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Dalla Zuanna P, Curci D, Lucafò M, Addobbati R, Fabretto A, Stocco G. Preanalytical Stability of 13 Antibiotics in Biological Samples: A Crucial Factor for Therapeutic Drug Monitoring. Antibiotics (Basel) 2024; 13:675. [PMID: 39061358 PMCID: PMC11274111 DOI: 10.3390/antibiotics13070675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Revised: 07/16/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024] Open
Abstract
The stability of antibiotic preanalytical samples is a critical factor in therapeutic drug monitoring (TDM), a practice of undoubted importance for the proper therapeutic use of antibiotics, especially in complex management patients, such as pediatrics. This review aims to analyze the data in the literature regarding the preanalytical stability of some of the antibiotics for which TDM is most frequently requested. The literature regarding the preanalytical stability of amikacin, ampicillin, cefepime, ceftazidime, ciprofloxacin, daptomycin, gentamicin, levofloxacin, linezolid, meropenem, piperacillin, teicoplanin, and vancomycin in plasma, serum, whole blood, and dried blood/plasma spot samples was analyzed. Various storage temperatures (room temperature, 4 °C, -20 °C, and -80 °C) and various storage times (from 1 h up to 12 months) as well as subjecting to multiple freeze-thaw cycles were considered. The collected data showed that the non-beta-lactam antibiotics analyzed were generally stable under the normal storage conditions used in analytical laboratories. Beta-lactam antibiotics have more pronounced instability, particularly meropenem, piperacillin, cefepime, and ceftazidime. For this class of antibiotics, we suggest that storage at room temperature should be limited to a maximum of 4 h, storage at 2-8 °C should be limited to a maximum of 24 h, and storage at -20 °C should be limited to a maximum of 7 days; while, for longer storage, freezing at -80 °C is suggested.
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Affiliation(s)
- Paolo Dalla Zuanna
- Clinical and Experimental Pharmacology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, 33081 Aviano, Italy;
| | - Debora Curci
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34137 Trieste, Italy; (D.C.); (R.A.); (A.F.)
| | - Marianna Lucafò
- Department of Life Science, University of Trieste, 34127 Trieste, Italy;
| | - Riccardo Addobbati
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34137 Trieste, Italy; (D.C.); (R.A.); (A.F.)
| | - Antonella Fabretto
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34137 Trieste, Italy; (D.C.); (R.A.); (A.F.)
| | - Gabriele Stocco
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, 34137 Trieste, Italy; (D.C.); (R.A.); (A.F.)
- Department of Medical, Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy
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Liu T, Chen L, Yu P, Li Q, Lou J. Development and Validation of a Strong Cation Exchange Chromatographic Column Coupled with High-Performance Liquid Chromatography Method for Meropenem and Evaluation of Its Stability in Human Plasma: Application to the Therapeutic Drug Monitoring. J Chromatogr Sci 2023; 61:656-664. [PMID: 36349369 DOI: 10.1093/chromsci/bmac086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Indexed: 08/22/2023]
Abstract
Meropenem is a wide inter-individual variability in the pharmacokinetic, and standard dosing may not be adequate in critically ill patients. Therapeutic drug monitoring is a useful tool to optimize dosing. Meropenem is the amphoteric compound with an isoelectric point of 5.15. The secondary amino group of meropenem is positively charged when pH ≤ 5.4, thus we attempted to separate by strong cation exchange (SCX) column using acetonitrile/25-mM potassium dihydrogen phosphate (pH 3.0; 60:40) as mobile phase, and good peak shape and effective separation obtained. Generally, meropenem were unstable in plasma. We try to investigate stability of plasma samples using the medium QC sample with or without 3-(N-morpholino) propanesulfonic acid (MOPS) as stabilizer solutions at possible conditions during handling and storage. Meropenem showed higher stability at -80°C, and addition of MOPS might increase the short-term and extracted samples stability. This method is suitable for the quantification of meropenem in human plasma from 0.5 to 100 μg/mL. The accuracy was ranged from 96.53 to 101.11% with relative standard deviation ≤ 4.76%. The method has been used for determined 63 critically ill patients treated with meropenem. During the first measurement, 11 patients showed trough levels below the target ranges despite standard dosing. Through continuous or prolonged infusion, 8/11 patients (72.73%) led to adequate trough levels. The described SCX-high-performance liquid chromatography method for meropenem in human plasma is a powerful tool for therapeutic drug monitoring.
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Affiliation(s)
- Ting Liu
- Department of Pharmacy, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, China
- Department of Clinical Pharmacy, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, China
| | - Ling Chen
- Department of Pharmacy, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, China
| | - Panpan Yu
- Department of General Surgery, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, China
| | - Qingyu Li
- Department of Pharmacy, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, China
| | - Jiang Lou
- Department of Pharmacy, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, China
- Department of Clinical Pharmacy, Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, No. 261 Huansha Road, Hangzhou 310006, China
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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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Patil K, Pathan A, Naik S, Zope V, Chavan R, Yeole R. Simultaneous determination of novel β‐lactamase inhibitor WCK 4234 and Meropenem in dog plasma by LC–MS/MS and its application to preclinical pharmacokinetic study. Biomed Chromatogr 2022; 36:e5377. [DOI: 10.1002/bmc.5377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/01/2022] [Accepted: 03/25/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Kiran Patil
- Wockhardt Research Centre, D‐4, MIDC, Chikalthana Aurangabad India
| | - Amin Pathan
- Wockhardt Research Centre, D‐4, MIDC, Chikalthana Aurangabad India
| | - Sukanta Naik
- Wockhardt Research Centre, D‐4, MIDC, Chikalthana Aurangabad India
| | - Vineet Zope
- Wockhardt Research Centre, D‐4, MIDC, Chikalthana Aurangabad India
| | - Rajesh Chavan
- Wockhardt Research Centre, D‐4, MIDC, Chikalthana Aurangabad India
| | - Ravindra Yeole
- Wockhardt Research Centre, D‐4, MIDC, Chikalthana Aurangabad India
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Roth T, Weber L, Niestroj M, Cipa F, Löscher A, Mihai S, Parsch H. Simultaneous determination of six antibiotics in human serum by high-performance liquid chromatography with UV detection. Biomed Chromatogr 2020; 35:e5010. [PMID: 33119907 DOI: 10.1002/bmc.5010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 10/02/2020] [Accepted: 10/16/2020] [Indexed: 11/07/2022]
Abstract
Antibiotics are widely used in intensive care patients to treat severe infections. To avoid bacterial resistance or toxic side effects, the determination of serum concentration of ABs is advisable. Therefore, in this study, we developed and validated a simple and fast high-performance liquid chromatography method with UV detection for the simultaneous determination of four β-lactam ABs (meropenem, imipenem, ceftazidime, and piperacillin) and two coadministered substances (cilastatin and tazobactam) in human serum. Sample preparation required a simple protein precipitation by methanol. The separation of the ABs occurred within a timeframe of 17 min. For this purpose, we used a Kinetex F5 column with a linear gradient of acetonitrile and phosphate buffer (pH 6.9). The UV detector recorded two separate chromatograms at 220 and 295 nm simultaneously. Validation has demonstrated that the method is linear, accurate, and precise within the clinically relevant range for each substance.
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Affiliation(s)
- Thomas Roth
- Central Laboratory, University Hospital Erlangen, Erlangen, Germany
| | - Lea Weber
- Central Laboratory, University Hospital Erlangen, Erlangen, Germany
| | - Marion Niestroj
- Central Laboratory, University Hospital Erlangen, Erlangen, Germany
| | - Franziska Cipa
- Central Laboratory, University Hospital Erlangen, Erlangen, Germany
| | - Astrid Löscher
- Central Laboratory, University Hospital Erlangen, Erlangen, Germany
| | - Sidonia Mihai
- Central Laboratory, University Hospital Erlangen, Erlangen, Germany
| | - Hans Parsch
- Central Laboratory, University Hospital Erlangen, Erlangen, Germany
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Burger R, Guidi M, Calpini V, Lamoth F, Decosterd L, Robatel C, Buclin T, Csajka C, Marchetti O. Effect of renal clearance and continuous renal replacement therapy on appropriateness of recommended meropenem dosing regimens in critically ill patients with susceptible life-threatening infections. J Antimicrob Chemother 2019; 73:3413-3422. [PMID: 30304491 DOI: 10.1093/jac/dky370] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 08/20/2018] [Indexed: 12/15/2022] Open
Abstract
Background Meropenem plasma concentration above a pathogen's MIC over the whole dosing interval (100% ƒT>MIC) is a determinant of outcome in severe infections. Significant variability of meropenem pharmacokinetics is reported in ICU patients. Objectives To characterize meropenem pharmacokinetics in variable CLCR or renal replacement therapy and assess the appropriateness of recommended regimens for MIC coverage. Methods A pharmacokinetic analysis (NONMEM) was conducted with external model validation. Patient characteristics were tested on meropenem clearance estimates, differentiated according to the presence/absence of continuous renal replacement therapy (CRRT, CLCRRT or CLno-CRRT). Simulations evaluated the appropriateness of recommended dosing for achieving 100% fT>MIC in 90% of patients. Results A total of 101 patients were studied: median 63 years (range 49-70), 56% male, SAPS II 38 (27-48). 32% had a CLCR >60 mL/min, 49% underwent CRRT and 32% presented severe sepsis or septic shock. A total of 127 pathogens were documented: 76% Gram-negatives, 24% Gram-positives (meropenem MIC90 2 mg/L, corresponding to EUCAST susceptibility breakpoint). Three hundred and eighty plasma and 129 filtrate-dialysate meropenem concentrations were analysed: two-compartment modelling best described the data. Predicted meropenem CLno-CRRT was 59% lower in impaired (CLCR 30 mL/min) compared to normal (CLCR 100 mL/min) renal function. Simulations showed that recommended regimens appropriately cover MIC90 in patients with CLCR <60 mL/min. Patients with CLCR of 60 to <90 mL/min need 6 g/day to achieve appropriate coverage. In patients with CLCR ≥90 mL/min, appropriate exposure is achieved with increased dose, frequency of administration and infusion duration, or continuous infusion. Conclusions Recommended meropenem regimens are suboptimal in ICU patients with normal or augmented renal clearance. Modified dosing or infusion modalities achieve appropriate MIC coverage for optimized antibacterial efficacy in meropenem-susceptible life-threatening infections.
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Affiliation(s)
- Raphaël Burger
- Internal Medicine Service, Department of Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,Infectious Diseases Service, Department of Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Monia Guidi
- Clinical Pharmacology Service, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland
| | - Valérie Calpini
- School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland
| | - Frédéric Lamoth
- Infectious Diseases Service, Department of Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,Institute of Microbiology, Department of Laboratories, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Laurent Decosterd
- Clinical Pharmacology Service, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Corinne Robatel
- Clinical Pharmacology Service, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Thierry Buclin
- Clinical Pharmacology Service, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Chantal Csajka
- Clinical Pharmacology Service, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland
| | - Oscar Marchetti
- Infectious Diseases Service, Department of Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,Department of Medicine, Ensemble Hospitalier de la Côte, Morges, Switzerland
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Zou L, Meng F, Hu L, Huang Q, Liu M, Yin T. A novel reversed-phase high-performance liquid chromatographic assay for the simultaneous determination of imipenem and meropenem in human plasma and its application in TDM. J Pharm Biomed Anal 2019; 169:142-150. [PMID: 30861406 DOI: 10.1016/j.jpba.2019.01.039] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 12/24/2018] [Accepted: 01/25/2019] [Indexed: 11/30/2022]
Abstract
A rapid and specific reversed-phase high-performance liquid chromatographic (RP-HPLC) assay with UV detection has been developed and validated for the simultaneous determination of imipenem and meropenem in human plasma. The extraction process was performed through protein precipitation method using acetonitrile and dichloromethane, and the recoveries of quality controls (QCs) were > 91.5%. Isocratic elution followed by gradient elution of acetonitrile and water was employed over a C18 analytical column for separation. The detection was performed at 298 nm. This method was accurate and reproducible (coefficient of variation, CV < 8%), allowing quantification of carbapenem at the plasma-level ranges from 0.1 to 100 μg/ml without interference of any of the 30 frequently prescribed drugs. Stabilities of imipenem and meropenem were determined with or without stabilizer solutions at -80°C, -20°C, +4 °C and room temperature 20°C. These two drugs showed higher stability at the low temperatures. Addition of 3-(N-morpholino) propanesulfonic acid (MOPS) might also increase their stability. The results of therapeutic drug monitoring (TDM) in neonates and adults showed high inter- and intra- individual variabilities in the trough concentrations of imipenem and meropenem, thus confirming the importance and necessity of TDM. For neonatal patients, imipenem 20 mg/kg, q12h (40mg/kg/day) failed to produce significant therapeutic effects, and either the dose or the frequency was adjusted to achieve 60mg/kg/day or above to maintain the trough concentration required for the curative effect. The low operational cost and good separation efficiency would help implement this assay for the routine therapeutic drug monitoring of imipenem and meropenem in hospitals.
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Affiliation(s)
- Le Zou
- Pharmacy department, Xiangya Hospital, Central south university, No. 87, Xiangya Road, Changsha, 410008, Hunan Province, China.
| | - Fanqi Meng
- Xiangya School of Pharmaceutical Sciences, Central South University, No. 172, Tongzipo Road, Changsha, 410013, Hunan Province, China.
| | - Lin Hu
- Pharmacy department, Xiangya Hospital, Central south university, No. 87, Xiangya Road, Changsha, 410008, Hunan Province, China.
| | - Qi Huang
- Pharmacy department, Xiangya Hospital, Central south university, No. 87, Xiangya Road, Changsha, 410008, Hunan Province, China.
| | - Min Liu
- Pharmacy department, Xiangya Hospital, Central south university, No. 87, Xiangya Road, Changsha, 410008, Hunan Province, China.
| | - Tao Yin
- Pharmacy department, Xiangya Hospital, Central south university, No. 87, Xiangya Road, Changsha, 410008, Hunan Province, China.
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Ferrone V, Cotellese R, Cichella A, Raimondi P, Carlucci M, Palumbo P, Carlucci G. Meropenem and ciprofloxacin in complicated gastric surgery for cancer patients: A simple SPE–UHPLC–PDA method for their determination in human plasma. Biomed Chromatogr 2019; 33:e4450. [DOI: 10.1002/bmc.4450] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 11/15/2018] [Accepted: 11/27/2018] [Indexed: 11/10/2022]
Affiliation(s)
- Vincenzo Ferrone
- Dipartimento di FarmaciaOrali e Biotecnologiche ‐ Università degli Studi “G. d'Annunzio” Chieti‐Pescara Chieti Italy
| | - Roberto Cotellese
- Dipartimento di Scienze MedicheOrali e Biotecnologiche ‐ Università degli Studi “G. d'Annunzio” Chieti‐Pescara Chieti Italy
| | - Annadomenica Cichella
- Dipartimento di Scienze MedicheOrali e Biotecnologiche ‐ Università degli Studi “G. d'Annunzio” Chieti‐Pescara Chieti Italy
| | - Paolo Raimondi
- Dipartimento di Scienze MedicheOrali e Biotecnologiche ‐ Università degli Studi “G. d'Annunzio” Chieti‐Pescara Chieti Italy
| | - Maura Carlucci
- Dipartimento di Scienze MedicheOrali e Biotecnologiche ‐ Università degli Studi “G. d'Annunzio” Chieti‐Pescara Chieti Italy
| | - Paola Palumbo
- Dipartimento di Medicina Clinica, Sanità PubblicaScienze della Vita e dell'Ambiente ‐ Università degli studi di L'Aquila L'Aquila Italy
| | - Giuseppe Carlucci
- Dipartimento di FarmaciaOrali e Biotecnologiche ‐ Università degli Studi “G. d'Annunzio” Chieti‐Pescara Chieti Italy
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Determination of meropenem levels in human serum by high-performance liquid chromatography with ultraviolet detection. Biomed Chromatogr 2017; 31. [DOI: 10.1002/bmc.3880] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 10/10/2016] [Accepted: 10/28/2016] [Indexed: 11/07/2022]
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Fournier A, Eggimann P, Pagani JL, Revelly JP, Decosterd LA, Marchetti O, Pannatier A, Voirol P, Que YA. Impact of the introduction of real-time therapeutic drug monitoring on empirical doses of carbapenems in critically ill burn patients. Burns 2015; 41:956-68. [PMID: 25678084 DOI: 10.1016/j.burns.2015.01.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 12/15/2014] [Accepted: 01/05/2015] [Indexed: 01/10/2023]
Abstract
PURPOSE Adequate empirical antibiotic dose selection for critically ill burn patients is difficult due to extreme variability in drug pharmacokinetics. Therapeutic drug monitoring (TDM) may aid antibiotic prescription and implementation of initial empirical antimicrobial dosage recommendations. This study evaluated how gradual TDM introduction altered empirical dosages of meropenem and imipenem/cilastatin in our burn ICU. METHODS Imipenem/cilastatin and meropenem use and daily empirical dosage at a five-bed burn ICU were analyzed retrospectively. Data for all burn admissions between 2001 and 2011 were extracted from the hospital's computerized information system. For each patient receiving a carbapenem, episodes of infection were reviewed and scored according to predefined criteria. Carbapenem trough serum levels were characterized. Prior to May 2007, TDM was available only by special request. Real-time carbapenem TDM was introduced in June 2007; it was initially available weekly and has been available 4 days a week since 2010. RESULTS Of 365 patients, 229 (63%) received antibiotics (109 received carbapenems). Of 23 TDM determinations for imipenem/cilastatin, none exceeded the predefined upper limit and 11 (47.8%) were insufficient; the number of TDM requests was correlated with daily dose (r=0.7). Similar numbers of inappropriate meropenem trough levels (30.4%) were below and above the upper limit. Real-time TDM introduction increased the empirical dose of imipenem/cilastatin, but not meropenem. CONCLUSIONS Real-time carbapenem TDM availability significantly altered the empirical daily dosage of imipenem/cilastatin at our burn ICU. Further studies are needed to evaluate the individual impact of TDM-based antibiotic adjustment on infection outcomes in these patients.
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Affiliation(s)
- Anne Fournier
- Service of Pharmacy, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland
| | - Philippe Eggimann
- Service of Intensive Care Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Jean-Luc Pagani
- Service of Intensive Care Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Jean-Pierre Revelly
- Service of Intensive Care Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Laurent A Decosterd
- Service of Biomedicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Oscar Marchetti
- Service of Infectious Diseases, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - André Pannatier
- Service of Pharmacy, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Pierre Voirol
- Service of Pharmacy, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland; School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, Geneva, Switzerland
| | - Yok-Ai Que
- Service of Intensive Care Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
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Casals G, Hernández C, Hidalgo S, Morales B, López-Púa Y, Castro P, Fortuna V, Martínez JA, Brunet M. Development and validation of a UHPLC diode array detector method for meropenem quantification in human plasma. Clin Biochem 2014; 47:223-7. [PMID: 25128839 DOI: 10.1016/j.clinbiochem.2014.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 07/11/2014] [Accepted: 08/02/2014] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Meropenem is a β-lactam antibiotic frequently used to treat serious infections in intensive care unit patients. The main objective was to develop and validate a sensitive and specific ultra high performance liquid chromatography method with photodiode array detection for the quantitation of meropenem in human plasma. The applicability of the method for meropenem monitoring was also examined. DESIGN AND METHODS The validation of the method was performed following the FDA's guidelines for bioanalytical methods. In parallel, the method was applied for monitoring meropenem in forty plasma samples from ten critically ill patients treated intravenously at a total dose of 1 g. Drug levels were measured in each patient at 0 h, 2 h, 4 h and 8 h after meropenem infusion. RESULTS With this method, intraday and day-to-day variation was below 10%; intraday and day-to-day accuracy was between 94% and 114%; the limit of quantification was 0.5 μg/mL and recovery was above 70%. The method was successfully applied to quantitate meropenem concentrations and the results showed significant pharmacokinetic interindividual variability. Of special interest is that 50% of treated patients had meropenem plasma levels below the minimum inhibitory concentration at 8h after the start of infusion, which was strongly related to creatinine clearance >60 mL/min. CONCLUSIONS The method meets the requirements to be applied for meropenem concentration measurements in pharmacokinetics studies and clinical routine. The results suggest the need for therapeutic drug monitoring of meropenem in treated critically-ill patients.
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Affiliation(s)
- Gregori Casals
- Pharmacology and Toxicology Laboratory, Biochemistry and Molecular Genetics, Centro de Diagnóstico Biomédico, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), IDIBAPS, Hospital Clínic de Barcelona, Barcelona University, C/Villarroel 170, 08036 Barcelona, Spain.
| | - Cristina Hernández
- Department of Infectious Diseases, Hospital Clínic-IDIBAPS, Barcelona Centre for International Health Research (CRESIB, Universitat de Barcelona), Barcelona, Spain
| | - Susana Hidalgo
- Pharmacology and Toxicology Laboratory, Biochemistry and Molecular Genetics, Centro de Diagnóstico Biomédico, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), IDIBAPS, Hospital Clínic de Barcelona, Barcelona University, C/Villarroel 170, 08036 Barcelona, Spain
| | - Blai Morales
- Pharmacology and Toxicology Laboratory, Biochemistry and Molecular Genetics, Centro de Diagnóstico Biomédico, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), IDIBAPS, Hospital Clínic de Barcelona, Barcelona University, C/Villarroel 170, 08036 Barcelona, Spain
| | - Yolanda López-Púa
- Direcció de Qualitat i Seguretat Clínica, Hospital Clínic, Barcelona, Spain
| | - Pedro Castro
- Medical Intensive Care Unit, Hospital Clínic, IDIBAPS, Barcelona Centre for International Health Research (CRESIB, Universitat de Barcelona), Barcelona, Spain
| | - Virginia Fortuna
- Pharmacology and Toxicology Laboratory, Biochemistry and Molecular Genetics, Centro de Diagnóstico Biomédico, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), IDIBAPS, Hospital Clínic de Barcelona, Barcelona University, C/Villarroel 170, 08036 Barcelona, Spain
| | - José Antonio Martínez
- Department of Infectious Diseases, Hospital Clínic-IDIBAPS, Barcelona Centre for International Health Research (CRESIB, Universitat de Barcelona), Barcelona, Spain
| | - Mercè Brunet
- Pharmacology and Toxicology Laboratory, Biochemistry and Molecular Genetics, Centro de Diagnóstico Biomédico, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), IDIBAPS, Hospital Clínic de Barcelona, Barcelona University, C/Villarroel 170, 08036 Barcelona, Spain
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12
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Measurement of meropenem concentration in different human biological fluids by ultra-performance liquid chromatography-tandem mass spectrometry. Anal Bioanal Chem 2014; 406:4997-5007. [DOI: 10.1007/s00216-014-7910-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 05/14/2014] [Accepted: 05/17/2014] [Indexed: 10/25/2022]
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13
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Dailly E, Bouquié R, Deslandes G, Jolliet P, Le Floch R. A liquid chromatography assay for a quantification of doripenem, ertapenem, imipenem, meropenem concentrations in human plasma: application to a clinical pharmacokinetic study. J Chromatogr B Analyt Technol Biomed Life Sci 2011; 879:1137-42. [PMID: 21474395 DOI: 10.1016/j.jchromb.2011.03.038] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2011] [Revised: 03/11/2011] [Accepted: 03/20/2011] [Indexed: 11/18/2022]
Abstract
A simple chromatographic assay based on ultra high performance liquid chromatography with ultraviolet detection at 295 nm is proposed to determinate simultaneously human plasma concentrations of imipenem, doripenem, meropenem and ertapenem. After deproteinization by acetonitrile, carbapenems are separated on a PentaFluoroPhenyl column with a binary gradient elution. This method is specific, accurate, precise (the intra-day and inter-day imprecision and inaccuracy are lower than 15%), sensitive (the limit of quantitation is equal to 0.50 mg/L for imipenem, doripenem, ertapenem, meropenem) and not time consuming (run time=7 min). An application of this method to measure ertapenem plasma concentrations in burn patients is presented.
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Affiliation(s)
- E Dailly
- Clinical Pharmacology Department, CHU de Nantes, Nantes, France.
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14
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Kipper K, Anier K, Leito I, Karjagin J, Oselin K, Herodes K. Rapid Determination of Meropenem in Biological Fluids by LC: Comparison of Various Methods for Sample Preparation and Investigation of Meropenem Stability. Chromatographia 2009. [DOI: 10.1365/s10337-009-1304-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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15
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Ikeda K, Ikawa K, Morikawa N, Miki M, Nishimura SI, Kobayashi M. High-performance liquid chromatography with ultraviolet detection for real-time therapeutic drug monitoring of meropenem in plasma. J Chromatogr B Analyt Technol Biomed Life Sci 2007; 856:371-5. [PMID: 17581801 DOI: 10.1016/j.jchromb.2007.05.043] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2007] [Revised: 05/21/2007] [Accepted: 05/23/2007] [Indexed: 10/23/2022]
Abstract
A simple, rapid, and precise high-performance liquid chromatography (HPLC) method using ultrafiltration to remove plasma protein was developed to determine meropenem concentrations in human plasma in a clinical setting. Plasma was separated by centrifugation at 4 degrees C from blood collected in heparinized vacuum tubes, and meropenem was stabilized by immediately mixing the plasma with 1M 3-morpholinopropanesulfonic acid buffer (pH 7.0) (1:1). Ultrafiltration was used for plasma deproteinization. Meropenem was detected by ultraviolet absorbance at 300 nm with no interfering plasma peak. The calibration curve of meropenem in human plasma was linear from 0.05 to 100 microg/mL. Intraday and interday precision was less than 7.17% (CV), and accuracy was between 97.7% and 106.3% over 0.05 microg/mL. The limit of detection was 0.01 microg/mL. The assay has been clinically applied to a real-time therapeutic drug monitoring in pediatric patients and pharmacokinetic studies.
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Affiliation(s)
- Kayo Ikeda
- Department of Clinical Pharmacotherapy, Graduate School of Biomedical Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima 734-8551, Japan.
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16
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Chou YW, Yang YH, Chen JH, Kuo CC, Chen SH. Quantification of meropenem in plasma and cerebrospinal fluid by micellar electrokinetic capillary chromatography and application in bacterial meningitis patients. J Chromatogr B Analyt Technol Biomed Life Sci 2007; 856:294-301. [PMID: 17625990 DOI: 10.1016/j.jchromb.2007.06.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Revised: 06/11/2007] [Accepted: 06/19/2007] [Indexed: 11/22/2022]
Abstract
A high-performance micellar electrokinetic capillary chromatography (MEKC) has been demonstrated for the determination of meropenem in human plasma and in cerebrospinal fluid (CSF) and application in meningitis patients after intravenous (IV) administration. Plasma sample was pretreated by means of solid-phase extraction (SPE) on C(18) cartridge and CSF sample was by direct injection without sample pretreatment, with subsequent quantitation by MEKC. The separation of meropenem was carried out in an untreated fused-silica capillary (40.2 cm x 50 microm I.D., effective length 30 cm) and was performed at 25 degrees C using a background electrolyte consisting of Tris buffer (40 mM, pH 8.0) solution with sodium dodecyl sulfate (SDS) as the running buffer and on-column detection at 300 nm. Several parameters affecting the separation and sensitivity of the drug were studied, including pH, the concentrations of Tris buffer and surfactant. Using cefotaxime as an internal standard (IS), the linear ranges of the method for the determination of meropenem in plasma and in CSF were all over 0.5-50 microg/mL; the detection limits (signal-to-noise ratio=3) of meropenem in plasma and in CSF were 0.2 microg/mL and 0.3 microg/mL, respectively.
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Affiliation(s)
- Yu-Wei Chou
- Graduate Institute of Pharmaceutical Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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17
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Koal T, Deters M, Resch K, Kaever V. Quantification of the carbapenem antibiotic ertapenem in human plasma by a validated liquid chromatography–mass spectrometry method. Clin Chim Acta 2006; 364:239-45. [PMID: 16098501 DOI: 10.1016/j.cccn.2005.07.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2005] [Revised: 07/08/2005] [Accepted: 07/08/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Ertapenem (Invanz) is a newly developed carbapenem beta-lactam antibiotic. LC-MS is the method of choice for therapeutic drug monitoring (TDM) of a variety of drugs including antibiotics. No validated LC-MS method for ertapenem quantification is described in the literature so far. METHODS A rapid and robust LC-MS quantification method for ertapenem was developed and validated for clinical routine application in plasma samples. After immediate stabilisation with MES buffer (pH 6.5), samples were prepared for LC-MS analysis using simple protein precipitation. LC-MS coupling was realised by the use of a Phenomenex Synergi 4micro Polar-RP A80 Mercury LC column (10 x 2.0 mm) in combination with a Single-MS (Agilent 1100 LC-MSD SL) operating in negative selected ion monitoring (SIM) detection mode with ceftazidime as internal standard for adequate selective and sensitive analysis. RESULTS LC-MS method validation by means of determination of limit of detection (LOD 0.1 microg mL-1), lower limit of quantification (LLOQ 1 microg mL-1), linearity (0.1-50 microg mL-1), recovery (> 90%), intra- and inter-day precision (RSD < 10%), accuracy (> 90%), inter-subject variability (< 10% at LLOQ), drug stability in plasma (> 3 months) and in post-extracted samples (> 99% for 24 h), and matrix effects (process efficiency > 90%) showed excellent performance parameters considering Guidance for Industry - Bioanalytical Method Validation. CONCLUSION This method is perfectly appropriate for routine quantification of ertapenem and possibly other polar carbapenem beta-lactam antibiotics.
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Affiliation(s)
- Therese Koal
- Hannover Medical School, Institute of Pharmacology, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany.
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18
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Isla A, Arzuaga A, Maynar J, Gascón AR, Solinís MA, Corral E, Pedraz JL. Determination of ceftazidime and cefepime in plasma and dialysate-ultrafiltrate from patients undergoing continuous veno-venous hemodiafiltration by HPLC. J Pharm Biomed Anal 2005; 39:996-1005. [PMID: 16026959 DOI: 10.1016/j.jpba.2005.05.027] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2004] [Revised: 05/16/2005] [Accepted: 05/20/2005] [Indexed: 11/24/2022]
Abstract
We have developed and validated a new, rapid and reproducible HPLC method for the determination of cefepime and ceftazidime in plasma and dialysate-ultrafiltrate samples obtained from intensive care unit (ICU) patients undergoing continuous veno-venous hemodiafiltration (CVVHDF). The method for plasma samples involved protein precipitation with acetonitrile, followed by washing with dichloromethane to remove apolar lipophilic compounds. Dialysate-ultrafiltrate samples did not require any preparation. Separation was performed on a muBondapak C18 (30 cm x 3.9 mm x 10 microm) with UV detection. The mobile phase contained acetate buffer: ACN and was delivered at 2 ml/min. The coefficients of determination of the calibration curves were always > or = 0.998 and R.S.D.% of the response factors <10%. The intra and inter-assay precision and accuracy of the quality controls (QC) and limit of quantification (LOQ) were satisfactory in all cases. Plasma and dialysate-ultrafiltrate samples were stable at -20 and -80 degrees C for 2 months and also after three freeze/thaw cycles. Dialysate-ultrafiltrate samples were stable in the chromatographic rack for 24h at room temperature, but we recommend storing processed plasma samples at 4 degrees C until the analysis. The described method has proved to be useful to give accurate measurements of ceftazidime and cefepime in samples obtained from patients undergoing CVVHDF.
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Affiliation(s)
- A Isla
- Laboratory of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of the Basque Country, Paseo de la Universidad no. 7, 01006 Vitoria-Gasteiz, Spain
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19
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Mendez ASL, Weisheimer V, Oppe TP, Steppe M, Schapoval EES. Microbiological assay for the determination of meropenem in pharmaceutical dosage form. J Pharm Biomed Anal 2004; 37:649-53. [PMID: 15797784 DOI: 10.1016/j.jpba.2004.11.030] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2004] [Accepted: 10/10/2004] [Indexed: 10/26/2022]
Abstract
Meropenem is a highly active carbapenem antibiotic used in the treatment of a wide range of serious infections. The present work reports a microbiological assay, applying the cylinder-plate method, for the determination of meropenem in powder for injection. The validation method yielded good results and included linearity, precision, accuracy and specificity. The assay is based on the inhibitory effect of meropenem upon the strain of Micrococcus luteus ATCC 9341 used as the test microorganism. The results of assay were treated statistically by analysis of variance (ANOVA) and were found to be linear (r=0.9999) in the range of 1.5-6.0 microg ml(-1), precise (intra-assay: R.S.D.=0.29; inter-assay: R.S.D.=0.94) and accurate. A preliminary stability study of meropenem was performed to show that the microbiological assay is specific for the determination of meropenem in the presence of its degradation products. The degraded samples were also analysed by the HPLC method. The proposed method allows the quantitation of meropenem in pharmaceutical dosage form and can be used for the drug analysis in routine quality control.
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Affiliation(s)
- Andreas S L Mendez
- Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre-RS, Brazil.
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20
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Cai SY, Hu CQ. Chromatographic determination of polymerized impurities in meropenem. J Pharm Biomed Anal 2004; 37:585-9. [PMID: 15740920 DOI: 10.1016/j.jpba.2004.11.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2004] [Revised: 11/14/2004] [Accepted: 11/14/2004] [Indexed: 10/26/2022]
Abstract
A method for the separation of polymerized impurities in meropenem has been developed by gel filtration chromatography (GFC). The chromatographic conditions included a Superdex peptide HR 10/30 column and the mobile phase consisting of 0.01 mol L(-1) sodium phosphate buffer (pH 7.0), at a flow rate of 0.8 mL min(-1). The wavelength of UV detector was set at 220 nm. The linear range was 0.08-10 microg (r=0.9998); relative standard deviation (R.S.D.)=0.5-1.5%; the LOD and LOQ were 2.4 and 12.4 ng, respectively. Specificity of the GFC was checked by switching the effluent of each peak on the GFC to a C18 trap column and analyzing the effluent by LC-MS. The result shows that for the determination of polymers, the gel filtration chromatography is a rather simple separation mode as compared to RPLC.
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Affiliation(s)
- Shan-Ying Cai
- National Institute for the Control of Pharmaceutical and Biological Products, Beijing 100050, PR China
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21
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Mendez ASL, Steppe M, Schapoval EES. Validation of HPLC and UV spectrophotometric methods for the determination of meropenem in pharmaceutical dosage form. J Pharm Biomed Anal 2004; 33:947-54. [PMID: 14656585 DOI: 10.1016/s0731-7085(03)00366-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A high-performance liquid chromatographic method and a UV spectrophotometric method for the quantitative determination of meropenem, a highly active carbapenem antibiotic, in powder for injection were developed in present work. The parameters linearity, precision, accuracy, specificity, robustness, limit of detection and limit of quantitation were studied according to International Conference on Harmonization guidelines. Chromatography was carried out by reversed-phase technique on an RP-18 column with a mobile phase composed of 30 mM monobasic phosphate buffer and acetonitrile (90:10; v/v), adjusted to pH 3.0 with orthophosphoric acid. The UV spectrophotometric method was performed at 298 nm. The samples were prepared in water and the stability of meropenem in aqueous solution at 4 and 25 degrees C was studied. The results were satisfactory with good stability after 24 h at 4 degrees C. Statistical analysis by Student's t-test showed no significant difference between the results obtained by the two methods. The proposed methods are highly sensitive, precise and accurate and can be used for the reliable quantitation of meropenem in pharmaceutical dosage form.
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Affiliation(s)
- Andreas S L Mendez
- Programa de Pós-Graduação em Ciências Farmacêuticas, Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
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22
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Robatel C, Decosterd LA, Biollaz J, Eckert P, Schaller MD, Buclin T. Pharmacokinetics and dosage adaptation of meropenem during continuous venovenous hemodiafiltration in critically ill patients. J Clin Pharmacol 2004; 43:1329-40. [PMID: 14615469 DOI: 10.1177/0091270003260286] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Meropenem, a carbapenem broad-spectrum antibiotic, is regularly used in patients undergoing continuous venovenous hemodiafiltration (CVVHDF). Its disposition was studied over one dosage interval in 15 patients under CVVHDF on a steady regimen of 500 or 1000 mg every 8 to 12 hours. Meropenem levels were measured in plasma and filtrate-dialysate by high-performance liquid chromatography (HPLC) with UV detection. The mean CVVHDF flow rates were 7.1 +/- 0.9 L/h for blood (mean +/- SD), 0.5 +/- 0.3 L/h for predilution solution, 1.2 +/- 0.3 L/h for countercurrent dialysate, and 1.8 +/- 0.5 L/h for the total filtrate-dialysate. The pharmacokinetic analysis was based both on a noncompartmental approach and on a four-compartment modeling. The mean (coefficient of variation [CV]) total body clearance, volume of distribution at steady state, and mean residence time were, respectively, 5.0 L/h (46%), 14.3 L (29%), and 4.8 h (36%). The hemodiafiltration clearances calculated from plasma data alone and plasma with filtrate-dialysate data were 1.2 L/h (26%) and 1.6 L/h (39%), respectively. The compartmental model was used to optimize the therapeutic schedule of meropenem, considering reference minimal inhibitory concentration (MIC) of sensitive strains (4 mg/L). The results indicate that two different therapeutic schedules of meropenem are equally applicable to patients receiving CVVHD: either 750 mg tid or 1500 bid.
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Affiliation(s)
- C Robatel
- Division of Clinical Pharmacology, Department of Medicine, University Hospital, Lausanne, Switzerland
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