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Chen CY, Li MY, Ma LY, Zhai XY, Luo DH, Zhou Y, Liu ZM, Cui YM. Precision and accuracy of commercial assays for vancomycin therapeutic drug monitoring: evaluation based on external quality assessment scheme. J Antimicrob Chemother 2020; 75:2110-2119. [PMID: 32464644 DOI: 10.1093/jac/dkaa150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Vancomycin remains a mainstay of the treatment of Gram-positive bacterial infections. It is crucial to accurately determine vancomycin serum concentration for adequate dose adjustment. OBJECTIVES To evaluate the precision and accuracy of commercial assay techniques for vancomycin concentration and to assess the comparability of vancomycin detection methods in Chinese laboratories. METHODS Human serum samples spiked with known concentrations of vancomycin were provided to laboratories participating in the external quality assessment scheme (EQAS). Assay methods included chemiluminescence, enzyme immunoassay (EIA) and so on. The dispersion of the measurements was analysed and the robust coefficient of variation (rCV), relative percentage difference (RPD) and satisfactory rate for method groups were calculated. Moreover, performance of the Chinese laboratories was assessed. RESULTS A total of 657 results from 75 laboratories were collected, including 84 samples from 10 Chinese laboratories. The median rCV, median RPD and satisfactory rates classified by methods ranged from 1.85% to 15.87%, -14.75% to 13.34% and 94.59% to 100.00%, respectively. Significant differences were seen in precision, between kinetic interaction of microparticles in solution (KIMS) and other methods, and in accuracy, between enzyme-multiplied immunoassay technique (EMIT), fluorescence polarization immunoassay (FPIA) and other techniques. Vancomycin detection in China mainly depended on the chemiluminescence and EMIT methods, which tended to result in lower measurements. CONCLUSIONS Although almost all assays in this study achieved an acceptable performance for vancomycin serum concentration monitoring, obvious inconsistencies between methods were still observed. Chinese laboratories were more likely to underestimate vancomycin concentrations. Thus, recognizing inconsistencies between methods and regular participation in vancomycin EQAS are essential.
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Affiliation(s)
- Chao-Yang Chen
- Department of Pharmacy, Peking University First Hospital, Beijing, China
| | - Meng-Ya Li
- Department of Pharmacy, Peking University First Hospital, Beijing, China.,Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University Health Science Center, Beijing, China
| | - Ling-Yun Ma
- Department of Pharmacy, Peking University First Hospital, Beijing, China
| | - Xing-Yu Zhai
- Department of Pharmacy, Peking University First Hospital, Beijing, China.,Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University Health Science Center, Beijing, China
| | - Dao-Huang Luo
- Department of Pharmacy, Peking University First Hospital, Beijing, China.,Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University Health Science Center, Beijing, China
| | - Ying Zhou
- Department of Pharmacy, Peking University First Hospital, Beijing, China.,Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University Health Science Center, Beijing, China
| | - Zhen-Ming Liu
- State Key Laboratory of Natural and Biomimetic Drugs, School of Pharmaceutical Sciences, Peking University Health Science Center, Beijing, China
| | - Yi-Min Cui
- Department of Pharmacy, Peking University First Hospital, Beijing, China.,Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University Health Science Center, Beijing, China
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Lima TDM, Seba KS, Gonçalves JCS, Cardoso FLL, Estrela RDCE. A Rapid and Simple HPLC Method for Therapeutic Monitoring of Vancomycin. J Chromatogr Sci 2018; 56:115-121. [PMID: 29069326 DOI: 10.1093/chromsci/bmx089] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Indexed: 01/05/2023]
Abstract
Therapeutic monitoring of the antibiotic vancomycin is important to achieve specific plasma concentration and prevent toxic effects. Several assays have been described for vancomycin determination in clinical practice, but high-performance liquid chromatography is still considered the gold standard for the quantification of vancomycin. In this study, we developed a new and rapid high-performance liquid chromatography method requiring 50 μL of plasma for the quantification of vancomycin. Acetonitrile was used for processing plasma by protein precipitation (1:2.5). Isocratic chromatographic analysis was carried out on a C18 silica-based (2.7 μm) column with the mobile phase containing 20 mM ammonium acetate/formic acid buffer (pH 4.0):methanol 88:12 (v/v). A diode array detector was used for UV detection at 240 nm. This method was validated according to the Brazilian Health Surveillance Agency legislation and International Conference on Harmonization guidelines. The measurement range was 1-100 μg/mL, analysis time was 8 min, and intermediate precision was <12%, supporting the present method as a fast, simple, and effective alternative for therapeutic monitoring of vancomycin.
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Affiliation(s)
- Tácio de Mendonça Lima
- Faculty of Pharmaceutical Sciences, University of São Paulo, Av. Professor Lineu Prestes, 580 - Cidade Universitária São Paulo- SP, CEP 05508-000, Brazil
| | - Karine Souza Seba
- National School of Public Health, Oswaldo Cruz Foundation, R. Leopoldo Bulhões, 1480 - Bonsucesso, Rio de Janeiro - RJ, CEP 21041-210, Brazil
| | - José Carlos Saraiva Gonçalves
- Faculty of Pharmacy, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, 373 - Cidade Universitária, Rio de Janeiro - RJ, CEP 21941-170, Brazil
| | - Fernando Luiz Lopes Cardoso
- Hospital Infection Control Team, University Hospital Clementino Fraga Filho, R. Prof. Rodolpho Paulo Rocco, 255 - Cidade Universitária, Rio de Janeiro - RJ, CEP 21941-913, Brazil
| | - Rita de Cássia Elias Estrela
- Faculty of Pharmacy, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, 373 - Cidade Universitária, Rio de Janeiro - RJ, CEP 21941-170, Brazil.,Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Av. Brasil, 4365 - Manguinhos, Rio de Janeiro - RJ, CEP 21040-360, Brazil, Brazil
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