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LC–MS/MS-based multiplex antibacterial platform for therapeutic drug monitoring in intensive care unit patients

Empirically prescribed standard dosing regimens of antibacterial agents may result in insufficient or excess plasma concentrations with persistently poor clinical outcomes, especially for patients in intensive care units (ICUs). Therapeutic drug monitoring (TDM) of antibacterial agents can guide dos...

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Autores principales: Liu, Liang, Zhang, Liu, Zheng, Xiangyi, Liu, Xing, Liu, Wei, Wu, Jianhua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10151781/
https://www.ncbi.nlm.nih.gov/pubmed/37144212
http://dx.doi.org/10.3389/fphar.2023.1116071
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author Liu, Liang
Zhang, Liu
Zheng, Xiangyi
Liu, Xing
Liu, Wei
Wu, Jianhua
author_facet Liu, Liang
Zhang, Liu
Zheng, Xiangyi
Liu, Xing
Liu, Wei
Wu, Jianhua
author_sort Liu, Liang
collection PubMed
description Empirically prescribed standard dosing regimens of antibacterial agents may result in insufficient or excess plasma concentrations with persistently poor clinical outcomes, especially for patients in intensive care units (ICUs). Therapeutic drug monitoring (TDM) of antibacterial agents can guide dose adjustments to benefit patients. In this study, we developed a robust, sensitive, and simple liquid chromatography-tandem mass spectrometry (LC–MS/MS) platform for the quantification of 14 antibacterial and antifungal agents (beta-lactams piperacillin, cefoperazone, and meropenem; beta-lactamase inhibitors tazobactam and sulbactam; antifungal agents fluconazole, caspofungin, posaconazole, and voriconazole; and daptomycin, vancomycin, teicoplanin, linezolid, and tigecycline) that can be used for patients with severe infection. This assay requires only 100 µL of serum with rapid protein precipitation. Chromatographic analysis was performed using a Waters Acquity UPLC C8 column. Three stable isotope-labeled antibacterial agents and one analogue were used as internal standards. Calibration curves ranged from 0.1–100 μg/mL, 0.1–50 μg/mL, and 0.3–100 μg/mL for different drugs, and all correlation coefficients were greater than 0.9085. Intra- and inter-day imprecision and inaccuracy values were below 15%. After validation, this new method was successfully employed for TDM in routine practice.
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spelling pubmed-101517812023-05-03 LC–MS/MS-based multiplex antibacterial platform for therapeutic drug monitoring in intensive care unit patients Liu, Liang Zhang, Liu Zheng, Xiangyi Liu, Xing Liu, Wei Wu, Jianhua Front Pharmacol Pharmacology Empirically prescribed standard dosing regimens of antibacterial agents may result in insufficient or excess plasma concentrations with persistently poor clinical outcomes, especially for patients in intensive care units (ICUs). Therapeutic drug monitoring (TDM) of antibacterial agents can guide dose adjustments to benefit patients. In this study, we developed a robust, sensitive, and simple liquid chromatography-tandem mass spectrometry (LC–MS/MS) platform for the quantification of 14 antibacterial and antifungal agents (beta-lactams piperacillin, cefoperazone, and meropenem; beta-lactamase inhibitors tazobactam and sulbactam; antifungal agents fluconazole, caspofungin, posaconazole, and voriconazole; and daptomycin, vancomycin, teicoplanin, linezolid, and tigecycline) that can be used for patients with severe infection. This assay requires only 100 µL of serum with rapid protein precipitation. Chromatographic analysis was performed using a Waters Acquity UPLC C8 column. Three stable isotope-labeled antibacterial agents and one analogue were used as internal standards. Calibration curves ranged from 0.1–100 μg/mL, 0.1–50 μg/mL, and 0.3–100 μg/mL for different drugs, and all correlation coefficients were greater than 0.9085. Intra- and inter-day imprecision and inaccuracy values were below 15%. After validation, this new method was successfully employed for TDM in routine practice. Frontiers Media S.A. 2023-04-18 /pmc/articles/PMC10151781/ /pubmed/37144212 http://dx.doi.org/10.3389/fphar.2023.1116071 Text en Copyright © 2023 Liu, Zhang, Zheng, Liu, Liu and Wu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Liu, Liang
Zhang, Liu
Zheng, Xiangyi
Liu, Xing
Liu, Wei
Wu, Jianhua
LC–MS/MS-based multiplex antibacterial platform for therapeutic drug monitoring in intensive care unit patients
title LC–MS/MS-based multiplex antibacterial platform for therapeutic drug monitoring in intensive care unit patients
title_full LC–MS/MS-based multiplex antibacterial platform for therapeutic drug monitoring in intensive care unit patients
title_fullStr LC–MS/MS-based multiplex antibacterial platform for therapeutic drug monitoring in intensive care unit patients
title_full_unstemmed LC–MS/MS-based multiplex antibacterial platform for therapeutic drug monitoring in intensive care unit patients
title_short LC–MS/MS-based multiplex antibacterial platform for therapeutic drug monitoring in intensive care unit patients
title_sort lc–ms/ms-based multiplex antibacterial platform for therapeutic drug monitoring in intensive care unit patients
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10151781/
https://www.ncbi.nlm.nih.gov/pubmed/37144212
http://dx.doi.org/10.3389/fphar.2023.1116071
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