Therapeutic drug monitoring and target attainment of unbound flucloxacillin in hospitalized patients with measured MICs (FLUTE)

Target attainment of unbound flucloxacillin was achieved in one third of patients, while a substantial number of patients had an unbound flucloxacillin concentration >10 mg/L, which was associated with increased toxicity. We advise routine TDM of unbound flucloxacillin for patients with impaired renal function and a high daily dose to mitigate the risk of flucloxacillin-associated nephrotoxicity and neurotoxicity.