TDM

The Clinical Pharmacy Lab of the Radboudumc

Our laboratory is a state of the art clinical laboratory facilitating local, national and international determination of drugs in the field of infectious diseases (HIV, TB, Hepatitis C and fungal infections).

Our laboratory is equiped with the newest techniques for the determination of antifungal drug concentrations. We use both UPLC-MSMS and LC-MSMS as well as UPLC techniques coupled to fluoresence detectors or ultraviolet detectors. Our laboratory is leading a large study into the development and application of dried blood spot analysis using a fully automated robot for pre-sample treatment.

For the purpose of in-vivo and human antifungal pharmacokinetic research we offer the possibility to determine concentrations of antifungal drugs in a wide variety of matrices. Also we run a daily program for the measurement of antifungal drugs for the purpose of therapeutic drug monitoring.  

Analytical assay

Performing PK studies as a reference centre and using TDM in routine practice implies that a validated analytical assay has to be readily available for the real-time determination of plasma or serum concentrations. Our laboratory is currently certifying for ISO. Further to this we participate in an international PT scheme (http://www.kkgt.nl/; certificate available upon request) and have demonstrated to be a solid partner in many national and international studies.

Scope of the TDM and PK Service

The Radboud University Medical Centre is the reference centre for mycology cultures in the Netherlands. To enlarge the scope of activities within the reference centre, we offer the opportunity to determine plasma concentrations of all antifungal drugs. Details with regards to our analytical assay  are available upon request.

The following drugs can be determined on a routine basis:
Azoles:

  • fluconazole
  • isavuconazole
  • itraconazole and metabolite hydroxy-itraconazole
  • posaconazole
  • voriconazole

Echinocandins:

  • anidulafungin
  • caspofungin
  • micafungin

Polyenes:

  • ambisome (both lipid bound as well as free amphotericin B)

Flucytosine

Logistics

For the purpose of TDM:
Upon receipt of the sample, the concentration of the antifungal drugs will be communicated within a timeframe of 24-48 hours and no longer, to either or both the physician and hospital pharmacist / pharmacologist. Communication on the obtained results will include a tailor-made advice from a clinical pharmacist / clinical pharmacologist with extensive experience in antifungal drug management. Recommendations for future follow-up will be included. All communication will be both by telephone and by writing. A formal report of results obtained will be sent to the treating physician. To provide an optimal advice, we will ask you to complete the attached laboratory form with necessary clinical details.

For the purpose of PK studies:
When analysing samples for the purpose of pharmacokinetic research it is best to sent samples batchwise and also perform the analysis batchwise. Results will be presented as official study documents combined with an analytical certificate. When requested we can also assist in the pharmacokinetic analysis using both non-parametric as parametric techniques. Please contact us if you wish to receive more information.

Costs

An overview of costs is of this service is available upon request.

Sample request form

Sample submission form