http://dx.doi.org/10.1136/archdischild-2022-323836

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A 15-year-old girl with cystic fibrosis (CF) and needle phobia has recently had a port-a-cath placed to facilitate regular intravenous antibiotic administration. She is admitted to the respiratory ward to receive ceftazidime and tobramycin to treat Pseudomonas aeruginosa. Local guidance requests a blood sample for trough tobramycin concentration to be taken peripherally prior to the second dose. This is due to concerns about the risk of falsely elevated concentrations if sampled from the same line used to give the drug. The patient is anxious and asks, “why can’t you just take it from my port like other blood tests?”

In other departments, such as paediatric oncology, antibiotic concentrations are sampled from the same central line through which the drug is given, prompting us to question could we also spare our respiratory patients the trauma of a peripheral venepuncture to measure tobramycin trough concentrations?

Contributors HT contributed to the conception of the work and wrote the first draft of the paper. GS and MB contributed to the conception of the work and commented on the final draft of the paper.

Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

Provenance and peer review Not commissioned; externally peer reviewed.

Online: ISSN 1468-2044 Print: ISSN 0003-9888 Copyright © 2022 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health. All rights reserved.