A fast reverse-phase high performance liquid chromatographic tandem mass spectrometry assay for the quantification of clindamycin in plasma and saliva using a rapid resolution package

Comparative Efficacy of Different Oral Doses of Clindamycin in Preventing Post-Operative Sequelae of Lower Third Molar Surgery—A Randomized, Triple-Blind Study

Background and Objectives. Antibiotic regimen optimization is a major concern in post extraction sequelae management following third molar surgery, mostly owing to the absence of universal guidelines. Hence, this study aimed to determine the effect of antibiotic prophylaxis using three different doses of clindamycin on the prevention of infection and other complications following mandibular third molar disimpaction. The secondary outcome was testing whether clindamycin exhibits activity in acute or chronic models of pain using the visual analog scale of pain and the necessity for post-operative rescue analgesia. The tertiary outcome was to assess clindamycin penetration into the saliva by measuring its concentration using liquid chromatography/electrospray ionization tandem mass spectrometry. Materials and Methods. A randomized, two-center, triple-blind, controlled clinical trial was conducted, in which the patients were randomly allocated to three groups: I, receiving 150 mg clindamycin every 8 h; II, receiving 300 mg clindamycin every 8 h; and III, receiving 600 mg clindamycin every 12 h. Each group continued the therapy for five days. Results. An overall decrease in the risk of infection and other post-operative complications, such as trismus, edema, dysphagia, and lymphadenopathy, was achieved, with the best results in group I. Conclusion. As no statistical association was observed between clindamycin concentration in saliva and degree of post-operative inflammation, clindamycin concentration, or pain intensity, smaller doses of clindamycin administered over shorter time periods is recommended.

Bio-analytical methods for investigating the effect of age, body mass index and gender on the PK/PD ratio of antibiotics

The effectiveness of antibiotics (ABs) is governed by achieving the adequate pharmacokinetic (PK)/pharmacodynamics (PD) ratio. In this study, fast LC-MS/MS methods were developed and validated for the bioanalysis of cefaclor (CFC), ciprofloxacin (CFC), roxithomycin (RXM) and clindamycin (CLD). Chromatographic separation was performed on a C₁₈ Zorbax-Eclipse Plus (3.5 μm, 100 × 4.6 mm) using isocratic elution. Detection was performed by positive electrospray ionization. The methods were applied for the assessment of PK parameters in volunteers (n = 101, 64 male and 37 female) and the effects of age, body mass index (BMI) and gender were investigated. Good linearity (r² ≥ 0.99), accuracy (>86%), precision (CV% ≤ 11) and extraction recovery (>83%) were observed for CFC, CFX, RXM and CLD. Application to PK studies revealed that age and BMI affected the T_half and the AUC of RXM and CLD (p < 0.023). Gender difference affected the critical PK parameters of the four ABs (T_half (U = 18; P = 0.036) of CFC, the C_max of CFX (U = 30; P = 0.017), the T_half (U = 23; P = 0.009) and AUC (U = 26; P = 0.008) of RXM and CLD), respectively. These results highlight the significance of age and BMI variations for RXM and CLD dosing. Furthermore, it indicates that the gender difference may be considered when adjusting the AB dose.

Stability studies of lincomycin hydrochloride in aqueous solution and intravenous infusion fluids

Purpose

The purpose of this study was to evaluate the chemical stability of Lincocin^® (lincomycin hydrochloride) in commonly used intravenous fluids at room temperature (25°C), at accelerated-degradation temperatures and in selected buffer solutions.

Materials and methods

The stability of Lincocin^® injection (containing lincomycin 600 mg/2 mL as the hydrochloride) stored at 25°C±0.1°C in sodium lactate (Hartmann’s), 0.9% sodium chloride, 5% glucose, and 10% glucose solutions was investigated over 31 days. Forced degradation of Lincocin^® in hydrochloric acid, sodium hydroxide, and hydrogen peroxide was performed at 60°C. The effect of pH on the degradation rate of lincomycin hydrochloride stored at 80°C was determined.

Results

Lincomycin hydrochloride w as found to maintain its shelf life at 25°C in sodium lactate (Hartmann’s) solution, 0.9% sodium chloride solution, 5% glucose solution, and 10% glucose solution, with less than 5% lincomycin degradation occurring in all intravenous solutions over a 31-day period. Lincomycin hydrochloride showed less rapid degradation at 60°C in acid than in basic solution, but degraded rapidly in hydrogen peroxide. At all pH values tested, lincomycin followed first-order kinetics. It had the greatest stability near pH 4 when stored at 80°C (calculated shelf life of 4.59 days), and was least stable at pH 2 (calculated shelf life of 0.38 days).

Conclusion

Lincocin^® injection was chemically found to have a shelf life of at least 31 days at 25°C when added to sodium lactate (Hartmann’s) solution, 0.9% sodium chloride solution, 5% glucose solution, and 10% glucose solution. Solutions prepared at approximately pH 4 are likely to have optimum stability.

Development of a method to quantify clindamycin in vitreous humor of rabbits' eyes by UPLC-MS/MS: application to a comparative pharmacokinetic study and in vivo ocular biocompatibility evaluation

Ocular toxoplasmosis may result in uveitis in the posterior segment of the eye, leading to severe visual complications. Clindamycin-loaded poly(lactide-co-glycolide) (PLGA) implants could be applied to treat the ocular toxoplasmosis. In this study, the pharmacokinetic profiles of the drug administrated by PLGA implants and by intravitreal injections in rabbits' eyes were evaluated. The implant released the drug for 6 weeks while the drug administrated by intravitreal injections remained in the vitreous cavity for 2 weeks. Compared to the injected drug, the implants containing clindamycin had higher values of area under the curve (AUC) (39.2 vs 716.7 ng week mL(-1)) and maximum vitreous concentration (Cmax) (8.7 vs 13.83 ng mL(-1)). The implants prolonged the delivery of clindamycin and increased the contact of the drug with the eyes' tissues. Moreover, the in vivo ocular biocompatibility of the clindamycin-loaded PLGA implants was evaluated regarding to the clinical examination of the eyes and the measurement of the intraocular pressure (IOP) during 6 weeks. The implantable devices caused no ocular inflammatory process and induced the increase of the IOP in the fourth week of the study. The IOP augmentation could be related to the maximum concentration of clindamycin released from the implants. In conclusion, the PLGA implants based on clindamycin may be a therapeutic alternative to treat ocular toxoplasmosis.