Impact of therapeutic drug monitoring on microbiological eradication in patients with staphylococcus aureus bacteremia.

This study aims to investigate the impact of therapeutic drug monitoring (TDM) on the microbiological eradication rate in patients with Staphylococcus aureus bacteremia. Demographic information and laboratory data were collected for patients who were diagnosed with Staphylococcus aureus bacteremia during their hospital stays from January 2021 to May 2024. A total of 105 patients were included in the TDM group and 208 patients in the non-TDM group. The Chi-squared test showed a significantly higher microbiological eradication rate in the TDM group compared to the non-TDM group before (p<0.001) and after (p=0.003) propensity score matching. Subgroup analysis showed that the eradication rate was significantly higher in the TDM group for patients with either methicillin-sensitive Staphylococcus aureus bacteremia (p<0.001) or methicillin-resistant Staphylococcus aureus bacteremia (p=0.007). Moreover, for patients with multi-site infections, the microbiological eradication rate was significantly higher in the TDM group for either methicillin-sensitive Staphylococcus aureus bacteremia (p<0.001) or methicillin-resistant Staphylococcus aureus bacteremia (p<0.001). Although the drugs undergoing TDM in this study-vancomycin, daptomycin, linezolid, and teicoplanin-are primarily used for treating methicillin-resistant Staphylococcus aureus bacteremia, TDM for these agents can also significantly improve the microbiological eradication rate in methicillin-sensitive Staphylococcus aureus bacteremia. Furthermore, multivariate logistic regression analysis confirmed that TDM is an independent protective factor for microbiological eradication rate (p<0.001). In conclusion, this study demonstrates that performing TDM in patients with Staphylococcus aureus bacteremia can indeed enhance the microbiological eradication rate, thereby improving patient outcomes.