2024 · Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · paywalled
Prevalence and predictors of residual antibiotics in children's blood in community settings in Tanzania
Lotto et al.
The finding, in our words
A community survey of 1699 Tanzanian children using dried blood spots found 17.4% had residual antibiotics, with half of those exposed having no reported use, showing microsampling can reveal hidden antibiotic exposure for stewardship programmes.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
A systematic review found mixed economic evidence for microsampling in therapeutic drug monitoring; one study reported no cost reduction with DBS home-sampling, €688 versus €676, whilst another predicted savings up to 61%. The authors caution that more work is required to assess costs alongside clinical outcomes and optimise logistics for decentralised implementation.
The authors validated a UPLC-PDA assay for ceftazidime in 10 microlitre dried blood spots collected with the Capitainer device from neonatal patients, achieving accuracy of 90.1 to 104.8 per cent and precision within 11.7 per cent coefficient of variation across a quantification range of 0.5 to 200 micrograms per millilitre, and confirmed the method worked on clinical neonatal samples. This supports microsampling-based therapeutic drug monitoring of an antimicrobial in a vulnerable population where conventional venous blood draws are difficult.
A validated high-throughput LC-MS/MS assay for piperaquine from dried blood spots achieved 54-72% recovery with <9% relative standard deviation and a quantification limit of 3 ng/mL, enabling detection for 4-8 weeks post-dose. The method showed minimal haematocrit interference and is suitable for therapeutic drug monitoring of antimalarial treatment in resource-limited settings and pediatric populations.
This review summarises liquid chromatography with tandem mass spectrometry assays using dried blood spots and volumetric absorptive microsampling for quantifying antimicrobial drugs in children, highlighting that VAMS reduces haematocrit bias and offers a viable alternative to traditional plasma sampling for therapeutic drug monitoring.
The validated LC-MS/MS method showed similar pharmacokinetic profiles for albendazole and its metabolites across plasma, whole blood, dried blood spots and Mitra microsamples from hookworm-infected adolescents, supporting microsampling for paediatric pharmacokinetic studies. Mitra extraction proved more robust than dried blood spots during validation and is recommended for future albendazole pharmacokinetic work, despite higher albendazole sulfone concentrations observed in both microsampling devices compared with wet matrices.