Antimicrobial Therapeutic Drug Monitoring (TDM) Service

Clinical service overview

The Antimicrobial Therapeutic Drug Monitoring (TDM) Service at Alfred Health is a collaborative, multidisciplinary service that provides individualised dosing recommendations for a wide range of antimicrobials, including aminoglycosides, beta-lactam antibiotics, azole antifungal agents, linezolid, and vancomycin.

Our goal is to optimise doses to achieve therapeutic concentrations. We work closely with Pharmacy, Alfred Pathology, and treating teams to tailor treatment dosing based on drug concentrations, patient-specific factors, and the nature of the infection.

TDM is provided at no additional cost to Alfred Pathology partner health services as part of our integrated pathology service. For all other health services, testing will incur a fee.

The Alfred antimicrobial TDM service is for clinically relevant orders. If samples need to be sent for research purposes contact Clinical Biochemistry, Alfred Pathology or Medical Consultants listed below. For contact information and link to pathology handbook, see below.

Dosing

For external sites, results are provided with interpretive comments. Dosing decisions should be made according to each site’s local guidelines and clinical assessment.

Antimicrobial TDM services offered

Antimicrobial	Specimen Type	Container Type	Adult Volume	Paediatric Volume	Transport Instructions	Assay Frequency
Amikacin	Serum, Plasma	SST, Lithium Heparin (with Gel)	N/A	N/A	Room Temperature	Daily
Cefazolin	Blood	Lithium Heparin (without Gel), EDTA 3 mL	2 mL	1 mL	On Ice	Weekdays
Cefepime	Blood	Lithium Heparin (without Gel), EDTA 3 mL	2 mL	1 mL	On Ice	Weekdays
Fluconazole	Blood	EDTA 3 mL	2 mL	1 mL	Room Temperature	3 x weekly
Flucloxacillin	Blood	Lithium Heparin (without Gel), EDTA 3 mL	2 mL	1 mL	On Ice	Weekdays
Gentamicin	Blood	SST, Lithium Heparin (with Gel)	N/A	N/A	Room Temperature	Daily
Isavuconazole	Blood	EDTA 3 mL	2 mL	1 mL	Room Temp (Alfred), Esky (External)	3 x weekly
Itraconazole	Plasma	EDTA 3 mL	2 mL	N/A	Room Temp (Alfred), Esky (External)	3 x weekly
Linezolid	Plasma	EDTA 3 mL	2 mL	1 mL	On Ice	Weekdays
Meropenem	Blood	Lithium Heparin (without Gel), EDTA 3 mL	2 mL	1 mL	On Ice	Weekdays
Posaconazole	Plasma	EDTA 3 mL	2 mL	1 mL	Room Temperature	3 x weekly
Piperacillin	Blood	Lithium Heparin (without Gel), EDTA 3 mL	2 mL	1 mL	On Ice	Weekdays
Tobramycin	Blood	SST, Lithium Heparin (with Gel)	N/A	N/A	Room Temperature	Daily
Vancomycin	Blood	Lithium Heparin (with Gel), SST	N/A	N/A	Room Temperature	Daily
Voriconazole	Plasma	EDTA 3 mL	2 mL	N/A	Room Temperature	3 x weekly

Laboratory contact

For sample requirements and testing information please contact (03) 9076 3888.