Building a Beta‐Lactam Model‐Informed Precision Dosing Service in a Quaternary Care Children's Hospital

There has been growing interest in precision dosing of beta-lactam antibiotics in recent years. At our institution, a quaternary children's hospital, we launched a new PK consult service utilizing a model-informed precision dosing (MIPD) approach to provide personalized dosing recommendations for cefepime. This consult service leveraged the infrastructure of an existing PK consult service at our institution for other drugs, such as immunosuppressants. In this manuscript, we describe the challenges in the development of a beta-lactam PK consult service due to fundamental differences between the new service and the existing PK consult service, such as varying levels of evidence for target goals for beta-lactam antibiotics versus immunosuppressants, and how they were addressed. We then present the workflow and infrastructure of our beta-lactam PK consult service to provide guidance for other institutions who may be interested in launching a similar service. Lessons learned throughout the process of building the service, including the importance of engaging multiple, diverse stakeholders early on and starting with one drug at a time, are provided.