Abstract
Therapeutic Drug Monitoring (TDM) is an important guide for the clinician to provide effective and safe drug therapy in the individual patient. However, the current state of implementation in Japan is unclear. The present study surveyed the current use of TDM, which promotes correct use of antimicrobial agents and antifungal agents, as well as Infection Control Team (ICT) activities. To compile this survey, questionnaire forms were sent to 1000 pharmacies within hospitals with beds for inpatients, and the responses of 540 pharmacies were processed and classified by size of the facilities. TDM implementation ratio varied between 38% to 92%, and was higher in large hospitals. TDM implementation ratio was also higher in hospitals with ICTs (82%) than without ICTs (46%), and this tendency was not affected by the size. TDM implementation ratio also depended on the types of antimicrobial agent, varying from 11% to 73%, with anti-MRSA agents ranking higher (vancomycin 73%, teicoplanin 57% and arbekacin 60%). However, the TDM implementation ratio was only 11% for the antifungal agent voriconazole, for which insurance recently started to cover the use of TDM. This survey indicated that TDM tended to be appropriately used for antimicrobial agents and antifungal agents in a large number of hospitals in Japan, but the implementation ratio varied with the size of the hospital.
