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Applications

Therapeutic drug monitoring aims to improve patient outcomes by driving accurate, tailored drug dosing for each individual. 

We’re optimizing our rapid drug monitoring technology for current and future applications reflecting the greatest clinical need. These applications include the rapid but accurate detection and quantification of antibiotics, oncology drugs, and antifungals. Our technology is also suited to patient adherence monitoring and can assist in accelerating drug development. 

As our technology requires no biomarker development, it is easily adapted to detect and quantify diverse molecules, since the signal is inherent to the molecule itself. The flexibility of our technology for research and development makes it primed to tackle bespoke drug monitoring needs at higher speed and lower cost than other biomarker-based assays.

Antibiotics

Our lead application focuses on the rapid therapeutic drug monitoring of β-lactam antibiotics in the intensive care setting (ICU).

6.9 million ICU patients receive β-lactams globally, but patients frequently receive inadequate drug concentrations for their personalized physiology or needs, hindering patient outcomes while increasing healthcare costs.

The problem

  • 65 – 85% of patients receive incorrect dosage 1, 2
  • 65 – 85% of patients receive incorrect dosage 1, 2
  • 30% dose variability over time within individual 4
  • Increasing antibiotic resistance 5

The benefits of monitoring β-lactams

  • Personalized dosing ensures drug effectiveness and reduces adverse reactions 1, 6, 7
  • 2 – 4 x more patients correctly dosed 6, 7
  • Therapeutic drug monitoring reduces length of ICU stay by 30% 4
  • Reduced healthcare costs and improved antimicrobial stewardship 8, 9, 10

Oncology

The number of cancer patients requiring first-course chemotherapy annually will increase from 9.8 million in 2018 to an estimated 15 million in 2040.11

However, often these cancer treatments suffer from a wide variability in systemic drug concentrations per patient. Chemotherapies are still often dosed based on patient body size or weight, resulting in potential toxicity, adverse events, and suboptimal treatment outcomes due to inappropriate dosages. 12

A shift to a rapid therapeutic drug monitoring approach stands to improve cancer healthcare with personalized, targeted dosing of common chemotherapies, including 5-fluorouracil, kinase inhibitors, and taxanes.

The problem

  • Incidence of cancer increasing, so more effective treatments needed 11
  • Imprecise dosing based on body weight 12
  • Suboptimal patient outcomes 12

The benefits of chemotherapy drug monitoring

  • Improve treatment efficacy and minimize side effects 12
  • Increased compliance with treatment regimes 12
  • Improve patient outcomes and reduce associated costs 12

Antifungals

The number of fungal infections is increasing year on year with serious implications for human health, ranging from allergies to life-threatening invasive fungal diseases. 13

Combined with increased prevalence of antifungal resistance, rapid therapeutic drug monitoring stands to improve antimicrobial stewardship, improve patient outcomes by delivering the right dose at the right time, and, ultimately, reduce the fungal healthcare burden.

The problem

  • 6.5 million invasive fungal infections and 3.8 million deaths annually 13
  • Increased prevalence of antifungal resistance 14
  • Considerable interindividual variability in drug concentrations 15
  • TDM not routine in the clinic or in outpatient setting 15

The benefits of antifungal monitoring

  • Optimal drug concentrations administered 15
  • Increase the probability of positive clinical outcome 16
  • Prevent drug-related toxicity 16
  • Reduce the emergence of antifungal drug resistance 14
Learn more about Axithra’s rapid drug monitoring solutions
  1. Roberts JA, Paul SK, Akova M, Bassetti M, De Waele JJ, Dimopoulos G, Kaukonen KM, Koulenti D, Martin C, Montravers P, Rello J. DALI: defining antibiotic levels in intensive care unit patients: are current β-lactam antibiotic doses sufficient for critically ill patients? Clinical infectious diseases. 2014 Apr 15;58(8):1072-83.
  2. Richter DC, Frey O, Röhr A, Roberts JA, Köberer A, Fuchs T, Papadimas N, Heinzel-Gutenbrunner M, Brenner T, Lichtenstern C, Weigand MA. Therapeutic drug monitoring-guided continuous infusion of piperacillin/tazobactam significantly improves pharmacokinetic target attainment in critically ill patients: a retrospective analysis of four years of clinical experience. Infection. 2019 Dec;47:1001-11.
  3. Wallenburg E, Ter Heine R, de Lange DW, van Leeuwen H, Schouten JA, Ten Oever J, Kolwijck E, Burger DM, Pickkers P, Gieling EM, de Maat MM. High unbound flucloxacillin fraction in critically ill patients. Journal of Antimicrobial Chemotherapy. 2021 Dec 1;76(12):3220-8.
  4. Al-Shaer MH, Rubido E, Cherabuddi K, Venugopalan V, Klinker K, Peloquin C. Early therapeutic monitoring of β-lactams and associated therapy outcomes in critically ill patients. Journal of Antimicrobial Chemotherapy. 2020 Dec;75(12):3644-51.
  5. Chinemerem Nwobodo D, Ugwu MC, Oliseloke Anie C, Al‐Ouqaili MT, Chinedu Ikem J, Victor Chigozie U, Saki M. Antibiotic resistance: The challenges and some emerging strategies for tackling a global menace. Journal of clinical laboratory analysis. 2022 Sep;36(9):e24655.
  6. De Waele JJ, Carrette S, Carlier M, Stove V, Boelens J, Claeys G, Leroux-Roels I, Hoste E, Depuydt P, Decruyenaere J, Verstraete AG. Therapeutic drug monitoring-based dose optimisation of piperacillin and meropenem: a randomised controlled trial. Intensive care medicine. 2014 Mar;40:380-7.
  7. Sime FB, Roberts MS, Tiong IS, Gardner JH, Lehman S, Peake SL, Hahn U, Warner MS, Roberts JA. Can therapeutic drug monitoring optimize exposure to piperacillin in febrile neutropenic patients with haematological malignancies? A randomized controlled trial. Journal of Antimicrobial Chemotherapy. 2015 Aug;70(8):2369-75.
  8. Vincent JL, Sakr Y, Singer M, Martin-Loeches I, Machado FR, Marshall JC, Finfer S, Pelosi P, Brazzi L, Aditianingsih D, Timsit JF. Prevalence and outcomes of infection among patients in intensive care units in 2017. Jama. 2020 Apr 21;323(15):1478-87.
  9. McLaughlin AM, Hardt J, Canavan JB, Donnelly MB. Determining the economic cost of ICU treatment: a prospective “micro-costing” study. Intensive care medicine. 2009 Dec;35:2135-40.
  10. Commission notice – EU Guidelines for the prudent use of antimicrobials in human health (2017/C 212/01) Available from: https://health.ec.europa.eu/publications/commission-notice-eu-guidelines-prudent-use-antimicrobials-human-health_en
  11. Wilson BE, Jacob S, Yap ML, Ferlay J, Bray F, Barton MB. Estimates of global chemotherapy demands and corresponding physician workforce requirements for 2018 and 2040: a population-based study. The Lancet Oncology. 2019 Jun 1;20(6):769-80.
  12. Knezevic CE, Clarke W. Cancer chemotherapy: The case for therapeutic drug monitoring. Therapeutic drug monitoring. 2020 Feb 1;42(1):6-19.
  13. Denning DW. Global incidence and mortality of severe fungal disease. The Lancet Infectious Diseases. 2024 Jan 12.
  14. Fisher MC, Alastruey-Izquierdo A, Berman J, Bicanic T, Bignell EM, Bowyer P, Bromley M, Brüggemann R, Garber G, Cornely OA, Gurr SJ. Tackling the emerging threat of antifungal resistance to human health. Nature reviews microbiology. 2022 Sep;20(9):557-71.
  15. Vena A, Muñoz P, Mateos M, Guinea J, Galar A, Pea F, Alvarez-Uria A, Escribano P, Bouza E. Therapeutic drug monitoring of antifungal drugs: another tool to improve patient outcome? Infectious Diseases and Therapy. 2020 Mar;9:137-49.
  16. Ashbee HR, Barnes RA, Johnson EM, Richardson MD, Gorton R, Hope WW. Therapeutic drug monitoring (TDM) of antifungal agents: guidelines from the British Society for Medical Mycology. Journal of Antimicrobial Chemotherapy. 2014 May 1;69(5):1162-76.

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