The LNS Medical Biology Department hosts the only clinical toxicology lab in Luxembourg

The Clinical Toxicology laboratory of the Laboratoire national de santé (LNS), established in 2017, carries out drug screening for occupational medicine purposes and analyses the concentration of drugs in the blood. It plays a vital role in tailoring dosages for patients by serving as Luxembourg’s sole clinical toxicology lab. In 2022, the laboratory officially launched the testing of several antibiotics in patients’ serum to ensure that therapeutic levels are achieved.

The pharmacological monitoring of B lactam antibiotics and Linezolid is recommended for intensive care patients, for whom pharmacokinetic variability is expected and those presenting signs suggestive of toxicity. It helps healthcare providers determine if the antibiotic dosage is appropriate, adjust the treatment if necessary, and ensure effective treatment of bacterial infections.

The Medical Biology Department focuses on the prevention of diseases within the context of the national project for neonatal screening, the treatment of diseases by specialised analysis (diagnosis of inborn errors of metabolism, analysis of stones), and the detection of drug addiction as well as the assessment of drug treatments. To fulfil the latter, the Clinical Toxicology laboratory was set up in 2017 from the analytical toxicology lab where there was no medical biologist.

In 2022, at the request of intensive care units, the Clinical Toxicology laboratory of the LNS officially launched the testing of antibiotics in patients’ serum including Ampicillin, Cefepime, Ceftazidime, Linezolid, Meropenem, and Piperacillin helping healthcare providers to determine appropriate antibiotic dosage and to adjust treatment if necessary.

Conducting toxicology screenings to enhance patient care

The primary missions of the Clinical Toxicology laboratory include performing biological monitoring of drugs, detecting and quantifying toxic substances, and using clinical expertise to assist stakeholders in providing the best possible patient care.

The Clinical Toxicology laboratory measures the concentration of drugs in the blood to help prescribers personalise dosages and also assists in the diagnosis and monitoring of intoxication in the medical context with broad, non-targeted toxicology screenings. It also participates in the monitoring of drug addiction (alcohol consumption markers, research and dosage of narcotics and new synthetic products).

All medical analyses normally require a valid medical prescription.

Different methods in use achieving 41651 analyses in 2022

The laboratory applies a number of specific analysis techniques, mainly using chromatographic methods coupled with different detection modes, such as gas chromatography coupled with mass spectrometry, liquid chromatography with UV spectrometry, and liquid chromatography-tandem mass spectrometry.

All of the aforementioned methods are powerful analytical techniques used in chemistry to separate, identify, and quantify individual components of a complex mixture. In 2022, the Clinical Toxicology laboratory team performed 41651 analyses in total.

Major contribution to the improvement of health care in Luxembourg

The presence of a dedicated clinical toxicology laboratory in Luxembourg contributes significantly to enhancing healthcare services by reducing analysis times through the availability of on-site testing. This eliminates the need for extensive sample transportation, ultimately leading to improved patient care. The laboratory has established itself as a reliable collaborator for physicians, particularly in the development of customised antibiotic dosages for patients in intensive care settings and many Luxembourgish organisations have taken up the labs’ expertise when conducting drug screenings for staff in the context of occupational medicine. By this means, the clinical toxicology laboratory of the LNS contributes sustainably to the wellbeing and health safety of Luxembourg’s citizens.