Real-time Assessment of Antimicrobial Concentrations for Personalized Treatment of Infectious Diseases

There is an urgent need to optimize antimicrobial dosing in order to address the prevalence of drug-resistant pathogens and the increase of minimum inhibitory concentrations (MICs) of antimicrobials. Antimicrobials typically have a narrow window of effective concentration or therapeutic indices. If the drug is dosed above this concentration window it becomes toxic. Conversely, if under-dosed, treatment is ineffective and drug resistance can arise. Each patients metabolic profile is unique and thus accurate dosing is difficult to achieve without monitoring. Current monitoring practices rely on laboratory-scale equipment such as high-performance liquid chromatography (HPLC) to quantify drug concentrations in clinical labs and hospitals. We propose to develop a portable device that is capable of performing real-time therapeutic monitoring at the point of care. The device will be similar to commercially available glucose meter containing a disposable testing strip and a small electrochemical detector with data processing functions. Aptamers will be used as recognition elements in the testing strip. A handheld potentiostat will be used for electrochemical analysis. The proposed device will allow clinicians to measure drug concentrations in near real-time, significantly improving treatment outcome and reducing the risk of administering suboptimal doses of antimicrobials.