About
Therapeutic drug monitoring (TDM) allows individualisation of medicine dosages by checking plasma or serum drug concentrations. This helps you adjust the dose to achieve the most appropriate target range and minimise toxicity.
We provide guidelines and advice to Queensland Health clinicians on paediatric TDM and complex antimicrobial medicines including:
- choosing the right starting doses for antimicrobials
- TDM targets
- how to interpret blood levels
- adjusting dosages
- help with patients with complex care needs such as antimicrobial resistant infections or multi organ dysfunction.
Antimicrobial TDM guidelines
Read our guidelines for antimicrobial medicines that commonly require TDM. Guidelines include indications for use, risk factors, appropriate TDM targets, monitoring levels and dosages.
Aminoglycosides
For Amikacin, Gentamicin and Tobramycin read the Intravenous aminoglycoside therapy guideline [PDF 368.53 KB].
If you work for Queensland Health you can also access the AUC calculation tool for Tobramycin and Gentamicin on the intranet. The tool helps you interpret your patient’s exposure to medicine through their blood plasma.
When interpreting plasma drug levels for aminoglycoside medicines you need to record your patient’s:
- age
- weight and height
- serum creatinine
- dosage
- timing of infusion and method of administration
- times of blood samples
- indication for treatment and any relevant comorbidities or risk factors
If you need help using the tool email antibiotics_CHQ@health.qld.gov.au.
Glycopeptides
For Vancomycin read the Paediatric medication guideline – intravenous vancomycin [PDF 343.32 KB].
Antifungals
For Itraconazole, Voriconazole, Posaconazole read Antifungal prophylaxis and treatment in paediatric oncology patients and other immunocompromised children [PDF 795.38 KB].
Other antimicrobial medicines
Contact the paediatric infection specialist or antimicrobial stewardship pharmacist for help interpreting blood levels or targets for the following medicines.
- Teicoplanin
- Linezolid
- Beta lactam antibiotics
- Fluoroquinolones
- Fluconazole
- Flucytosine
- Isavuconazole
- Ganciclovir and Valganciclovir
- Aciclovir
You can also find information about pathology test lists and antimicrobial assays and Adult TDM recommendations (HEIDI institute) on the Queensland Health website.
Referrals and help
Contact us for help or if you need to refer your patient for complex antimicrobial TDM.
- Phone: 0436 815 492
- Email: antibiotics_CHQ@health.qld.gov.au