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Preanalytical Stability of Flucloxacillin, Piperacillin, Tazobactam, Meropenem, Cefalexin, Cefazolin, and Ceftazidime in Therapeutic Drug Monitoring: A Structured Review. Ther Drug Monit 2022; 44:709-719. [PMID: 35175248 DOI: 10.1097/ftd.0000000000000975] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/22/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND Therapeutic drug monitoring is increasingly being used to optimize beta-lactam antibiotic dosing. Because beta-lactams are inherently unstable, confirming preanalytical sample stability is critical for reporting reliable results. This review aimed to summarize the published literature on the preanalytical stability of selected widely prescribed beta-lactams used in therapeutic drug monitoring. METHODS The published literature (2010-2020) on the preanalytical stability of flucloxacillin, piperacillin, tazobactam, meropenem, cefalexin, cefazolin, and ceftazidime in human plasma, serum, and whole blood was reviewed. Articles examining preanalytical stability at room temperature, refrigerated, or frozen (-20°C) using liquid chromatography with mass spectrometry or ultraviolet detection were included. RESULTS Summarizing the available data allowed for general observations to be made, although data were conflicting in some cases (piperacillin, tazobactam, ceftazidime, and meropenem at room temperature, refrigerated, or -20°C) or limited (cefalexin, cefazolin, and flucloxacillin at -20°C). Overall, with the exception of the more stable cefazolin, preanalytical instability was observed after 6-12 hours at room temperature, 2-3 days when refrigerated, and 1-3 weeks when frozen at -20°C. In all cases, excellent stability was detected at -70°C. Studies focusing on preanalytical stability reported poorer stability than studies investigating stability as part of method validation. CONCLUSIONS Based on this review, as general guidance, clinical samples for beta-lactam analysis should be refrigerated and analyzed within 2 days or frozen at -20°C and analyzed within 1 week. For longer storage times, freezing at -70°C was required to ensure sample stability. This review highlights the importance of conducting well-designed preanalytical stability studies on beta-lactams and other potentially unstable drugs under clinically relevant conditions.
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Magréault S, Jaureguy F, Zahar JR, Méchaï F, Toinon D, Cohen Y, Carbonnelle E, Jullien V. Automated HPLC-MS/MS assay for the simultaneous determination of ten plasma antibiotic concentrations. J Chromatogr B Analyt Technol Biomed Life Sci 2022; 1211:123496. [DOI: 10.1016/j.jchromb.2022.123496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/13/2022] [Accepted: 10/03/2022] [Indexed: 12/12/2022]
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Seraissol P, Lanot T, Baklouti S, Mané C, Ruiz S, Lavit M, De Riols P, Garrigues JC, Gandia P. Evaluation of 4 quantification methods for monitoring 16 antibiotics and 1 beta-lactamase inhibitor in human serum by high-performance liquid chromatography with tandem mass spectrometry detection. J Pharm Biomed Anal 2022; 219:114900. [PMID: 35752026 DOI: 10.1016/j.jpba.2022.114900] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 11/30/2022]
Abstract
Antibiotic (ATB) prescription in an intensive care unit (ICU) requires continuous monitoring of serum dosages due to the patient's pathophysiological condition. Dosing adjustment is necessary to achieve effective targeted concentrations. Since ICUs routinely use a large number of ATBs, global monitoring needs to be developed. In the present study, we developed a global analytical method for extracting, separating and quantifying the most widely used ATBs in ICUs: amoxicillin, piperacillin, cefazolin, cefepime, cefotaxime, ceftazidime, ceftolozane, ceftriaxone, ertapenem, meropenem, ciprofloxacin, moxifloxacin, levofloxacin, daptomycin, dalbavancin, linezolid and a beta-lactamase inhibitor: tazobactam. To guarantee the robustness of the quantification, we differentiated the 16 ATBs and the beta lactamase inhibitor into 4 pools (ATB1 to ATB4), taking into account prescription frequency in the ICU, the physicochemical properties and the calibration ranges of the ATBs selected. The whole ATB was then separated with two LC columns in reversed phase: Kinetex Polar-C18 100 Å and Polar-RP-80 synergy, in less than 6.5 min. Detection was carried out by electrospray in positive ion mode, by tandem mass spectrometry (LC-MS/MS. The four quantification methods were validated according to the European guidelines on bioanalytical method validation (EMEA guide), after determining the extraction yields, matrix effects, recovery, precision, accuracy, within-run precision and between-run precision. For all analyses, bias is < 15% and is comparable to the literature and LOQs vary from 0.05 mg.L-1 for ciprofloxacin to 1.00 mg.L-1 for ceftriaxone and dalbavancin. The stability time of cefepime and piperacillin is 3 hrs and for the other ATBs 6 hrs in serum at room temperature. For long-term stability, freezing at - 80 °C guarantees 3 months of stability for ceftriaxone and dalbavancin and more than 6 months for the other ATBs.
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Affiliation(s)
- Patrick Seraissol
- Laboratoire de Pharmacocinétique et Toxicologie, IFB, Hôpital Purpan, 330 Avenue de Grande-Bretagne, 31059 Toulouse Cedex 9, France; Laboratoire Départemental 31, Eau - Vétérinaire - Air, 76 chemin de Boudou, CS 50013, 31140 Launaguet, France
| | - Thomas Lanot
- Laboratoire de Pharmacocinétique et Toxicologie, IFB, Hôpital Purpan, 330 Avenue de Grande-Bretagne, 31059 Toulouse Cedex 9, France
| | - Sarah Baklouti
- Laboratoire de Pharmacocinétique et Toxicologie, IFB, Hôpital Purpan, 330 Avenue de Grande-Bretagne, 31059 Toulouse Cedex 9, France
| | - Camille Mané
- Laboratoire de Pharmacocinétique et Toxicologie, IFB, Hôpital Purpan, 330 Avenue de Grande-Bretagne, 31059 Toulouse Cedex 9, France
| | - Stéphanie Ruiz
- Service de Réanimation Polyvalente Adulte, Hôpital Rangueil, 1 avenue du Professeur Jean Poulhès, 31059 Toulouse Cedex 9, France
| | - Michel Lavit
- Laboratoire de Pharmacocinétique et Toxicologie, IFB, Hôpital Purpan, 330 Avenue de Grande-Bretagne, 31059 Toulouse Cedex 9, France
| | - Pascale De Riols
- Laboratoire de Pharmacocinétique et Toxicologie, IFB, Hôpital Purpan, 330 Avenue de Grande-Bretagne, 31059 Toulouse Cedex 9, France
| | - Jean-Christophe Garrigues
- Laboratoire des IMRCP, Université de Toulouse, UMR 5623, 118 Route de Narbonne, 31062 Toulouse Cedex 9, France.
| | - Peggy Gandia
- Laboratoire de Pharmacocinétique et Toxicologie, IFB, Hôpital Purpan, 330 Avenue de Grande-Bretagne, 31059 Toulouse Cedex 9, France; INTHERES, Université de Toulouse, INRA, ENVT, 23 Chemin des Capelles, BP 87614, 31 076 Toulouse Cedex 3, France
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Methods for Determination of Meropenem Concentration in Biological Samples. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2022. [DOI: 10.2478/sjecr-2022-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Measuring the concentration of antibiotics in biological samples allow implementation of therapeutic monitoring of these drugs and contribute to the adjustment of the dosing regimen in patients. This increases the effectiveness of antimicrobial therapy, reduces the toxicity of these drugs and prevents the development of bacterial resistance. This review article summarizes current knowledge on methods for determining concentration of meropenem, an antibiotic drug from the group of carbapenems, in different biological samples. It provides a brief discussion of the chemical structure, physicochemical and pharmacokinetic properties of meropenem, different sample preparation techniques, use of apparatus and equipment, knowledge of the advantages and limitations of available methods, as well as directions in which new methods should be developed. This review should facilitate clinical laboratories to select and apply one of the established methods for measuring of meropenem, as well as to provide them with the necessary knowledge to develop new methods for quantification of meropenem in biological samples according to their needs.
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