What if more precise testing could ensure every patient is given the right dosage of antibiotics — whatever their clinical condition?
In standard immunoassays, measuring the concentration of antibiotics in a patient’s blood comes with major challenges. Finding the right dosage — particularly for critically ill patients — is difficult.
These patients have severely altered and variable antibiotic pharmacokinetics and can be infected by pathogens less susceptible to antibiotic treatment. Getting the dosage wrong could put the patient’s life at risk; overdosing may lead to toxicity, but underdosing may result in inefficacy. Yet 40–60% of critically ill patients don’t attain target concentrations. This means lower rates of clinical cure and bacteriological eradication1.
In the Asia-Pacific region, widespread misuse and overuse of antimicrobials in common infections compound the threat to health systems. Rapidly growing antimicrobial resistance (AMR) makes these infections harder to treat and makes medical procedures and treatments, like surgery and chemotherapy, much riskier.
As treatments become more personalised, getting the drug dosage right has never been more important. So how can we give patients access to the precise measurements they urgently need — and improve patient safety across our region?
The shift to mass spectrometry
Advanced mass spectrometry — known for exceptional sensitivity, specificity and accuracy — can now address this challenge for the first time.
The ‘gold standard’ measurement tool has so far been limited to niche clinical use cases by operational complexity, lack of integration, automation and standardisation, and the need for highly skilled lab staff. Consequently, mass spectrometry has only been available in specialised laboratories.
But advanced mass spectrometry innovations are now breaking down these barriers by automating the entire lab workflow. The technology combines sample preparation, separation, analysis and result interpretation into one streamlined process.
Crucially, advanced mass spectrometry moves beyond batch processing. It offers continuous random access, meaning a clinician can load a single urgent sample the moment it arrives and receive a result in under 40 minutes, rather than waiting hours for a full tray to be processed.
Bringing this state-of-the-art technology into routine lab settings will impact the lives of thousands of patients across the Asia-Pacific region. It gives clinicians and patients faster, more accurate and standardised results, no matter where the sample was analysed.
A patient with sepsis and fluctuating renal function, for example, may be prescribed a potent antibiotic with a narrow therapeutic index (meaning the difference between a healing dose and a toxic dose is razor-thin).
Standard immunoassays can struggle to distinguish the active drug from its inactive metabolites in such a complex patient, potentially leading a clinician to believe the dosage is sufficient when it is actually too low.
With advanced mass spectrometry, the lab can isolate and quantify the active drug molecule within minutes. The clinician gets a precise, true reading, allowing them to adjust the dose immediately to fight the infection without risking organ damage.
Mass spectrometry can be our most powerful tool for antibiotic stewardship
By integrating precise mass spectrometry testing into routine clinical practice, we can overcome the challenges of traditional dosing.
This precision is a vital pillar of antibiotic stewardship to prevent the emergence of drug-resistant bacteria. Ultimately, it gives us a powerful tool in the fight against antimicrobial resistance in Asia-Pacific, the epicentre of the AMR crisis2 — and time is short.
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