PK\/PD targets, and improving clinical outcomes in patients with deep-seated infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review of studies reporting on beta-lactam TDM, PK\/PD target attainment, and clinical outcomes in adult (\u226518\u2005years) patients with confirmed deep-seated infections, including complex bacteraemias with a suspected or proven deep-seated source, infective endocarditis, bone and joint infection, and epidural abscess. The search was conducted using MEDLINE (via PubMed), Embase, CINAHL and CENTRAL from inception to June 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve studies were included in the final analysis. Considerable variability was observed in PK\/PD target definitions and attainment, dosing adjustments and outcome reporting. Eleven of the twelve studies were rated as poor quality on the Newcastle-Ottawa Scale due to lack of comparability. Only one study included a non-TDM comparator group and the authors reported no significant difference in clinical outcomes. Three studies showed a trend towards improved clinical outcomes with TDM-guided dosing. TDM frequently led to dose reductions due to concerns of beta-lactam antibiotic toxicity with standard dosing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current evidence supporting beta-lactam antibiotic TDM in deep-seated infections is limited by methodological heterogeneity and poor study quality. Well-designed trials are needed to establish the clinical utility of TDM in this setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkag142","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T11:51:38Z","timestamp":1775130698000},"source":"Crossref","is-referenced-by-count":2,"title":["Therapeutic drug monitoring and the role of pharmacokinetics\/pharmacodynamics in optimizing beta-lactam antibiotic dosing for deep-seated infections: a systematic review"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9726-8382","authenticated-orcid":false,"given":"Cassandra","family":"Vale","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Queensland Centre for Clinical Research (UQCCR), the University of Queensland , Brisbane, Queensland 4029 QLD ,","place":["Australia"]},{"name":"Department of Pharmacy, The Prince Charles Hospital , Brisbane, Queensland 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