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Davies Forsman L, Kim HY, Nguyen TA, Alffenaar JWC. Salivary Therapeutic Drug Monitoring of Antimicrobial Therapy: Feasible or Futile? Clin Pharmacokinet 2024; 63:269-278. [PMID: 38300489 PMCID: PMC10954910 DOI: 10.1007/s40262-024-01346-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2024] [Indexed: 02/02/2024]
Abstract
Personalised drug dosing through therapeutic drug monitoring (TDM) is important to maximise efficacy and to minimise toxicity. Hurdles preventing broad implementation of TDM in routine care include the need of sophisticated equipment and highly trained staff, high costs and lack of timely results. Salivary TDM is a non-invasive, patient-friendly alternative to blood sampling, which has the potential to overcome barriers with traditional TDM. A mobile UV spectrophotometer may provide a simple solution for analysing drug concentrations in saliva samples. Salivary TDM utilising point-of-care tests can support personalised dosing in various settings including low-resource as well as remote settings. In this opinion paper, we describe how hurdles of implementing traditional TDM may be mitigated by salivary TDM with new strategies for patient-friendly point-of-care testing.
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Affiliation(s)
- Lina Davies Forsman
- Division of Infectious Diseases, Department of Medicine, Karolinska Institute, Solna, Sweden
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Building A15, Science Road, Sydney, NSW, 2006, Australia
- Westmead Hospital, Sydney, Australia
| | - Hannah Yejin Kim
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Building A15, Science Road, Sydney, NSW, 2006, Australia
- The University of Sydney Infectious Diseases Institute (Sydney ID), Sydney, Australia
- Westmead Hospital, Sydney, Australia
| | - Thi Anh Nguyen
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Building A15, Science Road, Sydney, NSW, 2006, Australia
- The University of Sydney Infectious Diseases Institute (Sydney ID), Sydney, Australia
- Westmead Hospital, Sydney, Australia
| | - Jan-Willem C Alffenaar
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Building A15, Science Road, Sydney, NSW, 2006, Australia.
- The University of Sydney Infectious Diseases Institute (Sydney ID), Sydney, Australia.
- Westmead Hospital, Sydney, Australia.
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Almukainzi M. Saliva Sampling in Therapeutic Drug Monitoring and Physiologically Based Pharmacokinetic Modeling: Review. Drug Res (Stuttg) 2023; 73:65-69. [PMID: 36368679 DOI: 10.1055/a-1956-9313] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Therapeutic drug monitoring investigations based on saliva samples can be utilized as an alternative to blood sampling for many advantages. Moreover, the development of physiologically based pharmacokinetic (PBPK) modeling tools can further help to estimate drug exposure from saliva. This review discusses the use of saliva samples and illustrates the applications and examples of PBPK modeling systems for estimating drug exposure from saliva.
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Affiliation(s)
- May Almukainzi
- Department of Pharmaceutical Sciences, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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