Therapeutic Drug Monitoring in Tuberculosis Treatment

Therapeutic drug monitoring (TDM) is individualising drug dosage by maintaining plasma or blood drug concentrations within a targeted therapeutic range or window. By combining knowledge of pharmaceutics, pharmacokinetics (PK) and pharmacodynamics (PD), TDM enables the assessment of the efficacy and safety of a particular medication in a variety of clinical settings. The goal of TDM is to individualise therapeutic regimens for optimal patient benefit. The PK/PD indices are crucial for understanding the efficacy of anti-TB drugs against M. tuberculosis and their toxicity in patients. While the blood level monitoring of anti-TB drugs is not routinely done and has limitations, this strategy may have benefits in individuals with pharmacokinetics variability, high risk of toxicities, drug-drug interactions and others.  The present lecture will discuss the basic concepts of TDM and its application in anti-TB treatment.