Delivering precision antimicrobial therapy through closed-loop control systems

T M Rawson; D O'Hare; P Herrero; S Sharma; L S P Moore; E de Barra; J A Roberts; A C Gordon; W Hope; P Georgiou; A E G Cass; A H Holmes

doi:10.1093/jac/dkx458

Delivering precision antimicrobial therapy through closed-loop control systems

J Antimicrob Chemother. 2018 Apr 1;73(4):835-843. doi: 10.1093/jac/dkx458.

Authors

T M Rawson¹, D O'Hare², P Herrero³, S Sharma⁴, L S P Moore^{1

5}, E de Barra⁵, J A Roberts^{6

7}, A C Gordon⁸, W Hope⁹, P Georgiou³, A E G Cass¹⁰, A H Holmes^{1

5}

Affiliations

¹ National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, Hammersmith Campus, Du Cane Road, London W12 0NN, UK.
² Department of Bioengineering, Imperial College London, London SW7 2AZ, UK.
³ Department of Electrical and Electronic Engineering, Imperial College London, South Kensington Campus, London SW7 2AZ, UK.
⁴ College of Engineering, Swansea University, Swansea SA1 8EN, UK.
⁵ Imperial College Healthcare NHS Trust, Hammersmith Hospital, Du Cane Road, Acton W12 0NN, UK.
⁶ University of Queensland Centre for Clinical Research, Faculty of Medicine and Centre for Translational Pharmacodynamics, School of Pharmacy, The University of Queensland, Brisbane, Australia.
⁷ Royal Brisbane and Women's Hospital, Brisbane, Australia.
⁸ Section of Anaesthetics, Pain Medicine & Intensive Care, Imperial College London, London SW7 2AZ, UK.
⁹ Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool L69 3GE, UK.
¹⁰ Department of Chemistry & Institute of Biomedical Engineering, Imperial College London, Kensington Campus, London SW7 2AZ, UK.

Abstract

Sub-optimal exposure to antimicrobial therapy is associated with poor patient outcomes and the development of antimicrobial resistance. Mechanisms for optimizing the concentration of a drug within the individual patient are under development. However, several barriers remain in realizing true individualization of therapy. These include problems with plasma drug sampling, availability of appropriate assays, and current mechanisms for dose adjustment. Biosensor technology offers a means of providing real-time monitoring of antimicrobials in a minimally invasive fashion. We report the potential for using microneedle biosensor technology as part of closed-loop control systems for the optimization of antimicrobial therapy in individual patients.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Anti-Bacterial Agents / therapeutic use*
Biosensing Techniques / methods
Drug Monitoring / methods*
Drug Therapy / methods*
Drug Utilization / standards*
Humans
Precision Medicine / methods*

Substances

Anti-Bacterial Agents

Abstract

Publication types

MeSH terms

Substances

Grants and funding