Enhancement of detection sensitivity and cleanup selectivity for tobramycin through pre-column derivatization

Reversed-phase high-performance liquid chromatography, UV detection and reversed-phase solid-phase extraction (SPE) as analytical methods for pharmaceutical compounds face a challenge when the compound is rather polar and lack UV absorptivity. A good example is tobramycin. To overcome these problems, a method has been developed using pre-column derivatization of tobramycin with o-phthalaldehyde and automated with an autosampler with microrobotic routines. The detection enhancement of the derivatives was achieved by using fluorescence detection which was forty times more sensitive than using UV detection. Recovery studies of standards and spiked serum samples show that pre-SPE derivatization significantly enhances the recoveries (by at least a factor of 3) and the quality of cleanup over post-SPE derivatization.

The pH of antibiotic vitreous infusion combinations: a potential cause of retinal toxicity

Experiments were undertaken to measure the pH of solutions of commonly used intravitreal antibiotics in various irrigating solutions to determine whether a change in pH might be a factor in antibiotic-induced retinal toxicity. Such retinal toxicity has been particularly damaging when solutions of gentamicin have been used. The pHs of the following solutions were measured: gentamicin, amikacin, methicillin, tobramycin, and vancomycin, combined with balanced salt solution (BSS) PLUS (bicarbonate buffer), BSS (citrate/acetate buffer), and lactated Ringer's solution (lactate buffer). Each of these antibiotics induced a concentration-dependent decrease in pH of the solutions; gentamicin, amikacin and tobramycin produced the largest shifts. The results also demonstrated that BSS PLUS acts as the strongest buffer and lactated Ringer's as the weakest. We conclude that it is important to determine the pH of intraocular antibiotic irrigating solutions, not just the pH of the antibiotics.

The solubility of antibiotic and corticosteroid combinations

The use of collagen shields soaked in various combinations of medications has been advocated to enhance drug delivery to the cornea. Recently, severe corneal toxicity associated with aggregate formation in mixtures of gentamicin and methylprednisolone prompted our study of the effect of drug concentration, pH, and temperature on the solubility of several antibiotic and corticosteroid formulations commonly used to treat ocular disease. Selected combinations of cefazolin, vancomycin, tobramycin, gentamicin, methylprednisolone, and dexamethasone were evaluated. Mixtures of tobramycin and vancomycin produced no precipitates, but many spheroid aggregates were seen when methylprednisolone and gentamicin were combined. Although the effects of precipitate formation on drug bioavailability and toxicity have not been fully determined, until such information is available, the use of combinations of drugs that remain in solution during administration is recommended.

Structure-function relationships for the effects of various aminoglycoside antibiotics on dispersed bovine parathyroid cells

We previously showed that the polycationic aminoglycoside antibiotic neomycin mimics the effects of high extracellular calcium (Ca2+) concentrations on several aspects of parathyroid function. In the present studies we examined the actions of several additional aminoglycosides on dispersed bovine parathyroid cells to investigate the relationship between antibiotic structure and function in eliciting Ca(2+)-like effects on intracellular second messengers and PTH release. Of the antibiotics tested, those with six amino groups (neomycin-B and -C) were most potent in inhibiting dopamine-stimulated cAMP accumulation, showing IC50 values (the concentration producing a half-maximal inhibitory effect) of 7.7 x 10(-5) and 1.5 x 10(-4) M. Gentamicin-C, paromomycin, and tobramycin, which have five amino groups, were less potent, with IC50 values of 4 x 10(-4), 10(-3), and 3.3 x 10(-4) M, respectively, while gentamicin-B, kanamycin, and ribostamycin, with four amino groups, were least potent (respective IC50 values, 2.0, 2.9, and 3 x 10(-3) M). These antibiotics showed a similar order of potency for inhibiting PTH release, with a close correlation between their IC50 values for modulating cAMP accumulation and PTH release (r = 0.98; P less than 0.001). Finally, they showed qualitatively similar potencies for eliciting transient increases in the cytosolic free Ca2+ concentration arising from the release of Ca2+ from intracellular stores. Neomycin-B and -C both acted at 10(-4) M; gentamicin-C, paromomycin, and tobramycin evoked free intracellular Ca2+ spikes at 1.4 x 10(-4) to 6.3 x 10(-4) M; and gentamicin-B, kanamycin, and ribostamycin had little or no effect at 7 x 10(-4) M, the highest concentration tested. Thus, a variety of aminoglycoside antibiotics mimic the effects of Ca2+ and other polyvalent cations on parathyroid function. Their relative potencies are closely related to the total number of amino groups on the molecule, with a 5- to 6-fold increase in potency for each additional amino group between four and six.

Effect of hand mixing tobramycin on the fatigue strength of Simplex P

In a recent study, we showed that the presence of gentamicin in Palacos R or erythromycin plus colistin in Simplex P bone cement did not significantly decrease the fatigue strength of the cement. [J.P. Davies, D.O. O'Connor, D.W. Burke, and W.H. Harris, "Influence of antibiotic impregnation on the fatigue life of Simplex P and Palacos R acrylic bone cements, with and without centrifugation," J. Biomed. Mater. Res., 23, 379-397 (1989)] However, the commercially prepared Palacos R with Gentamicin and AKZ (Simplex P with colistin and erythromycin) which were tested are not approved by the FDA for use in the United States. Because of this, many surgeons in the United States hand mix tobramycin with the cement in the operating room if a case calls for the use of antibiotic-impregnated cement. In this study, we determined the effect of adding 1.2 g of tobramycin to one pack (40 g) of Simplex P powder on the fatigue strength of the cement. The effect of centrifugation on the fatigue strength of Simplex P with the tobramycin added was also assessed. Simplex P was prepared according to the manufacturer's instructions with and without the addition of 1.2 g tobramycin per 40-g pack and with and without centrifugation. Fifteen specimens of each of the four cement preparations were tested in fully reversed tension-compression fatigue at +/- 15 MPa, 2 Hz. The fatigue strength of the uncentrifuged and centrifuged Simplex P was not significantly reduced by the tobramycin. Centrifugation significantly increased the fatigue life of Simplex P both with and without the addition of tobramycin. The fatigue life of the Simplex P with tobramycin was increased by a factor of 8 by centrifugation.

Compatibility of ciprofloxacin injection with selected drugs and solutions

The compatibility of ciprofloxacin injection with selected antimicrobials and aminophylline was studied. Ciprofloxacin, amikacin sulfate, aminophylline, clindamycin phosphate, gentamicin sulfate, and tobramycin sulfate were mixed separately in minibags containing 0.9% sodium chloride injection or 5% dextrose injection; admixtures were stored for up to 48 hours at either 4 degrees C or 25 degrees C. Ciprofloxacin was also combined separately with each of the other drugs and solutions and stored under the same conditions. In addition, ciprofloxacin was combined with metronidazole in ready-to-use mini-bags of the latter drug and stored at 25 degrees C. Drug concentrations were measured by fluorescence polarization immunoassay or high-performance liquid chromatography. All admixtures were also examined visually. Stability was defined as retention of at least 90% of the original drug concentration with no visual evidence of incompatibility. With one exception, drugs in all single-drug admixtures were stable for 48 hours. The drug concentration eight hours after amikacin was mixed in 0.9% sodium chloride and refrigerated was 89% of the original concentration. When ciprofloxacin was combined with gentamicin, metronidazole, or tobramycin, all of the involved drugs were stable for 48 hours. Compatibility of ciprofloxacin-amikacin admixtures depended on the fluid and storage temperature; all such admixtures were stable for at least eight hours. A precipitate formed immediately whenever ciprofloxacin was mixed with clindamycin and within four hours after ciprofloxacin was mixed with aminophylline. Ciprofloxacin injection was compatible with gentamicin, metronidazole, and tobramycin and incompatible with aminophylline and clindamycin. The compatibility of ciprofloxacin-amikacin admixtures depended on the i.v. solution and storage temperature.

Solid-state properties of tobramycin

Tobramycin (I) obtained from two different sources was subjected to powder X-ray diffractometry, thermal analyses, and Karl Fischer titrimetry. It was concluded to be tobramycin monohydrate (C18H37N5O9 . H2O). When heated in the differential scanning calorimeter (DSC), the dehydration of I resulted in the formation of metastable anhydrous tobramycin, which melted at 164 degrees C. This was followed by the crystallization of the stable anhydrous tobramycin, which then melted at 217 degrees C. The polymorphic transition was concluded to be monotropic and the calculated free energy difference between the metastable and the stable forms, at 25 degrees C, was 348 cal.mol-1. Both the heating rate in the DSC and the sample size had a significant influence on the enthalpy values of most of the thermal events. These observations were attributed to the presence of trace amounts of moisture in the sample. No detectable decomposition of I occurred when it was heated up to 224 degrees C.

Stability of gentamicin sulfate and tobramycin sulfate in extemporaneously prepared ophthalmic solutions at 8 degrees C

The stability of gentamicin sulfate and tobramycin sulfate in fortified ophthalmic solutions stored under refrigeration was studied. Fortified gentamicin ophthalmic solution and fortified tobramycin ophthalmic solution were prepared to a final theoretical concentration of 13.6 mg/mL by using commercially available ophthalmic and injectable solutions. Volumes of each solution were packaged in plastic bottles and refrigerated at 4-8 degrees C. Samples of each solution were analyzed by fluorescence polarization immunoassay on days 0 (before refrigeration), 1, 2, 3, 4, 7, 14, 28, 63, and 91. To validate the method, identical solutions were prepared, stored under refrigeration at 4-8 degrees C, and analyzed by a stability-indicating high-performance liquid chromatographic assay on days 0 (before refrigeration), 9, 28, 56, and 91. Fluorescence polarization immunoassay showed the mean concentrations of gentamicin and tobramycin on day 91 to be 104.4% and 97.4%, respectively, of the time 0 concentrations; the difference was not significant in either case. HPLC validated these results; the mean concentration of gentamicin and tobramycin on day 91 was 103.3% and 101.2%, respectively, of the mean day 0 concentrations. Gentamicin and tobramycin in ophthalmic solutions prepared by mixing ophthalmic and injectable products and stored in plastic bottles at 4-8 degrees C were stable for three months.

A liquid-chromatographic method for the determination of tobramycin

A rapid and sensitive liquid-chromatographic method was developed to quantify the release of tobramycin from polymeric drug delivery systems in vitro. Pre-column derivatization of tobramycin and kanamycin B sulphate (internal standard) was carried out with 2,4,6-trinitrobenzenesulphonic acid. The sample volume required was only 50 microliters. The chromatographic separation was achieved on an octyl reversed-phase column with UV detection at 340 nm. This isocratic method was performed at ambient temperature and required only 8 min of chromatography time. The standard curves were linear over the concentration range 0.50-50.0 mg l-1. Inter-day and intra-day relative standard deviations ranged from 3.6 to 9.3% and from 1.6 to 6.8%, respectively. The assay method was used to determine the tobramycin content in different pharmaceutical formulations and to study the stability of the drug both in the solid-state and in solution.