Laboratory of Metabolic Pathology
Bambino Gesù Children’s Hospital, Rome, Italy
This month we hear from Bianca Maria Goffredo from the Laboratory of Metabolic Pathology at Bambino Gesù Children’s Hospital in Rome. Bianca shares about her experience in developing drug assays and applying them to personalize therapy, especially for pediatric patients. |
I am a biologist and my work involves determining drug concentrations for the purposes of optimizing dosing. I work with a group of collaborators, pharmacists, biologists and technicians.
On a typical day, we start by calibrating our HPLC and MS instruments, then we perform the analyses for the day, and I put together the report for clinicians. There are also meetings and online calls. I also develop protocols to carry out research. Often, clinician colleagues ask to determine concentrations where we need to develop an assay, primarily for one-off plasma samples. However, in some situations we determine a concentration-time curve to better understand the drug response for a particular patient and personalize treatment.
Yes, our job can be considered innovative especially when it comes to controlling and personalizing therapies.
HPLC has been innovative for dosing many drugs in the last 10 years. MS has revealed to be very innovative and made a significant contribution to clinical practice.
My interest in TDM began 15 years ago when Prof. Locatelli arrived at our hospital and specifically asked me for a specific assay. My area of expertise was determinations based on HPLC, and this is how I became interested in TDM and PK. In recent years, I have also become more involved in clinical toxicology.
When I began TDM, I thought “I’d like to incorporate the idea at my centre” because personalized therapy was lacking at my hospital, especially for the pediatric population, which are a very vulnerable population.
My idea is to put into practice the evaluation of antibiotic levels with MIC. Precise use of antibiotic therapy is very important to avoid severe complications for patients in intensive care. In this way the therapy is shorter, but more efficacious.
The future for TDM and CT is to organize very technological laboratories and increase the culture of TDM and CT among doctors, health operators and hospital directors. The challenges are to improve a culture of drug use and to raise awareness among hospital directors in hospitals.
I worked during the lockdown due to Covid-19 and TDM continued in hospitalized patients. Unfortunately, there were no scientific meetings during this period, which I missed a lot.