1
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Wang X, Qiu Y, Wen H, Weng R, Chen D, Liu H. Separation and structural characterization of unknown impurity in vancomycin by two-dimensional preparative liquid chromatography, LC-MS and NMR. J Pharm Biomed Anal 2023; 232:115403. [PMID: 37120972 DOI: 10.1016/j.jpba.2023.115403] [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: 03/05/2023] [Revised: 04/17/2023] [Accepted: 04/17/2023] [Indexed: 05/02/2023]
Abstract
Vancomycin is an effective antibiotic used for the treatment of Gram-positive bacterial infections. During the analysis of vancomycin, an unknown impurity at the level of 0.5% was detected by high-performance liquid chromatography (HPLC). To characterize the structure of the impurity, a new two-dimensional preparative liquid chromatography (2D-Prep-LC) method was developed to separate the impurity from the vancomycin sample. After further analysis including liquid chromatography-mass spectrometry (LC-MS) and nuclear magnetic resonance (NMR) spectroscopy, the structure of the unknown impurity was identified as a vancomycin analog in which the N-Methyl-leucine residue on the side chain is replaced by an N-methylmethionine residue. In this study, we established a reliable and efficient method for separating and identifying vancomycin impurities, which will provide a valuable contribution to the field of pharmaceutical analysis and quality control.
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Affiliation(s)
- Xuantang Wang
- Shanghai Institute for Food and Drug Control, Shanghai 201203, China
| | - Ya Qiu
- Shanghai Institute for Food and Drug Control, Shanghai 201203, China
| | - Hongliang Wen
- Shanghai Institute for Food and Drug Control, Shanghai 201203, China
| | - Rongwen Weng
- Department of pharmacy, Fudan University, Shanghai 200433, China
| | - Dongying Chen
- Laboratory of Pharmaceutical Analysis, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, 555 Rd. Zuchongzhi, Shanghai 201203, China.
| | - Hao Liu
- Shanghai Institute for Food and Drug Control, Shanghai 201203, China.
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2
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Wang H, He Y, Jian M, Fu X, Cheng Y, He Y, Fang J, Li L, Zhang D. Breaking the Bottleneck in Anticancer Drug Development: Efficient Utilization of Synthetic Biology. Molecules 2022; 27:7480. [PMID: 36364307 PMCID: PMC9656990 DOI: 10.3390/molecules27217480] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 08/13/2024] Open
Abstract
Natural products have multifarious bioactivities against bacteria, fungi, viruses, cancers and other diseases due to their diverse structures. Nearly 65% of anticancer drugs are natural products or their derivatives. Thus, natural products play significant roles in clinical cancer therapy. With the development of biosynthetic technologies, an increasing number of natural products have been discovered and developed as candidates for clinical cancer therapy. Here, we aim to summarize the anticancer natural products approved from 1950 to 2021 and discuss their molecular mechanisms. We also describe the available synthetic biology tools and highlight their applications in the development of natural products.
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Affiliation(s)
- Haibo Wang
- Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Yu He
- Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Meiling Jian
- Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Xingang Fu
- Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Yuheng Cheng
- Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Yujia He
- Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Jun Fang
- Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Lin Li
- Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
| | - Dan Zhang
- Department of Laboratory Medicine, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu 610072, China
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3
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Smartphone-based digital image colorimetry for the determination of vancomycin in drugs. MONATSHEFTE FUR CHEMIE 2022. [DOI: 10.1007/s00706-022-02964-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
AbstractA simple smartphone-based digital image colorimetry is proposed for the determination of vancomycin in drugs. The analytical method relied on the reaction of vancomycin with copper(II) in ethanol–water medium with pH 4.3. The reaction resulted in the formation of a blue–grey complex, presenting an absorption maximum at 555 nm. A mobile application was used for smartphone-based analysis to decompose the individual channels of the colour model representations. The determination was performed using three smartphones followed by a comparison of the outcomes with spectrophotometric measurements. The most optimal analytical parameters were achieved for the H channel. The linear ranges obtained for the smartphone-based method proved to be comparable to the spectrophotometric range of 0.044–1.500 g dm−3 and were 0.049–1.500 g dm−3, 0.057–1.500 g dm−3, and 0.040–1.500 g dm−3 for Smartphones 1–3, respectively. Moreover, the determined coefficients of variance (CV, n = 9) and limits of detection (LOD) were 2.3% and 0.015 g dm−3, 6.2% and 0.017 g dm−3, and 2.5% and 0.012 g dm−3, respectively. Whereas for spectrophotometry, the obtained precision, CV was of 0.9% and a LOD of 0.013 g dm−3. The accuracy of the method was verified using model samples, generally the results were obtained with accuracy better than 10.9% (relative error). The method was applied to the determination of vancomycin in drugs. The results obtained by smartphone-based colorimetry did not differ from the expected values for more than 2.6%, were consistent with each other and with the results of spectrophotometric determinations.
Graphical abstract
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4
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Yoon TH, Kim JH. Development of Drying Process for Removal of Residual Solvent from Crystalline Vancomycin and Kinetic and Thermodynamic Analysis Thereof. BIOTECHNOL BIOPROC E 2021. [DOI: 10.1007/s12257-020-0290-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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5
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Kapil S, Sharma V. d-Amino acids in antimicrobial peptides: a potential approach to treat and combat antimicrobial resistance. Can J Microbiol 2020; 67:119-137. [PMID: 32783775 DOI: 10.1139/cjm-2020-0142] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Antimicrobial resistance is one of the leading challenges in the human healthcare segment. Advances in antimicrobial resistance have triggered exploration of natural alternatives to stabilize its seriousness. Antimicrobial peptides are small, positively charged oligopeptides that are as potent as commercially available antibiotics against a wide spectrum of organisms, such as Gram-positive bacteria, Gram-negative bacteria, viruses, and fungal strains. In addition to their antibiotic capabilities, these peptides possess anticancer activity, activate the immune response, and regulate inflammation. Peptides have distinct modes of action and fall into various categories due to their amino acid composition. Although antimicrobial peptides specifically target the bacterial cytoplasmic membrane, they can also target the cell nucleus and protein synthesis. Owing to the increasing demand for novel treatments against the threat of antimicrobial resistance, naturally synthesized peptides are a beneficial development concept. Antimicrobial peptides are pervasive and can easily be modified using de-novo synthesis technology. Antimicrobial peptides can be isolated from natural resources such as humans, plants, bacteria, and fungi. This review gives a brief overview of antimicrobial peptides and their diastereomeric composition. Other current trends, the future scope of antimicrobial peptides, and the role of d-amino acids are also discussed, with a specific emphasis on the design and development of new drugs.
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Affiliation(s)
- Shikha Kapil
- University Institute of Biotechnology, Chandigarh University, Gharuan Mohali, Punjab 140413, India.,University Institute of Biotechnology, Chandigarh University, Gharuan Mohali, Punjab 140413, India
| | - Vipasha Sharma
- University Institute of Biotechnology, Chandigarh University, Gharuan Mohali, Punjab 140413, India.,University Institute of Biotechnology, Chandigarh University, Gharuan Mohali, Punjab 140413, India
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6
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Kim HK, Choi SM, Kang G, Park KH, Lee DG, Park WB, Rhee SJ, Lee S, Jung SI, Jang HC. Comparison of In Vivo Pharmacokinetics and Pharmacodynamics of Vancomycin Products Available in Korea. Yonsei Med J 2020; 61:301-309. [PMID: 32233172 PMCID: PMC7105400 DOI: 10.3349/ymj.2020.61.4.301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 03/10/2020] [Accepted: 03/10/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Few studies have been investigated the in vivo efficacy of generic vancomycin products available outside of the United States. In this study, we aimed to compare the in vivo pharmacokinetics (PK) and pharmacodynamics (PD) of five generic vancomycin products available in Korea with those of the innovator. MATERIALS AND METHODS The in vitro vancomycin purity of each product was examined using high-pressure liquid chromatography. Single-dose PK analyses were performed using neutropenic mice. The in vivo efficacy of vancomycin products was compared with that of the innovator in dose-effect experiments (25 to 400 mg/kg per day) using a thigh-infection model with neutropenic mice. RESULTS Generic products had a lower proportion of vancomycin B (range: 90.3-93.8%) and a higher proportion of impurities (range: 6.2-9.7%) than the innovator (94.5% and 5.5%, respectively). In an in vivo single-dose PK study, the maximum concentration (Cmax) values of each generic were lower than that of the innovator, and the geographic mean area under the curve ratios of four generics were significantly lower than that of the innovator (all p<0.1). In the thigh-infection model, the maximum efficacies of generic products reflected in maximal effect (Emax) values were not significantly different from the innovator. However, the PD profile curves of some generic products differed significantly from that of the innovator in mice injected with a high level of Mu3 (all p≤0.05). CONCLUSION Some generic vancomycin products available in Korea showed inferior PK and PD profiles, especially in mice infected with hetero-vancomycin-resistant Staphylococcus aureus.
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Affiliation(s)
- Hee Kyung Kim
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Su-Mi Choi
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Gaeun Kang
- Division of Clinical Pharmacology, Department of Pharmacology, Chonnam National University Medical School, Gwangju, Korea
| | - Kyung-Hwa Park
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Dong-Gun Lee
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Wan-Beom Park
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Su-jin Rhee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - SeungHwan Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - Sook-In Jung
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
| | - Hee-Chang Jang
- Department of Infectious Diseases, Chonnam National University Medical School, Gwangju, Korea
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Sheu MJ, Chen CC, Lu YC, Su BA, Zhang CC, Wang SS, Chuang YC, Tang HJ, Lai CC. In Vitro Antimicrobial Activity of Various Cefoperazone/Sulbactam Products. Antibiotics (Basel) 2020; 9:antibiotics9020077. [PMID: 32059590 PMCID: PMC7168170 DOI: 10.3390/antibiotics9020077] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 02/06/2020] [Accepted: 02/10/2020] [Indexed: 11/16/2022] Open
Abstract
: This study aims to assess the in vitro activity of different samples of cefoperazone/sulbactam (CFP/SUL) against multidrug-resistant organisms (MDROs). Clinical isolates of extended-spectrum β-lactamase (ESBL)-Escherichia coli, ESBL-Klebsiella pneumoniae, carbapenem-resistant Acinetobacter baumannii (CR-AB), and carbapenem-resistant Pseudomonas aeruginosa (CR-PA) were collected. The minimum inhibitory concentration (MIC) and time-killing methods were used to assess and compare the in vitro activities of different samples of cefoperazone/sulbactam (CFP/SUL) against these MDROs. For ESBL-E. coli, ESBL-K. pneumoniae, and CR-PA, product C had smaller variations than product A and B (p < 0.05). For CR-AB, product B had the largest variation compared to the other two products (p < 0.05). In the time-killing studies, significant differences among the products when used at 16/16 µg/mL were noted for ESBL-E. coli, ESBL-K. pneumoniae, and CR-AB isolates. In conclusion, this study demonstrated the significantly different activity of different products of CFP/SUL against MDROs.
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Affiliation(s)
- Ming-Jen Sheu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi Mei Medical Center, Tainan 710, Taiwan;
- Department of Medicinal Chemistry, Chia Nan University of Pharmacy & Science, Tainan 717, Taiwan
| | - Chi-Chung Chen
- Department of Medical Research; Chi Mei Medical Center; Tainan 710, Taiwan; (C.-C.C.); (Y.-C.L.)
- Department of Food Science, National Chiayi University, Chiayi 717, Taiwan
| | - Ying-Chen Lu
- Department of Medical Research; Chi Mei Medical Center; Tainan 710, Taiwan; (C.-C.C.); (Y.-C.L.)
| | - Bo-An Su
- Department of Internal Medicine, Chi Mei Medical Center, Tainan 710, Taiwan; (B.-A.S.); (S.-S.W.)
| | - Chun-Cheng Zhang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan 710, Taiwan; (B.-A.S.); (S.-S.W.)
| | - Shu-Shen Wang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan 710, Taiwan; (B.-A.S.); (S.-S.W.)
| | - Yin-Ching Chuang
- Department of Medicinal Chemistry, Chia Nan University of Pharmacy & Science, Tainan 717, Taiwan
- Department of Food Science, National Chiayi University, Chiayi 717, Taiwan
| | - Hung-Jen Tang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan 710, Taiwan; (B.-A.S.); (S.-S.W.)
- Correspondence: (H.-J.T.); (C.-C.L.)
| | - Chih-Cheng Lai
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan 710, Taiwan
- Correspondence: (H.-J.T.); (C.-C.L.)
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8
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Qin X, Tsoi MF, Zhao X, Zhang L, Qi Z, Cheung BMY. Vancomycin-associated acute kidney injury in Hong Kong in 2012-2016. BMC Nephrol 2020; 21:41. [PMID: 32013870 PMCID: PMC6998253 DOI: 10.1186/s12882-020-1704-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 01/24/2020] [Indexed: 11/12/2022] Open
Abstract
Background To study the incidence of vancomycin-associated acute kidney injury (VA-AKI) in Hong Kong and identify risk factors for VA-AKI. Method Patients with vancomycin prescription and blood level measurement in 2012–2016 were identified using the Hong Kong Hospital Authority Clinical Data Analysis and Reporting System. Acute kidney injury was defined using KDIGO criteria. Patients without creatinine measurements, steady-state trough vancomycin level or who had vancomycin treatment < 3 days were excluded. Results were analyzed using SPSS version 22.0. Logistic regression was used to identify the predictors for VA-AKI. Odds ratio and 95% confidence interval were estimated. Results One thousand four hundred fifty patients were identified as VA-AKI from 12,758 records in Hong Kong in 2012–2016. The incidence was respectively 10.6, 10.9, 11.3, 12.2, 11.2% from 2012 to 2016. The incidence of VA-AKI was 16.3, 12.2, 11.3 and 6.2% in patients aged 1–12, 12–60, elderly aged > 60 and newborn and infants, respectively. Baseline creatinine, serum trough vancomycin level, systematic disease history including respiratory failure, hypertension, congestive heart failure, chronic renal failure, anemia and type II diabetes, and concomitant diuretics, piperacillin-tazobactam (PTZ) and meropenem prescription were significantly higher in VA-AKI patients older than 12 years. Logistic regression showed that older age group, higher baseline creatinine, serum trough vancomycin level, respiratory failure, chronic renal failure and congestive heart failure, concomitant diuretics, PTZ and meropenem prescription, and longer hospital stay were all associated with increased risk of VA-AKI. Conclusion The incidence of VA-AKI in Hong Kong is low but shows no decline. Patients with higher baseline creatinine, multi-organ diseases and multiple drugs administration should have their vancomycin level monitored to decrease the risk of VA-AKI.
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Affiliation(s)
- Xuzhen Qin
- Department of Laboratory Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, China
| | - Man-Fung Tsoi
- Department of Medicine, The University of Hong Kong, Hong Kong, China
| | - Xinyu Zhao
- Department of epidemiology and health statistics, Institute of basic medicine, Peking Union Medical College, Beijing, China
| | - Lin Zhang
- Department of Laboratory Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, China
| | - Zhihong Qi
- Department of Laboratory Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, China
| | - Bernard M Y Cheung
- Department of Medicine, The University of Hong Kong, Hong Kong, China. .,State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong, China.
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9
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Zhang D, He Y, Ye Y, Ma Y, Zhang P, Zhu H, Xu N, Liang S. Little Antimicrobial Peptides with Big Therapeutic Roles. Protein Pept Lett 2019; 26:564-578. [PMID: 30799781 DOI: 10.2174/1573406415666190222141905] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/24/2019] [Accepted: 01/25/2019] [Indexed: 02/05/2023]
Abstract
Antimicrobial Peptides (AMPs) are short amphipathic biological molecules generally with less than 100 amino acids. AMPs not only present high bioactivities against bacteria, fungi or protists-induced infections, but also play important roles in anticancer activity, immune response and inflammation regulation. AMPs are classified as ribosomally synthesized, non-ribosomally synthesized and post-translationally modified, non-ribosomally synthesized ones and several synthetic or semisynthetic peptides according to their synthesis with or without the involvement of ribosomes. The molecular characterization and bioactivity action mechanisms are summarized for several ribosomally synthesized AMPs and main non-ribosomally synthesized members (cyclopeptides, lipopeptides, glycopeptides, lipoglycopeptides). We also analyze challenges and new strategies to overcome drug resistance and application limitations for AMP discovery. In conclusion, the growing novel small molecular AMPs have huge therapeutic potentials of antibacterial, antiviral, anticancer and immunoregulatory bioactivities through new techniquesdriven drug discovery strategy including bioinformatics prediction, de novo rational design and biosynthesis.
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Affiliation(s)
- Dan Zhang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University / Collaborative Innovation Center for Biotherapy, Chengdu 610041, China
| | - Yu He
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University / Collaborative Innovation Center for Biotherapy, Chengdu 610041, China
| | - Yang Ye
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University / Collaborative Innovation Center for Biotherapy, Chengdu 610041, China
| | - Yanni Ma
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University / Collaborative Innovation Center for Biotherapy, Chengdu 610041, China
| | - Peng Zhang
- Department of Urinary Surgery, West China Hospital, West China Medical School, Sichuan University, Chengdu 610041, China
| | - Hongxia Zhu
- Laboratory of Cell and Molecular Biology, State Key Laboratory of Molecular Oncology, Cancer Institute & Cancer Hospital, Chinese Academy of Medical Sciences, Beijing 100034, China
| | - Ningzhi Xu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University / Collaborative Innovation Center for Biotherapy, Chengdu 610041, China.,Laboratory of Cell and Molecular Biology, State Key Laboratory of Molecular Oncology, Cancer Institute & Cancer Hospital, Chinese Academy of Medical Sciences, Beijing 100034, China
| | - Shufang Liang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University / Collaborative Innovation Center for Biotherapy, Chengdu 610041, China
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10
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Secco G, Sachetti C, Rossato-Grando LG, Regina Hahn S, Pagnussat LR, da Cruz Fresco PMF, Dallazem Bertol C. Quality of Vancomycin for Injection Formulations in Brazil. CURR PHARM ANAL 2019. [DOI: 10.2174/1573412914666180116143232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
The presence of impurities in vancomycin compromised the safety and contributed
to decrease of its use for years. In Brazil, vancomycin generic drug represents an option to reduce
hospital costs. However, the controversy over the quality of these formulations and their relationship
to effectiveness and safety raised concerns.
Objective and Methods:
To assess in vitro quality of vancomycin injections through uniformity of
weight, pH, clarity of solution, microbiological assay and impurities determination by High Performance
Liquid Chromatography (HPLC).
Results:
The samples were approved in the tests.
Conclusion:
The injectable formulations of vancomycin proved to be safe for use in hospital environment.
This work contributes to increase health professionals’ confidence on generic vancomycin.
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Affiliation(s)
- Gabriela Secco
- Curso de Farmacia, Instituto de Ciencias Biologicas, Universidade de Passo Fundo, Passo Fundo, RS, Brazil
| | - Cristiane Sachetti
- Curso de Farmacia, Instituto de Ciencias Biologicas, Universidade de Passo Fundo, Passo Fundo, RS, Brazil
| | | | - Siomara Regina Hahn
- Curso de Farmacia, Instituto de Ciencias Biologicas, Universidade de Passo Fundo, Passo Fundo, RS, Brazil
| | - Lidiane Riva Pagnussat
- Servico de Controle de Infeccao Hospitalar, Hospital Sao Vicente de Paulo, Passo Fundo, RS, Brazil
| | | | - Charise Dallazem Bertol
- Curso de Farmacia, Instituto de Ciencias Biologicas, Universidade de Passo Fundo, Passo Fundo, RS, Brazil
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11
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Gyamlani G, Potukuchi PK, Thomas F, Akbilgic O, Soohoo M, Streja E, Naseer A, Sumida K, Molnar MZ, Kalantar-Zadeh K, Kovesdy CP. Vancomycin-Associated Acute Kidney Injury in a Large Veteran Population. Am J Nephrol 2019; 49:133-142. [PMID: 30677750 DOI: 10.1159/000496484] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 12/21/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND To determine the association of vancomycin with acute kidney injury (AKI) in relation to its serum concentration value and to examine the risk of AKI in patients treated with vancomycin when compared with a matched cohort of patients receiving non-glycopeptide antibiotics (linezolid/daptomycin). METHODS From a cohort of > 3 million US veterans with baseline estimated glomerular filtration rate ≥60 mL/min/1.73 m2, we identified 33,527 patients who received either intravenous vancomycin (n = 22,057) or non-glycopeptide antibiotics (linezolid/daptomycin, n = 11,470). We examined the association of the serum trough vancomycin level recorded within the first 48 h of administration with subsequent AKI in all patients treated with vancomycin and association of vancomycin vs. non-glycopeptide antibiotics use with the risk of incident AKI. RESULTS The overall multivariable adjusted ORs of AKI stages 1, 2, and 3 in patients on vancomycin vs. non-glycopeptides were 1.1 (1.1-1.2), 1.2 (1-1.4), and 1.4 (1.1-1.7), respectively. When examined in strata divided by vancomycin trough level, the odds of AKI were similar or lower in patients receiving vancomycin compared to non-glycopeptide antibiotics as long as serum vancomycin levels were ≤20 mg/L. However, in patients with serum vancomycin levels > 20 mg/L, the ORs of AKI stages 1, 2, and 3 in patients on vancomycin vs. non-glycopeptide antibiotics were 1.5 (1.4-1.7), 1.9 (1.5-2.3), and 2.7 (2-3.5), respectively. CONCLUSIONS Vancomycin use is associated with a higher risk of AKI when serum levels exceed > 20 mg/L.
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Affiliation(s)
- Geeta Gyamlani
- Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, Tennessee, USA
| | - Praveen K Potukuchi
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
- IHOP, College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Fridtjof Thomas
- Division of Biostatistics, Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Oguz Akbilgic
- Center for Biomedical Informatics, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Melissa Soohoo
- Division of Nephrology, University of California, Irvine, California, USA
| | - Elani Streja
- Division of Nephrology, University of California, Irvine, California, USA
| | - Adnan Naseer
- Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, Tennessee, USA
| | - Keiichi Sumida
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Miklos Z Molnar
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA
- Division of Transplant Surgery, Methodist University Hospital Transplant Institute, Memphis, Tennessee, USA
- Division of Transplant Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | | | - Csaba P Kovesdy
- Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, Tennessee, USA,
- Division of Nephrology, University of Tennessee Health Science Center, Memphis, Tennessee, USA,
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Vass P, Démuth B, Hirsch E, Nagy B, Andersen SK, Vigh T, Verreck G, Csontos I, Nagy ZK, Marosi G. Drying technology strategies for colon-targeted oral delivery of biopharmaceuticals. J Control Release 2019; 296:162-178. [PMID: 30677436 DOI: 10.1016/j.jconrel.2019.01.023] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/16/2019] [Accepted: 01/17/2019] [Indexed: 12/12/2022]
Abstract
In chronic intestinal diseases like inflammatory bowel disease, parenteral administration of biopharmaceuticals is associated with numerous disadvantages including immune reactions, infections, low patient compliance, and toxicity caused by high systemic bioavailability. One alternative that can potentially overcome these limitations is oral administration of biopharmaceuticals, where the local delivery will reduce the systemic exposure and furthermore the manufacturing costs will be lower. However, the development of oral dosage forms that deliver the biologically active form to the intestines is one of the greatest challenges for pharmaceutical technologists due to the sensitive nature of biopharmaceuticals. The present article discusses the various drug delivery technologies used to produce orally administered solid dosage forms of biopharmaceuticals with an emphasis on colon-targeted delivery. Solid oral dosage compositions containing different types of colon-targeting biopharmaceuticals are compiled followed by a review of currently applied and emerging drying technologies for biopharmaceuticals. The different drying technologies are compared in terms of their advantages, limitations, costs and their effect on product stability.
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Affiliation(s)
- Panna Vass
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME), H-1111 Budapest, Műegyetem rakpart 3, Hungary
| | - Balázs Démuth
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME), H-1111 Budapest, Műegyetem rakpart 3, Hungary
| | - Edit Hirsch
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME), H-1111 Budapest, Műegyetem rakpart 3, Hungary
| | - Brigitta Nagy
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME), H-1111 Budapest, Műegyetem rakpart 3, Hungary
| | - Sune K Andersen
- Oral Solids Development, Janssen R&D, B-2340 Beerse, Turnhoutseweg 30, Belgium.
| | - Tamás Vigh
- Oral Solids Development, Janssen R&D, B-2340 Beerse, Turnhoutseweg 30, Belgium
| | - Geert Verreck
- Oral Solids Development, Janssen R&D, B-2340 Beerse, Turnhoutseweg 30, Belgium
| | - István Csontos
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME), H-1111 Budapest, Műegyetem rakpart 3, Hungary
| | - Zsombor K Nagy
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME), H-1111 Budapest, Műegyetem rakpart 3, Hungary.
| | - György Marosi
- Department of Organic Chemistry and Technology, Budapest University of Technology and Economics (BME), H-1111 Budapest, Műegyetem rakpart 3, Hungary
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Fabri FV, Lolis MA, Gimenes M, Tognim MCB, Caparroz-Assef SM. Different formulations of vancomycin: In vitro antimicrobial activity against clinical isolates of methicillin-resistant Staphylococcus aureus. Diagn Microbiol Infect Dis 2018; 92:332-337. [PMID: 30033164 DOI: 10.1016/j.diagmicrobio.2018.06.020] [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: 02/22/2017] [Revised: 02/18/2018] [Accepted: 06/21/2018] [Indexed: 11/16/2022]
Abstract
We compared in vitro antimicrobial activity of four vancomycin formulations used clinically against clinical isolates of Staphylococcus aureus, including methicillin-resistant and -susceptible (MRSA and MSSA, respectively), using different susceptibility assays. The minimal inhibitory concentrations (MICs) against MRSA clinical isolates were significantly different for some vancomycin formulations by the broth microdilution and agar dilution methods. However, these variations would not compromise their clinical use, since the MICs were within the range recommended by the Clinical and Laboratory Standards Institute. Furthermore, 26.9% of MRSA clinical isolates showed a vancomycin MIC ≥1.5 μg/mL according to the Etest® method but none by broth microdilution. Regarding quality, all formulations were in accordance with United States Pharmacopeia criteria. Our results showed that all vancomycin formulations tested showed similar in vitro antimicrobial activity, making them suitable for clinical use, and that the evaluation method chosen to determine sensitivity to this antimicrobial should be carefully performed, particularly for MRSA.
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Affiliation(s)
- Franciele Viana Fabri
- Post Graduate Program in Biociências e Fisiopatologia, Universidade Estadual de Maringá, Maringá, PR, Brazil.
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Sinha Ray A, Haikal A, Hammoud KA, Yu AS. Vancomycin and the Risk of AKI: A Systematic Review and Meta-Analysis. Clin J Am Soc Nephrol 2016; 11:2132-2140. [PMID: 27895134 PMCID: PMC5142072 DOI: 10.2215/cjn.05920616] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 08/25/2016] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND OBJECTIVES Vancomycin has been in use for more than half a century, but whether it is truly nephrotoxic and to what extent are still highly controversial. The objective of this study was to determine the risk of AKI attributable to intravenous vancomycin. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We conducted a systematic review of randomized, controlled trials and cohort studies that compared patients treated with intravenous vancomycin with a control group of patients given a comparator nonglycopeptide antibiotic and in which kidney function or kidney injury outcomes were reported. PubMed and Cochrane Library were searched from 1990 to September of 2015. Two reviewers extracted data and assessed study risk of bias, and one reviewer adjudicated the assessments. A meta-analysis was conducted on seven randomized, controlled trials (total of 4033 patients). RESULTS Moderate quality evidence suggested that vancomycin treatment is associated with a higher risk of AKI, with a relative risk of 2.45 (95% confidence interval, 1.69 to 3.55). The risk of kidney injury was similar in patients treated for skin and soft tissue infections compared with those treated for nosocomial pneumonia and other complicated infections. There was an uncertain risk of reporting bias, because kidney function was not a prespecified outcome in any of the trials. The preponderance of evidence was judged to be indirect, because the majority of studies compared vancomycin specifically with linezolid. CONCLUSIONS Our findings suggest that there is a measurable risk of AKI associated with vancomycin, but the strength of the evidence is moderate. A randomized, controlled trial designed to study kidney function as an outcome would be needed to draw unequivocal conclusions.
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Affiliation(s)
| | | | - Kassem A. Hammoud
- Infectious Diseases, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, Kansas
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Sun HY, Liao HW, Sheng MH, Tai HM, Kuo CH, Sheng WH. Bioequivalence and in vitro antimicrobial activity between generic and brand-name levofloxacin. Diagn Microbiol Infect Dis 2016; 85:347-351. [PMID: 27181716 DOI: 10.1016/j.diagmicrobio.2016.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 03/18/2016] [Accepted: 04/23/2016] [Indexed: 01/07/2023]
Abstract
Generic agents play a crucial role in reducing the cost of medical care in many countries. However, the therapeutic equivalence remains a great concern. Our study aims to assess the in vitro antimicrobial activity and bioequivalence between generic and brand-name levofloxacin. Enantiomeric purity test, dissolution test, and in vitro antimicrobial susceptibility against seven clinically important pathogens by the agar dilution method were employed to assess the similarity between four generic products and brand-name levofloxacin (Daiichi Sankyo). All the generic and brand-name levofloxacin passed enantiomeric purity test. The results of dissolution tests were not similar among the generic products and the brand-name levofloxacin. Compared with the generic products, the brand-name levofloxacin had the smallest mean variations (-25% to 13%) with reference standard (United States Pharmacopeia levofloxacin Reference Standards). Variations were observed particularly in dissolution profiles and in vitro activity between generic products and brand-name levofloxacin.
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Affiliation(s)
- Hsin-Yun Sun
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Hsiao-Wei Liao
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | - Hui-Min Tai
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Hua Kuo
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
| | - Wang-Huei Sheng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
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Demonstration of Therapeutic Equivalence of Fluconazole Generic Products in the Neutropenic Mouse Model of Disseminated Candidiasis. PLoS One 2015; 10:e0141872. [PMID: 26536105 PMCID: PMC4633286 DOI: 10.1371/journal.pone.0141872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 10/14/2015] [Indexed: 11/25/2022] Open
Abstract
Some generics of antibacterials fail therapeutic equivalence despite being pharmaceutical equivalents of their innovators, but data are scarce with antifungals. We used the neutropenic mice model of disseminated candidiasis to challenge the therapeutic equivalence of three generic products of fluconazole compared with the innovator in terms of concentration of the active pharmaceutical ingredient, analytical chemistry (liquid chromatography/mass spectrometry), in vitro susceptibility testing, single-dose serum pharmacokinetics in infected mice, and in vivo pharmacodynamics. Neutropenic, five week-old, murine pathogen free male mice of the strain Udea:ICR(CD-2) were injected in the tail vein with Candida albicans GRP-0144 (MIC = 0.25 mg/L) or Candida albicans CIB-19177 (MIC = 4 mg/L). Subcutaneous therapy with fluconazole (generics or innovator) and sterile saline (untreated controls) started 2 h after infection and ended 24 h later, with doses ranging from no effect to maximal effect (1 to 128 mg/kg per day) divided every 3 or 6 hours. The Hill’s model was fitted to the data by nonlinear regression, and results from each group compared by curve fitting analysis. All products were identical in terms of concentration, chromatographic and spectrographic profiles, MICs, mouse pharmacokinetics, and in vivo pharmacodynamic parameters. In conclusion, the generic products studied were pharmaceutically and therapeutically equivalent to the innovator of fluconazole.
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Jiang Y, Xia JP, Yang JH, Zhang ZF, Hu CQ, Zhang ZR. Guidelines and strategy of the International Conference of Harmonization (ICH) and its member states to overcome existing impurity control problems for antibiotics in China. Chin J Nat Med 2015; 13:498-506. [PMID: 26233840 DOI: 10.1016/s1875-5364(15)30044-3] [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: 04/02/2015] [Indexed: 10/23/2022]
Abstract
In the present report, we review the technical guidelines and principles on impurity research and control for antibiotics established by various agencies, including the International Conference of Harmonization (ICH), the US Food and Drug Administration (FDA), the European Medicines Agency (EMA) and the China Food and Drug Administration (CFDA). Progresses with the US Pharmacopoeia (USP), the European Pharmacopoeia (EP) and the Chinese Pharmacopoeia (ChP) to control impurities in antibiotics are also presented. Next, our discussion is focused on analyzing the CFDA's requirements on impurity research and control for antibiotics, and the implementation of ICH, FDA and other technical guidelines for generic drugs impurity control in China. Existing problems are further reviewed, in order to improve the overall process for the control of antibiotic purity.
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Affiliation(s)
- Yu Jiang
- Key Laboratory of Drug Targeting and Drug Delivery System, Ministry of Education, West China School of Pharmacy, Sichuan University, Chengdu 610041, China; Center for Drug Evaluation, China Food and Drug Administration, Beijing 100038, China
| | - Jun-Ping Xia
- China Pharmaceutical University, Nanjing 210009, China
| | - Jian-Hong Yang
- Center for Drug Evaluation, China Food and Drug Administration, Beijing 100038, China
| | - Zhe-Feng Zhang
- Center for Drug Evaluation, China Food and Drug Administration, Beijing 100038, China
| | - Chang-Qin Hu
- China National Institutes for Food and Drug Control, Beijing 100035, China
| | - Zhi-Rong Zhang
- Key Laboratory of Drug Targeting and Drug Delivery System, Ministry of Education, West China School of Pharmacy, Sichuan University, Chengdu 610041, China.
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Sullivan BP, El-Gendy N, Kuehl C, Berkland C. Pulmonary Delivery of Vancomycin Dry Powder Aerosol to Intubated Rabbits. Mol Pharm 2015; 12:2665-74. [PMID: 25915095 DOI: 10.1021/acs.molpharmaceut.5b00062] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Antibiotic multiresistant pneumonia is a risk associated with long-term mechanical ventilation. Vancomycin is commonly prescribed for methicillin-resistant Staphylococcus aureus infections; however, current formulations of vancomycin are only given intravenously. High doses of vancomycin have been associated with severe renal toxicity. In this study, we characterized dry powder vancomyin as a potential inhaled therapeutic aerosol and compared pharmacokinetic profiles of iv and pulmonary administered vancomycin in intubated rabbits through an endotracheal tube system. Cascade impaction studies indicated that using an endotracheal tube, which bypasses deposition in the mouth and throat, increased the amount of drug entering the lung. Bypassing the endotracheal tube with a catheter further enhanced drug deposition in the lung. Interestingly, intubated rabbits administered 1 mg/kg vancomycin via inhalation had similar AUC to rabbits that were administered 1 mg/kg vancomycin via a single bolus iv infusion; however, inhalation of vancomycin reduced Cmax and increased Tmax, indicating that inhaled vancomycin resulted in more sustained pulmonary levels of vancomycin. Collectively, these results suggested that dry powder vancomycin can successfully be delivered by pulmonary inhalation in intubated patients. Furthermore, as inhaled vancomycin is delivered locally to the site of pulmonary infection, this delivery route could reduce the total dose required for therapeutic efficacy and simultaneously reduce the risk of renal toxicity by eliminating the high levels of systemic drug exposure required to push the pulmonary dose to therapeutic thresholds during iv administration.
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Affiliation(s)
- Bradley P Sullivan
- †Department of Pharmaceutical Chemistry, University of Kansas, Lawrence, Kansas 66047, United States
| | - Nashwa El-Gendy
- †Department of Pharmaceutical Chemistry, University of Kansas, Lawrence, Kansas 66047, United States.,§Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Christopher Kuehl
- †Department of Pharmaceutical Chemistry, University of Kansas, Lawrence, Kansas 66047, United States
| | - Cory Berkland
- †Department of Pharmaceutical Chemistry, University of Kansas, Lawrence, Kansas 66047, United States.,∥Department of Chemical and Petroleum Engineering, University of Kansas, Lawrence, Kansas 66045, United States
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Lewis PO, Kirk LM, Brown SD. Comparison of three generic vancomycin products using liquid chromatography-mass spectrometry and an online tool. Am J Health Syst Pharm 2015; 71:1029-38. [PMID: 24865760 DOI: 10.2146/ajhp130516] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Three different generic vancomycin products were compared using liquid chromatography-mass spectrometry (LC-MS) and open-access metabolomic tools. METHODS Single-lot samples of vancomycin hydrochloride from three different manufacturers (Hospira, APP Pharmaceuticals, and Pfizer) were reconstituted and injected into a high-resolution LC-MS system. The mass spectral fingerprints were compared for similarity of nonvancomycin B components using the XCMS Online system through Scripps University. Significance was defined as a p of ≤0.01 and a fold change of ≥1.5. The concentration of vancomycin B in each product was also measured using LC-MS on days 0, 1, 2, 4, 7, 10, and 14. RESULTS Qualitative comparisons of the products using the XCMS Online interface indicated the presence of significant differences among the products at the time of reconstitution; however, these variations seemed to converge after 14 days of storage. The concentration profiles of vancomycin B during refrigerated storage did not differ significantly among the three products. XCMS Online analyses revealed that the Pfizer and Hospira products were the most similar to each other. CONCLUSION While there were no significant differences found in the concentration of vancomycin B among Pfizer, APP, and Hospira products, there were differences in their initial mass spectral analysis after reconstitution. Liquid chromatography-tandem mass spectrometry profiles of the ions or isotopes present in the three products showed significant differences in impurities such as crystalline degradation product (CDP)-1 and CDP intermediate. After 14 days of refrigerated storage, the differences among the products converged, and fewer distinct features could be detected.
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Affiliation(s)
- Paul O Lewis
- Paul O. Lewis, Pharm.D., BCPS, is Clinical Pharmacy Specialist-Infectious Diseases, Johnson City Medical Center, Johnson City, TN. Loren M. Kirk, B.S., is Pharm.D. Candidate; and Stacy D. Brown, Ph.D., is Associate Professor of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City.
| | - Loren M Kirk
- Paul O. Lewis, Pharm.D., BCPS, is Clinical Pharmacy Specialist-Infectious Diseases, Johnson City Medical Center, Johnson City, TN. Loren M. Kirk, B.S., is Pharm.D. Candidate; and Stacy D. Brown, Ph.D., is Associate Professor of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City
| | - Stacy D Brown
- Paul O. Lewis, Pharm.D., BCPS, is Clinical Pharmacy Specialist-Infectious Diseases, Johnson City Medical Center, Johnson City, TN. Loren M. Kirk, B.S., is Pharm.D. Candidate; and Stacy D. Brown, Ph.D., is Associate Professor of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City
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Pharmacodynamic evaluation of the activities of six parenteral vancomycin products available in the United States. Antimicrob Agents Chemother 2014; 59:622-32. [PMID: 25385113 DOI: 10.1128/aac.03710-14] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A recent report found that generic parenteral vancomycin products may not have in vivo efficacies equivalent to those of the innovator in a neutropenic murine thigh infection model despite having similar in vitro microbiological activities and murine serum pharmacokinetics. We compared the in vitro and in vivo activities of six of the parenteral vancomycin products available in the United States. The in vitro assessments for the potencies of the vancomycin products included MIC/minimal bactericidal concentration (MBC) determinations, quantifying the impact of human and murine serum on the MIC values, and time-kill studies. Also, the potencies of the vancomycin products were quantified with a biological assay, and the human and mouse serum protein binding rates for the vancomycin products were measured. The in vivo studies included dose-ranging experiments with the 6 vancomycin products for three isolates of Staphylococcus aureus in a neutropenic mouse thigh infection model. The pharmacokinetics of the vancomycin products were assessed in infected mice by population pharmacokinetic modeling. No differences were seen across the vancomycin products with regard to any in vitro evaluation. Inhibitory sigmoid maximal bacterial kill (Emax) modeling of the relationship between vancomycin dosage and the killing of the bacteria in mice in vivo yielded similar Emax and EC50 (drug exposure driving one-half Emax) values for bacterial killing. Further, there were no differences in the pharmacokinetic clearances of the 6 vancomycin products from infected mice. There were no important pharmacodynamic differences in the in vitro or in vivo activities among the six vancomycin products evaluated.
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Precision of vancomycin and daptomycin MICs for methicillin-resistant Staphylococcus aureus and effect of subculture and storage. J Clin Microbiol 2014; 52:3898-905. [PMID: 25143569 DOI: 10.1128/jcm.01571-14] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The reproducibility of vancomycin and daptomycin MICs, measured by broth microdilution (BMD) and Etest, was prospectively assessed for 10 methicillin-resistant Staphylococcus aureus (MRSA) isolates from the blood samples from patients on vancomycin therapy. The isolates were tested at the time of isolation from blood and following 5, 10, and 20 subcultures and at 1, 3, 6, and 12 months of storage at -70 °C. The MICs were determined by Etest and BMD using two different manufacturers (BBL and Difco) of cation-adjusted Mueller-Hinton broth (CA-MHB), and using three different drug powders: vancomycin from Sigma, vancomycin from Novation, and daptomycin from Cubist. The antimicrobial concentrations tested were 0.25, 0.5, 0.75, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, and 4.0 μg/ml. Two isolates were vancomycin intermediate and daptomycin nonsusceptible, and two isolates had reduced susceptibility to vancomycin (BMD MIC, 1.5 or 2.0 μg/ml). The vancomycin MICs were significantly higher in the BBL CA-MHB than those in the Difco CA-MHB, and with Sigma versus Novation vancomycin powder. The daptomycin MICs were also significantly higher in the BBL CA-MHB. The Etest MICs were significantly higher than those obtained by BMD for vancomycin but not for daptomycin. The average precision of the vancomycin BMD MICs when analyzing 20 results was ± 1.10-fold log2 dilutions, and it was ± 1.67-fold for daptomycin (10 results). The average precision for Etest was ± 1.11-fold for vancomycin and ± 1.16-fold for daptomycin. No significant change in MICs was noted following 5, 10, or 20 subcultures or at up to 6 months of frozen storage. However, the vancomycin MICs alone were significantly lower (0.74-fold) following 12 months of frozen storage. From these data, despite variations in CA-MHB and antimicrobial powder, the MIC result precision was <0.5 log2 dilutions in a single laboratory, suggesting that testing interdilution MICs (e.g., MICs between serial 2-fold dilutions) is a possibility. A more accurate method for measuring vancomycin MIC results is thus possible, but further standardization of BMD testing would be required to achieve this goal.
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Monnier A, Malbranche C, Fagnoni P, Serge Aho L, Guerard P, Sgro C, Guignard MH, Croisier-Bertin D, Chavanet P, Chrétien ML, Caillot D, Boulin M. Generic vancomycin products: Analysis of serum concentrations in patients with acute myeloid leukemia. ANNALES PHARMACEUTIQUES FRANÇAISES 2014; 72:178-83. [PMID: 24780833 DOI: 10.1016/j.pharma.2013.12.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 12/13/2013] [Accepted: 12/19/2013] [Indexed: 11/26/2022]
Abstract
UNLABELLED Concerns have recently emerged about the quality of generic vancomycin products. Our aim is to analyze serum vancomycin concentrations measured 48 hours after the start of an empirical treatment regimen in patients with acute myeloid leukemia (AML) who received one of the two generic vancomycin products available in France. PATIENTS AND METHODS Seventy-nine AML patients treated with vancomycin during two study periods were included in the study. Our vancomycin dosing regimen was based on the patients' total body weight adjusted for renal clearance. RESULTS A total of 93 serum vancomycin concentrations were collected: 31 in period 1 and 62 in period 2. In bivariate analysis, the mean serum vancomycin concentrations were not significantly different (19.9 ± 11.2 mg/L in period 1 vs 18.9 ± 6.0 mg/L in period 2, P=0.64). In the final generalized estimating equations model, serum vancomycin concentrations correlated statistically with a positive coefficient for age (P<0.001) and with negative coefficients for male sex (P=0.001) and hemoglobin level (P=0.021). CONCLUSION Serum vancomycin concentrations measured 48 hours after the start of an empirical treatment were not influenced by the nature of the generic product but correlated with age, sex and hemoglobin level in AML patients.
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Affiliation(s)
- A Monnier
- Department of Pharmacy, University Hospital, 14, rue Gaffarel, 21000 Dijon, France
| | - C Malbranche
- Department of Pharmacy, University Hospital, 14, rue Gaffarel, 21000 Dijon, France
| | - P Fagnoni
- Department of Pharmacy, University Hospital, 14, rue Gaffarel, 21000 Dijon, France; University of Burgundy, EA4184, BP 87900, 21079 Dijon, France
| | - L Serge Aho
- Department of Epidemiology, University Hospital, 14, rue Gaffarel, 21000 Dijon, France
| | - P Guerard
- Department of Pharmacology-Toxicology, University Hospital, 2, rue Angélique-Ducoudray, 21000 Dijon, France
| | - C Sgro
- Department of Pharmacovigilance, University Hospital, 14, rue Gaffarel, 21000 Dijon, France
| | - M-H Guignard
- Department of Pharmacy, University Hospital, 14, rue Gaffarel, 21000 Dijon, France
| | - D Croisier-Bertin
- Department of Infectious Diseases and Vivexia, University Hospital, 14, rue Gaffarel, 21000 Dijon, France
| | - P Chavanet
- Department of Infectious Diseases and Vivexia, University Hospital, 14, rue Gaffarel, 21000 Dijon, France
| | - M-L Chrétien
- Department of Hematology, University Hospital, 14, rue Gaffarel, 21000 Dijon, France
| | - D Caillot
- Department of Hematology, University Hospital, 14, rue Gaffarel, 21000 Dijon, France
| | - M Boulin
- Department of Pharmacy, University Hospital, 14, rue Gaffarel, 21000 Dijon, France; University of Burgundy, EA4184, BP 87900, 21079 Dijon, France.
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Encore des évidences en faveur des génériques ! ANNALES PHARMACEUTIQUES FRANÇAISES 2014; 72:141-2. [DOI: 10.1016/j.pharma.2014.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Even apparently insignificant chemical deviations among bioequivalent generic antibiotics can lead to therapeutic nonequivalence: the case of meropenem. Antimicrob Agents Chemother 2013; 58:1005-18. [PMID: 24277034 DOI: 10.1128/aac.00350-13] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Several studies with animal models have demonstrated that bioequivalence of generic products of antibiotics like vancomycin, as currently defined, do not guarantee therapeutic equivalence. However, the amounts and characteristics of impurities and degradation products in these formulations do not violate the requirements of the U.S. Pharmacopeia (USP). Here, we provide experimental data with three generic products of meropenem that help in understanding how these apparently insignificant chemical differences affect the in vivo efficacy. Meropenem generics were compared with the innovator in vitro by microbiological assay, susceptibility testing, and liquid chromatography/mass spectrometry (LC/MS) analysis and in vivo with the neutropenic guinea pig soleus infection model (Pseudomonas aeruginosa) and the neutropenic mouse thigh (P. aeruginosa), brain (P. aeruginosa), and lung (Klebisella pneumoniae) infection models, adding the dihydropeptidase I (DHP-I) inhibitor cilastatin in different proportions to the carbapenem. We found that the concentration and potency of the active pharmaceutical ingredient, in vitro susceptibility testing, and mouse pharmacokinetics were identical for all products; however, two generics differed significantly from the innovator in the guinea pig and mouse models, while the third generic was therapeutically equivalent under all conditions. Trisodium adducts in a bioequivalent generic made it more susceptible to DHP-I hydrolysis and less stable at room temperature, explaining its therapeutic nonequivalence. We conclude that the therapeutic nonequivalence of generic products of meropenem is due to greater susceptibility to DHP-I hydrolysis. These failing generics are compliant with USP requirements and would remain undetectable under current regulations.
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Tattevin P, Cremieux AC, Rabaud C, Gauzit R. Efficacy and Quality of Antibacterial Generic Products Approved for Human Use: A Systematic Review. Clin Infect Dis 2013; 58:458-69. [DOI: 10.1093/cid/cit769] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Sommers CD, Pang ES, Ghasriani H, Berendt RT, Vilker VL, Keire DA, Boyne MT. Analyses of marketplace tacrolimus drug product quality: Bioactivity, NMR and LC–MS. J Pharm Biomed Anal 2013; 85:108-17. [DOI: 10.1016/j.jpba.2013.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Revised: 06/25/2013] [Accepted: 07/01/2013] [Indexed: 02/01/2023]
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Kassamali Z, Rotschafer JC, Jones RN, Prince RA, Danziger LH. Polymyxins: Wisdom Does Not Always Come With Age. Clin Infect Dis 2013; 57:877-83. [DOI: 10.1093/cid/cit367] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Jones RN, Watters AA, Flamm RK, Sader HS. Comparative potencies of contemporary generic vancomycin lot: in vitro assay results from nine products and a reference reagent-grade sample. Diagn Microbiol Infect Dis 2013; 76:237-8. [PMID: 23434498 DOI: 10.1016/j.diagmicrobio.2013.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Accepted: 01/09/2013] [Indexed: 10/27/2022]
Abstract
Numerous studies of generic vancomycin (GV) lots have emerged since the 1980s, casting some doubt on product quality. Publications question the in vivo activity, even when concurrent in vitro and chemical assays meet regulatory guidelines. This study assessed contemporary GV lots by an in vitro assay capable of measuring small variations from target-benchmark (BM) activity. Nine GV lots (Hospira [6 lots; 0.5- or 1.0-g vials], Akorn [1 lot; 1.0-g vial], APP [2 lots; 1.0-g vials]) were obtained from local United States distributors. A reagent-grade lot (Sigma lot 080M1341V) was tested as BM component due to the inability to purchase branded product vials in the USA. All lots of GV did not vary significantly from the analytical control when testing the 3 Staphylococcus aureus (wild-type 4B25, ATCC 25923, and 29213) and Enterococcus faecalis (ATCC 29212) strains. These MIC end points were read at 18 h of incubation, and Hospira lots averaged +3.5% potency (range, -3% to +8%), and Akorn and APP at 0% variance, e.g., acceptable performance. In conclusion, with a validated, precise multi-organism assay, current GV lots marketed in the USA showed minimal activity variations from a selected BM control lot. Generic antimicrobial products, in general, should be regularly monitored for potency, chemical purity, and in vivo activity before routine use in medical centers.
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Gauzit R, Petitjean O. Réponse à la lettre à la rédaction : « Commentaires sur les génériques d’antibiotiques ». Med Mal Infect 2013; 43:36-7. [DOI: 10.1016/j.medmal.2012.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 11/18/2012] [Indexed: 11/26/2022]
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Levêque D, Gourieux B. Commentaires sur les génériques d’antibiotiques. Med Mal Infect 2013; 43:35-6. [DOI: 10.1016/j.medmal.2012.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Accepted: 11/18/2012] [Indexed: 11/25/2022]
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Comparison of six generic vancomycin products for treatment of methicillin-resistant Staphylococcus aureus experimental endocarditis in rabbits. Antimicrob Agents Chemother 2012; 57:1157-62. [PMID: 23254435 DOI: 10.1128/aac.01669-12] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Concerns have recently emerged about the potency and the quality of generic vancomycin (VAN) products approved for use in humans, based on experiments in a neutropenic mouse thigh infection model. However, other animal models may be more appropriate to decipher the bactericidal activities of VAN generics in vivo and to predict their efficacy in humans. We aimed to compare the bactericidal activities of six generic VAN products currently used in France (Mylan and Sandoz), Spain (Hospira), Switzerland (Teva), and the United States (Akorn-Strides and American Pharmaceutical Products [APP]) in a rabbit model of aortic valve endocarditis induced by 8 × 10(7) CFU of methicillin-resistant Staphylococcus aureus (MRSA) strain COL (VAN MIC, 1.5 μg/ml). In vitro, there were no significant differences in the time-kill curve studies performed with the six generic VAN products. Ten rabbits in each group were treated with intravenous (i.v.) VAN, 60 mg/kg of body weight twice a day (b.i.d.) for 4 days. Mean peak serum VAN levels, measured 45 min after the last injection, ranged from 35.5 (APP) to 45.9 μg/ml (Teva). Mean trough serum VAN levels, measured 12 h after the last injection, ranged from 2.3 (Hospira) to 9.2 (APP) μg/ml. All generic VAN products were superior to controls (no treatment) in terms of residual organisms in vegetations (P < 0.02 for each comparison) and in the spleen (P < 0.005 for each comparison). Pairwise comparisons of generic VAN products found no significant differences. In conclusion, a stringent MRSA endocarditis model found no significant differences in the bactericidal activities of six generic VAN products currently used in Europe and America.
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Quality assessment of U.S. marketplace vancomycin for injection products using high-resolution liquid chromatography-mass spectrometry and potency assays. Antimicrob Agents Chemother 2012; 56:2824-30. [PMID: 22371900 DOI: 10.1128/aac.00164-12] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In response to a published concern about the potency and quality of generic vancomycin products, the United States Food and Drug Administration investigated a small sampling of the vancomycin products available in North America with regard to purity, content, and potency. To facilitate identification of impurities, a new liquid chromatography method was developed using high-resolution mass spectrometry in addition to diode array detection to characterize impurities in several commercial products. Furthermore, a microbiological assay was utilized to link the analytical profiles with an in vitro potency. All products tested met the quality specifications outlined in the United States Pharmacopeia (USP) (vancomycin hydrochloride for injection monograph) for impurities and potency (USP, Vancomycin hydrochloride for injection. United States Pharmacopeia and National Formulary, vol USP 34-NF 29, 2011).
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