Therapeutic Drug Monitoring for IC UNITS
The right dose,for this patient,right now.
Titrix is a bedside, closed-loop system for antibiotic dosing in intensive care. It measures the drug actually in the patient's blood and uses predictive AI to keep exposure inside the therapeutic range — hour after hour.
01 — The problem
The ICU patient is a moving target.
Antibiotic doses are set by the label — designed around average patients. But critical illness rewrites how a body handles a drug: clearance can double, or collapse, within a day. The same dose can be too little for one patient and toxic for the next.
Where therapeutic drug monitoring exists at all, samples travel to a central lab and results come back hours later — often after the next dose has already been given.
- Augmented renal clearance
- Acute kidney injury
- CRRT
- ECMO
- Fluid resuscitation
- Capillary leak
- Hypoalbuminaemia
- Shifting MIC
ICU patients on β-lactam antibiotics did not reach even a conservative target concentration.
DALI study — Roberts et al., Clin Infect Dis 2014
sepsis-related deaths worldwide in a single year — around one in five deaths globally.
Rudd et al., The Lancet 2020
deaths directly attributable to bacterial antimicrobial resistance in 2019.
GBD 2019 AMR Collaborators, The Lancet 2022
Under-dosing lets infections persist and drives resistance. Over-dosing harms kidneys and nerves. Both are invisible without a measurement.
02 — Titrix
Same patient.
Two strategies.
A simulated septic patient with augmented, drifting renal clearance — one of the most common reasons ICU antibiotic levels fall short. Fixed dosing swings above and below the target, and a lab level takes about 6 hours to come back. Titrix reads the level at the bedside in about 10 minutes, learns this patient, and corrects.
Time in therapeutic range
- ▲ Standard: fixed bolus every 8 h
- □ Lab level: result in ~6 h, after the next dose is already in
- ○ Titrix: bedside level every 4 h, result in ~10 min → re-titrated dose
Illustrative simulation — not clinical data.
03 — How it works
A closed loop around every dose.
- 01At the bedside
Measure
Titrix quantifies the actual antibiotic concentration in the patient's blood, next to the bed — not in a central lab hours later.
- 02Patient-specific AI
Model
Predictive software combines each measurement with the patient's clinical characteristics — renal function, body weight, fluid balance, organ support — to estimate how this patient handles the drug.
- 03Clinician in control
Recommend
Titrix proposes the next dose and its timing, alongside the expected exposure. The clinician reviews, decides, and stays accountable.
- 04The loop closes
Adapt
New measurements continuously refine the model as the patient changes, keeping exposure inside the therapeutic range for the whole course of therapy.
Bedside, not backlog
Results arrive while they can still change the next dose.
Patient-specific
Dosing driven by this patient's measured exposure, not a population average.
Decision support
Titrix recommends. Clinicians decide. Every suggestion is explainable.
Continuous
Exposure is tracked through the whole course of therapy, not a single snapshot.
04 — Company
πρᾶγμα
/ˈpraɡ.ma/ from Greek: a deed; the thing done.
PRAGMA Diagnostics is an early-stage MedTech startup advancing therapeutic drug monitoring in intensive care. We are clinicians, engineers and data scientists who believe precision dosing should happen where the decision is made: at the bedside.
Our first product, Titrix, brings measurement and prediction together in a single closed loop, so that every patient receives antibiotic exposure matched to their own physiology — helping improve outcomes and protect the antibiotics we still have.
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CEO
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CTO
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Clinical lead
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Head of AI
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