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Simultaneous Measurement of 11 Antibiotics for Use in the Intensive Care Unit by Ultra-High Performance Liquid Chromatography-Tandem Mass Spectrometry
Linnaeus University, Faculty of Health and Life Sciences, Department of Medicine and Optometry. Kalmar County Hospital, Sweden.ORCID iD: 0000-0002-1707-2655
Linköping University, Sweden.
Linköping University, Sweden.
Linköping University, Sweden.
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2022 (English)In: Therapeutic Drug Monitoring, ISSN 0163-4356, E-ISSN 1536-3694, Vol. 44, no 2, p. 308-318Article in journal (Refereed) Published
Abstract [en]

Background: Recent studies indicate that a high proportion of patients in the intensive care unit fail to attain adequate antibiotic levels. Thus, there is a need to monitor the antibiotic concentration to ensure effective treatment. In this article, the authors aimed to develop an ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method for the simultaneous quantification of antimicrobials to assess individualized therapeutic drug monitoring. Methods: A UHPLC-MS/MS method with 11 antibiotics (ciprofloxacin, moxifloxacin, benzylpenicillin, levofloxacin, linezolid, rifampicin, meropenem, cloxacillin, cefotaxime, clindamycin, and piperacillin) was developed. Chromatographic separation was performed using a Kinetex Biphenyl reversed-phase column, with gradient elution using 0.1% formic acid and methanol with 0.1% formic acid. Sample preparation was performed using methanol protein precipitation. The total run time was 5 minutes. Results: For all analytes, the interassay inaccuracies for calibrators were <= 5%. The interday inaccuracies for the quality controls (QCs) were <= 5% for all analytes. The interassay precision for calibration standards ranged between 1.42% and 6.11%. The interassay imprecision for QCs of all antibiotics and concentrations ranged between 3.60% and 16.1%. Interassay inaccuracy and imprecision for the QCs and calibration standards were <= 15% for all drugs, except benzylpenicillin. Conclusions: A rapid UHPLC-MS/MS method was developed for the simultaneous quantification of 11 different antibiotics. Minimal sample preparation was required to ensure a rapid turnaround time. The method was applied to clinical samples collected from 4 intensive care units.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2022. Vol. 44, no 2, p. 308-318
Keywords [en]
UHPLC-MS, MS, antibiotics, therapeutic drug monitoring, critically ill patients, clinical application
National Category
Analytical Chemistry Pharmacology and Toxicology
Research subject
Biomedical Sciences, Pharmacology
Identifiers
URN: urn:nbn:se:lnu:diva-111120DOI: 10.1097/FTD.0000000000000911ISI: 000769195300007PubMedID: 34224537Scopus ID: 2-s2.0-85126830421OAI: oai:DiVA.org:lnu-111120DiVA, id: diva2:1650438
Available from: 2022-04-07 Created: 2022-04-07 Last updated: 2023-05-02Bibliographically approved

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