Rapid, sensitive and selective liquid chromatography–tandem mass spectrometry (LC–MS/MS) method for the quantification of topically applied azithromycin in rabbit conjunctiva tissues

An AIE active luminogen derived using 2-hydroxy-1-naphthaldehyde and 3-hydroxy-2-naphthohydrazide for the detection of sparfloxacin and azithromycin

Herein, an aggregation-induced emission (AIE) luminogen (AIEgen) NANH was developed by condensing equimolar amounts of 2-hydroxy-1-naphthaldehyde and 3-hydroxy-2-naphthohydrazide. The AIE behaviour of NANH was explored in a mixed DMSO-H2O (HEPES buffer, pH 7.4, 10 mM) medium. The self-aggregates of NANH show enhanced emission at HEPES fractions (fHEPES) ≥70%. AIEgen NANH (fHEPES 95%, λex = 390 nm, λem = 490 nm) was applied for the fluorescence turn-off sensing of sparfloxacin and azithromycin. With the addition of different analytes, the fluorescence intensity of AIEgen NANH was quenched by sparfloxacin and azithromycin. No noticeable changes in the fluorescence of AIEgen NANH were observed with other added analytes. Experimental evidence supported that the fluorescence quenching of AIEgen NANH by sparfloxacin and azithromycin is static in nature. From the fluorescence titrations, the detection limits of AIEgen NANH were estimated down to 0.64 μM and 0.65 μM for sparfloxacin and azithromycin, respectively. Further, blood serum samples spiked with sparfloxacin and azithromycin were used to examine the analytical utility of AIEgen NANH.

Monitoring Antibiotic Pollutants in Water Using Electrochemical Techniques: A Detailed Review

This review article examines the application of electrochemical methods for detecting four prevalent antibiotics - azithromycin (AZM), amoxicillin (AMX), tetracycline (TC), and ciprofloxacin (CIP) - in environmental monitoring. Although, antibiotics are essential to contemporary treatment, their widespread usage has contaminated the environment and given rise to antibiotic resistance. Electrochemical techniques offer sensitive, rapid, and cost-effective solutions for monitoring these antibiotics, addressing the limitations of traditional methods. The review provides a comprehensive analysis of various electrochemical approaches, including voltammetry, amperometry, photoelectrochemical and so on, highlighting their principles, advantages, and limitations. Key findings underscore the effectiveness of these methods in detecting antibiotics at trace levels in complex environmental matrices. Implications for environmental health and policy are discussed, emphasizing the importance of reliable detection techniques in mitigating antibiotic resistance and safeguarding ecosystems. Lastly, the article outlines future research directions aimed at enhancing the sensitivity, selectivity, and field-applicability of electrochemical sensors, thus advancing their utility in environmental monitoring and public health protection.

Can use of hydroxychloroquine and azithromycin as a treatment of COVID-19 affect aquatic wildlife? A study conducted with neotropical tadpole

The impacts on human health and the economic and social disruption caused by the pandemic COVID-19 have been devastating. However, its environmental consequences are poorly understood. Thus, to assess whether COVID-19 therapy based on the use of azithromycin (AZT) and hydroxychloroquine (HCQ) during the pandemic affects wild aquatic life, we exposed (for 72 h) neotropical tadpoles of the species Physalaemus cuvieri to the water containing these drugs to 12.5 μg/L. We observed that the increase in superoxide dismutase and catalase in tadpoles exposed to AZT (alone or in combination with HCQ) was predominant to keep the production of NO, ROS, TBARS and H2O2 equitable between the experimental groups. In addition, the uptake of AZT and the strong interaction of AZT with acetylcholinesterase (AChE), predicted by the molecular docking analysis, were associated with the anticholinesterase effect observed in the groups exposed to the antibiotic. However, the unexpected increase in butyrylcholinesterase (BChE) in these same groups suggests its constitutive role in maintaining cholinergic homeostasis. Therefore, taken together, our data provide a pioneering evidence that the exposure of P. cuvieri tadpoles to AZT (alone or in combination with HCQ) in a predictably increased environmental concentration (12.5 μg/L) elicits a compensatory adaptive response that can have, in the short period of exposure, guaranteed the survival of the animals. However, the high energy cost for maintaining physiological homeostasis, can compromise the growth and development of animals and, therefore, in the medium-long term, have a general negative effect on the health of animals. Thus, it is possible that COVID-19 therapy, based on the use of AZT, affects wild aquatic life, which requires greater attention to the impacts that this drug may represent.

A review of pretreatment and analysis of macrolides in food (Update Since 2010)

Macrolides are versatile broad-spectrum antibiotics whose activity stems from the presence of a macrolide ring. They are widely used in veterinary medicine to prevent and treat disease. However, because of their improper use and the absence of effective regulation, these compounds pose a threat to human health and the environment. Consequently, simple, quick, economical, and effective techniques are required to analyze macrolides in animal-derived foods, biological samples, and environmental samples. This paper presents a comprehensive overview of the pretreatment and analytical methods used for macrolides in various sample matrices, focusing on the developments since 2010. Pretreatment methods mainly include liquid-liquid extraction, solid-phase extraction, matrix solid-phase dispersion, and microextraction methods. Detection and quantification methods mainly include liquid chromatography (coupled to mass spectrometry or other detectors), electrochemical methods, capillary electrophoresis, and immunoassays. Furthermore, a comparison between the pros and cons of these methods and prospects for future developments are also discussed.

Detection of azithromycin residue in broiler feathers by liquid chromatography-tandem mass spectrometry

In the study, a sensitive and reproducible method for the quantitative analysis of azithromycin in broiler feather samples by liquid chromatography-tandem mass spectrometry (LC-MS/MS) was developed. Feather samples were rinsed after being wrapped in medical gauze, then chopped and then added to 5% (v/v) ammonia in methanol solution for ultrasonic extraction. The extract was purified by the combination of commercial polymeric microparticles (Oasis MCX) and Fe₃O₄ nanoparticles. The LC separation was performed on an Agilent Eclipse plus C18 column. Multiple reaction monitoring was used for the selective detection of azithromycin. The good linearity curve of azithromycin in feather sample was in the range from 1.0 μg kg^-1 to 100.0 μg kg^-1 with 0.9935 of correlation coefficient. And the limit detection and limit of quantification was 0.5 μg kg^-1 and 2.0 μg kg^-1 in spiked feather samples. The recoveries of azithromycin were 85.2-94.7% with the relative standard deviation less than 10%. The established method is simple, rapid, sensitive and specific, and could meet the need of government and enterprises to monitor the illegal use of azithromycin in livestock and poultry breeding.

Pharmacokinetic interaction between shuanghuanglian and azithromycin injection: a nonlinear mixed-effects model analysis in rats

1. This study aimed to evaluate the pharmacokinetic interaction of shuanghuanglian (SHL) and azithromycin in rats, and to provide experimental support for rational drug use in clinics. 2. High-performance liquid chromatography with ultraviolet detection (HPLC-UV) and high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) approaches were respectively developed to detect the forsythiaside (active component of SHL) and azithromycin concentrations. Both non-compartmental and compartmental analyzes were employed to calculate pharmacokinetic parameters. A nonlinear mixed-effects modeling method was applied to fit the drug concentration-time data. The influence of drug coadministration on pharmacokinetic parameters was tested using forward inclusion and backward elimination procedures. 3. After drug co-administration, areas under the drug concentration-time curve (AUC) and half-lives (T_1/2) of both azithromycin and forsythiaside increased significantly, meanwhile, the drug clearance (CL) decreased compared to single drug administration. Both forsythiaside and azithromycin exposures increased after coadministration. Two-compartment models were suitable to describe the in vivo behavior of both azithromycin and forsythiaside. The coadministration of SHL could significantly decrease the central volume of azithromycin (V_CA) and forsythiaside clearance (CL_F) decreased after co-intravenous administration of azithromycin. 4. Co-intravenous administration of forsythiaside and azithromycin could significantly increase drug exposures for both drugs. Lower dose can provide sufficient drug exposure to obtain antibacterial activity. The coadministration may be a potential method to increase therapy efficiency while decrease adverse drug reactions.

Measurement of tissue azithromycin levels in self-collected vaginal swabs post treatment using liquid chromatography and tandem mass spectrometry (LC-MS/MS)

BACKGROUND

Azithromycin is recommended for the treatment of uncomplicated urogenital chlamydia infection although the standard 1gram dose sometimes fails to eradicate the infection (treatment failure). One hypothesis proposed for treatment failure has been insufficient levels of the antibiotic at the site of infection. We developed an assay using liquid chromatography and tandem mass spectrometry (LC-MS/MS) to measure azithromycin concentration in high-vaginal swabs and monitor how concentration changes over time following routine azithromycin treatment.

METHODS

Azithromycin concentrations were measured in two groups of women either within the first 24h of taking a 1g dose (N = 11) or over 9 days (N = 10). Azithromycin concentrations were normalised to an internal standard (leucine enkephalin), and the bulk lipid species phosphatidylcholine [PC(34:1)], using an Agilent 6490 triple quadrupole instrument in positive ionisation mode. The abundances of azithromycin, PC(34:1), and leu-enkephalin were determined by multiple reaction monitoring and absolute levels of azithromycin estimated using standard curves prepared on vaginal specimens.

RESULTS

Vaginal azithromycin concentrations of women were rapidly obtained after 5h post-treatment (mean concentration = 1031mcg/mg of lipid, range = 173-2693mcg/mg). In women followed for 9 days, peak concentrations were highest after day 2 (mean concentration = 2206mcg/mg, range = 721-5791mcg/mg), and remained high for at least 9 days with a mean concentration of 384mcg/mg (range = 139-1024mcg/mg) on day 9.

CONCLUSION

Our study confirmed that a single 1g dose of azithromycin is rapidly absorbed and remains in the vagina at relatively high levels for at least a week, suggesting that poor antibiotic absorption is unlikely to be an explanation for treatment failure.

Pharmacokinetics of a single 1g dose of azithromycin in rectal tissue in men

Chlamydia is the most common bacterial sexually transmitted infection among men who have sex with men. Repeat infection following treatment with 1g azithromycin is common and treatment failure of up to 22% has been reported. This study measured the pharmacokinetics of azithromycin in rectal tissue in men following a single 1g dose to assess whether azithromycin reaches the rectal site in adequate concentrations to kill chlamydia. Ten healthy men took a single oral dose of 1g azithromycin and provided nine self-collected swabs and one blood sample over 14 days. Participant demographics, medications, sexual behaviour, treatment side effects, lubricant use and douching practices were recorded with each swab. Drug concentration over time was determined using liquid chromatography-mass spectrometry and total exposure (AUC0-∞) was estimated from the concentration-time profiles. Following 1g of azithromycin, rectal concentrations peaked after a median of 24 hours (median 133mcg/g) and remained above the minimum inhibitory concentration for chlamydia (0.125mcg/mL) for at least 14 days in all men. AUC0-∞ was the highest ever reported in human tissue (13103((mcg/g).hr)). Tissue concentrations were not associated with weight (mg/kg), but data suggest that increased gastric pH could increase azithromycin levels and diarrhoea or use of water-based lubricants could decrease concentrations. High and sustained concentrations of azithromycin were found in rectal tissue following a single 1g dose suggesting that inadequate concentrations are unlikely to cause treatment failure. Factors effecting absorption (pH and diarrhoea) or drug depletion (douching and water-based lubricants) may be more important determinants of concentrations in situ.

Transport of Azithromycin into Extravascular Space in Rats

Recent clinical trials showed a prolonged retention of subinhibitory concentrations of unbound azithromycin in the interstitial fluid of soft tissues despite the fact that azithromycin is extensively distributed in tissues. In these clinical trials, interstitial fluid samples were obtained by using the microdialysis method, and it was established that drug concentrations represent protein-unbound drug concentrations. The present study was designed to measure total azithromycin concentrations in the interstitial fluid of the skin of rats by directly collecting interstitial fluid samples from a pore formed on the skin by a dissolving microneedle array. The total azithromycin concentrations in interstitial fluid of the skin were about 4 to 5 times higher than those in plasma throughout the experimental period, and stasis of the azithromycin concentration in interstitial fluid was observed when the concentration of azithromycin in plasma was at the lower limit of quantification. In addition, the skin/plasma concentration ratio transiently increased after dosing (from 4.3 to 83.1). Our results suggest that azithromycin was trapped inside white blood cells and/or phagocytic cells in not only blood but also interstitial fluid, resulting in a high total azithromycin concentration and the retention of its antimicrobial activity at the primary infection site. The stasis of azithromycin in interstitial fluid and skin would lead to long-lasting pharmacological effects (including those against skin infection) at concentrations exceeding the MIC.

An optimal LC-MS/MS method for determination of azithromycin in white blood cells: application to pediatric samples

Background: Studies suggest that particular antimicrobial and anti-inflammatory properties of azithromycin (AZM) can be related to its extensive accumulation in white blood cells (WBCs). However, available methods for determination of AZM in WBCs require large blood volumes unsuited to a pediatric context. Therefore, an LC-MS/MS method was developed for determination of AZM in WBCs. Results: WBCs were isolated from 500 µl of whole blood by lysing red blood cells. Then, lysis of WBCs was performed with methanol/buffer containing AZM-d3-13C as internal standard. After reversed phase LC, detection was performed under multiple reaction monitoring conditions in positive electrospray mode. Linearity ranged from 0.5 to 200 ng per WBC sample. Within-run and overall accuracy and precision ranged from 95.3 to 101.1% and from 1.6 to 4.7%, respectively. All validation parameters fulfilled international requirements. Conclusions: This method can be easily performed on small samples and provides reliable data, including in children and neonates.

A liquid chromatography-mass spectrometric method for the quantification of azithromycin in human plasma

A liquid chromatographic mass spectrometric assay for the quantification of azithromycin in human plasma was developed. Azithromycin and imipramine (as internal standard, IS) were extracted from 0.5 mL human plasma using extraction with diethyl ether under alkaline conditions. Chromatographic separation of drug and IS was performed using a C18 column at room temperature. A mobile phase consisting of methanol, water, ammonium hydroxide and ammonium acetate was pumped at 0.2 mL/min. The mass spectrometer was operated in positive ion mode and selected ion recording acquisition mode. The ions utilized for quantification of azithromycin and IS were m/z 749.6 (M + H)(+) and m/z 591.4 (fragment) for azithromycin, and 281.1 m/z for internal standard; retention times were 6.9 and 3.4 min, respectively. The calibration curves were linear (r(2) > 0.999) in the concentration ranges of 10-1000 ng/mL. The mean absolute recoveries for 50 and 500 ng/mL azithromycin and 1 µg/ mL IS were >75%. The percentage coefficient of variation and mean error were <11%. Based on validation data, the lower limit of quantification was 10 ng/mL. The present method was successfully applied to determine azithromycin pharmacokinetic parameters in two obese volunteers. The assay had applicability for use in pharmacokinetic studies.

Bioanalysis of drug in tissue: current status and challenges

Distribution of drugs into tissues is an important determinant of the overall PK and PD profile. Thus, bioanalysis of drugs and their metabolites in tissues can play an important role in understanding the pharmacological and toxicological properties of new drug candidates. Unlike liquid matrices, bioanalysis in tissues offers unique challenges such as proper tissue sampling, appropriate tissue sample preparation, efficient extraction of the analytes from the tissue homogenates, and demonstration of stability and recovery of analytes in intact tissues. This article provides a systematic review of tissue sample analysis for small molecules using LC–MS/MS. The authors provide rationale for tissue sample analysis, and discuss strategies for method development, method qualification or validation, and sample analysis. Unique aspects of method development and qualification/validation are highlighted based on authors’ direct experiences and literature summary. Analysis using intact tissue samples such as MALDI imaging is also briefly discussed.