Therapeutic drug monitoring in the treatment of tuberculosis patients

Therapeutic drug monitoring (TDM) is one of the most promising technologies for personalized tuberculosis therapy, which can significantly improve the efficacy and safety of treatment in the most complex categories of patients. The applied goal of TDM is to optimize doses of TB drugs based on the control of their serum concentrations during treatment. The review considers the basic principles, definitions and parameters of TLM, current indications for testing, methods of data collection, analysis and interpretation from the perspective of a practicing phthisiatric physician; analysis of the evidence base is presented. The target populations for implementation of TLM are patients with HIV infection, diabetes mellitus, other severe multicomorbid pathology; pediatric and elderly patients, with delayed response to treatment and high risk of severe adverse reactions. For effective implementation of TLM it is necessary to conduct controlled studies to assess its clinical and economic results, to develop methods to increase the availability of this technology for the maximum number of TB institutions.