Monitoring trimethoprim therapy to ensure drug absorption,
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Antimicrobial Assay, Trimethoprim
Bactrim (Sulfamethoxazole and Trimethoprim)
Septra (Sulfamethoxazole and Trimethoprim)
Trimethoprim, Antimicrobial Assay
Serum Red
Supplies: Sarstedt Aliquot Tube, 5 mL (T914)
Collection Container/Tube: Red top (gel tubes/SST are not acceptable)
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions:
1. Serum for a peak level should be collected at least 60 minutes after a dose.
2. Within 2 hours of collection, centrifuge and aliquot serum into a plastic vial.
If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.
0.5 mL
Gross hemolysis | OK |
Gross lipemia | OK |
Gross icterus | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum Red | Refrigerated (preferred) | 28 days | |
Ambient | 28 days | ||
Frozen | 28 days |
Monitoring trimethoprim therapy to ensure drug absorption,
Trimethoprim is coadministered with sulfamethoxazole for prophylaxis or treatment of bacterial infections. These agents are used to treat a variety of infections, including methicillin-resistant Staphylococcus aureus, and for prophylaxis in immunosuppressed patients, such as individuals who are HIV-positive.
Trimethoprim has a wide therapeutic index and dose-dependent toxicity. Trimethoprim accumulates in patients with kidney failure.
Therapeutic drug monitoring is not commonly performed unless there are concerns about adequate absorption, clearance, or compliance. Accordingly, routine drug monitoring is not indicated in all patients.
>2.0 mcg/mL (Peak)
Most patients will display peak steady state serum concentrations of more than 2.0 mcg/mL when the specimen is collected at least 1 hour after an oral dose. Target concentrations may be higher depending on the intent of therapy.
Specimens collected in serum gel tubes are not acceptable, as the drug can absorb on the gel and lead to falsely decreased concentrations.
1. Kamme C, Melander A, Nilsson NI. Serum and saliva concentrations of sulfamethoxazole and trimethoprim in adults in children: Relation between saliva concentrations and in vitro activity against nasopharyngeal pathogens. Scand J Infect Dis. 1983;15(1):107-113. doi:10.3109/inf.1983.15.issue-1.18
2. Young T, Oliphant C, Araoyinbo I, Volmink J. Co-trimoxazole prophylaxis in HIV: the evidence. S Afr Med J. 2008;98(4):258-259
3. Avdic E, Cosgrove SE. Management and control strategies for community-associated methicillin-resistant Staphylococcus aureus. Expert Opin Pharmacother. 2008;9(9):1463-1479. doi:10.1517/14656566.9.9.1463
4. Brunton LL, Hilal-Dandan R, Knollmann BC, eds. Goodman and Gilman's: The Pharmacological Basis of Therapeutics. 13th ed. McGraw-Hill Publishing; 2018
Samples are extracted with analyte detection by tandem mass spectrometry.(Unpublished Mayo method)
Monday, Thursday
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
80299
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
TMP | Trimethoprim, S | 11005-6 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
80146 | Trimethoprim, S | 11005-6 |
Change Type | Effective Date |
---|---|
Test Changes - Specimen Information | 2024-08-14 |