2018 · Journal for specialists in pediatric nursing : JSPN · paywalled
Therapeutic antibiotic serum concentrations by two blood collection methods within the pediatric patient: A comparative effectiveness trial
Lichliter et al.
The finding, in our words
The study found substantial agreement between serum tobramycin and vancomycin concentrations collected from existing peripheral or central venous catheters and those obtained by venipuncture or fingerstick in pediatric patients. This suggests that using a strict flush and waste protocol allows for therapeutic drug monitoring without additional painful needle sticks, thereby improving patient satisfaction.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
This study validated a method requiring only 10 microlitres of serum and found high agreement between fingerstick capillary samples and venous serum for monitoring twelve antibiotics. The results suggest capillary serum sampling is a feasible, minimally invasive alternative that avoids the haematocrit effect associated with whole blood microsampling.
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.
Guardian-collected capillary dried blood spots were feasible for home monitoring of lamotrigine, and for carbamazepine and valproic acid when conversion factors were applied, with only 4 of 190 comparisons risking a conflicting dose decision and negligible risk of patient harm. Levetiracetam DBS showed high variability against plasma and is recommended only for checking nonadherence, not for dose adjustment.
The True Dose TD-EPI kit demonstrated strong analytical agreement with venous blood for epirubicin monitoring, and the capillary samples remained stable for 72 hours at ambient temperature.
Fingerstick capillary sampling showed strong agreement with venous sampling for mycophenolic acid, tacrolimus and cyclosporine A, with acceptable bias and improved agreement for mycophenolic acid after haematocrit correction. This minimally invasive approach may reduce procedural burden and support outpatient or home based therapeutic drug monitoring in children.