TDM - Maryland
Therapeutic Drug Monitoring (TDM)TDM should be strongly considered within 2-3 weeks of treatment initiation for any TB patient if one or more of the following conditions are present: HIVDiabetesSevere TB disease with cavitation and high bacillary load indicated on AFB smearEvidence of relapse or treatment failureEvidence of malnutrition or malabsorption (e.g., abnormally low BMI, abnormal serum albumin levels, previous diagnosis of Crohn’s or another GI disease)“Slow Responder” (indicated by delayed clinical or microbiological response to treatment e.g., failure to convert cultures within 60 days)If indicated, perform a 2-hour TDM test unless otherwise requested by a TB consultant. 6-hour TDM monitoring for TB patients can be used to help differentiate between malabsorption and slow absorption of medications. A 6-hour test is not recommended for initial TDM monitoring and should only be performed after consultation with a TB expert. Consult with CTBCP or TB Expert regarding any TB medication dosage changes based on the results of TDM.If you have any questions please call the Maryland Department of Health’s Center for Tuberculosis Control and Prevention at 410-767-6698. ................
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