Rapid serum vancomycin assay by high-performance liquid chromatography using a semipermeable surface packing material column

Recent Trends in Therapeutic Drug Monitoring of Peptide Antibiotics

Antimicrobial peptides take a specific position in the field of antibiotics (ATBs), however, from a large number of available molecules only a few of them were approved and are used in clinics. These therapeutic modalities play a crucial role in the management of diseases caused by multidrug-resistant bacterial pathogens and represent the last-line therapy for bacterial infections. Therefore, there is a demand for a rationale use of such ATBs based on optimization of the dosing strategy to minimize the risk of resistance and ensure the sustainable efficacy of the drug in real clinical practice. Therapeutic drug monitoring, as a measurement of drug concentration in the body fluids or tissues, results in the optimization of the patient´s medication and therapy outcome. This strategy is beneficial and could result in tailored therapy for different types of infection and the prolongation of the use and efficacy of ATBs in hospitals. This review paper provides an actual overview of approved antimicrobial peptides used in clinical practice and covers current trends in their analysis by convenient and advanced methodologies used for their identification and/or quantitation in biological matrices for therapeutic drug monitoring purposes. Special emphasis is given to the methods with perspective clinical outcomes.

An Overview of Analytical Methodologies for Determination of Vancomycin in Human Plasma

Vancomycin is regarded as the last resort of defense for a wide range of infections due to drug resistance and toxicity. The detection of vancomycin in plasma has always aroused particular concern because the performance of the assay affects the clinical treatment outcome. This article reviews various methods for vancomycin detection in human plasma and analyzes the advantages and disadvantages of each technique. Immunoassay has been the first choice for vancomycin concentration monitoring due to its simplicity and practicality, occasionally interfered with by other substances. Chromatographic methods have mainly been used for scientific research due to operational complexity and the particular requirement of the instrument. However, the advantages of a small amount of sample needed, high sensitivity, and specificity makes chromatography irreplaceable. Other methods are less commonly used in clinical applications because of the operational feasibility, clinical application, contamination, etc. Simplicity, good performance, economy, and environmental friendliness have been points of laboratory methodological concern. Unfortunately, no one method has met all of the elements so far.

An ultra-performance liquid chromatography–tandem mass spectrometry method to quantify vancomycin in human serum by minimizing the degradation product and matrix interference

Aim: This study aimed to develop and validate a method for better therapeutic monitoring of vancomycin serum concentration. Methods & results: An ultra-performance liquid chromatography–tandem mass spectrometry (UPLC–MS/MS) method was developed and validated to minimize the interference of crystalline degradation product and matrix. It was compared with chemiluminescence microparticle immunoassay (CMIA) and ultra-performance liquid chromatography with ultraviolet detection (UPLC-UV) in the performance of testing normal, on-dialysis and hemolytic serum samples. For on-dialysis samples, a moderate correlation (r = 0.534) was observed between UPLC-UV and UPLC–MS/MS. In testing hemolytic samples, ten (10/85, 11.8%) samples were overestimated by CMIA method. Conclusion: Vancomycin concentration determined by CMIA, UPLC-UV was more affected by various panels of serum samples than UPLC–MS/MS assay, suggesting that UPLC–MS/MS is a more reliable and promising tool for clinical vancomycin therapeutic drug monitoring.

Stability-indicating spectrofluorimetric method with enhanced sensitivity for determination of vancomycin hydrochloride in pharmaceuticals and spiked human plasma: Application to degradation kinetics

Based on investigating the relative fluorescence intensity of vancomycin hydrochloride (VCM) in methanol, a simple, highly sensitive, time-saving and specific spectrofluorimetric method was developed and validated. VCM fluorescence was measured at 335 nm when excited at 268 nm. Excellent linearity is obeyed in the concentration range 1–100 ng/mL with a detection limit of 5.94 pg/mL, a quantitation limit of 18.03 pg/mL and a very good correlation coefficient (r = 0.9999). Our method was applied to analyze VCM in pharmaceuticals as well as spiked human plasma. Moreover, VCM stability was studied when exposed to various degradation conditions such as oxidative, alkaline as well as acidic stress. Acidic and alkaline degradation kinetics of VCM was studied for the first time. The degradation follows pseudo-first-order kinetics. The apparent rate constants and half-life times were calculated. The Arrhenius equation was assessed and the activation energies of the degradation were also calculated. The developed method can be easily applied in quality control laboratories due to its sensitivity, specificity, simplicity and low cost.

A novel permanganate–morin–CdS quantum dots flow injection chemiluminescence system for sensitive determination of vancomycin

The intensity of emitted light from KMnO₄−morin−CdS QDs system is described as a novel chemiluminescence (CL) reaction. The CL intensity of this CL system was remarkably enhanced in the presence of vancomycin.

CuO nanosheets-enhanced flow-injection chemiluminescence system for determination of vancomycin in water, pharmaceutical and human serum

A novel, rapid and sensitive CuO nanosheets (NSs) amplified flow-injection chemiluminescence (CL) system, luminol-H2O2-CuO nanosheets, was developed for determination of the vancomycin hydrochloride for the first time. It was found that vancomycin could efficiently inhibit the CL intensity of luminol-H2O2-CuO nanosheets system in alkaline medium. Under the optimum conditions, the inhibited CL intensity was linearly proportional to the concentration of vancomycin over the ranges of 0.5-18.0 and 18.0-40.0 mg L(-1), with a detection limit (3σ) of 0.1 mg L(-1). The precision was calculated by analyzing samples containing 5.0 mg L(-1) vancomycin (n=11) and the relative standard deviation (RSD) was 2.8%. Also, a high injection throughput of 120 sample h(-1) was obtained. The CuO nanosheets were synthesized by a sonochemical method. Also, X-ray diffraction (XRD) and scanning electron microscopy (SEM) analyses were employed to characterize the CuO nanosheets. The method was successfully employed to determine vancomycin hydrochloride in environmental water samples, pharmaceutical formulation and spiked human serum.

Simultaneous and Direct Determination of Vancomycin and Cephalexin in Human Plasma by Using HPLC-DAD Coupled with Second-Order Calibration Algorithms

A simple, rapid, and sensitive method for the simultaneous determination of vancomycin and cephalexin in human plasma was developed by using HPLC-DAD with second-order calibration algorithms. Instead of a completely chromatographic separation, mathematical separation was performed by using two trilinear decomposition algorithms, that is, PARAFAC-alternative least squares (PARAFAC-ALSs) and self-weight-alternative-trilinear-decomposition- (SWATLD-) coupled high-performance liquid chromatography with DAD detection. The average recoveries attained from PARAFAC-ALS and SWATLD with the factor number of 4 (N = 4) were 101 ± 5% and 102 ± 4% for vancomycin, and 96 ± 3% and 97 ± 3% for cephalexininde in real human samples, respectively. The statistical comparison between PARAFAC-ALS and SWATLD is demonstrated to be similar. The results indicated that the combination of HPLC-DAD detection with second-order calibration algorithms is a powerful tool to quantify the analytes of interest from overlapped chromatographic profiles for complex analysis of drugs in plasma.

Simultaneous determination of cefepime, vancomycin and imipenem in human plasma of burn patients by high-performance liquid chromatography

A liquid chromatographic method with UV detection for simultaneous determination of cefepime, vancomycin and imipenem has been developed. Cefuroxime was used as internal standard. After the clean up of samples by plasma protein precipitation, 5 microl of the extract were injected into the chromatograph and peaks were eluted from the Sulpelcosil LC-18 column using a mobile phase consisting of 0.075 M acetate buffer:acetonitrile (92:8, v/v), pH 5.0 at low rate (0.8 ml/min). The detection wavelength was 230 nm. The limit of detection was 0.4 microg/ml for cefepime and 0.2 microg/ml for vancomycin and imipenem. The method was applied to plasma samples of burn patients, and only small volumes of plasma were required for the simultaneous determination of those antimicrobial agents.

Simultaneous determination of cefepime and vancomycin in plasma and cerebrospinal fluid by MEKC with direct sample injection and application for bacterial meningitis

A simple MEKC with UV detection at 214 nm for simultaneous analysis of cefepime and vancomycin in plasma and in cerebrospinal fluid (CSF) by direct injection without any sample pretreatment is described. The separation of cefepime and vancomycin from biological matrices was performed at 25 degrees C using a BGE consisting of a Tris buffer with SDS and methanol as the electrolyte solution. Under optimal MEKC conditions for biological samples, good separations with high efficiency and short analysis time are achieved. Several parameters affecting the separation of the drugs from biological matrices were studied, including methanol, pH, and concentrations of the Tris buffer and SDS. The linear ranges of the method for the determination of cefepime and vancomycin in plasma and in CSF using imidazole or cefazolin as an internal standard, respectively, were all over the range of 1-30 microg/mL; the detection limits of cefepime and vancomycin in biological matrices (injection 10 kV, 15 s) were 0.3 and 0.5 microg/mL, respectively. The applicability of the proposed method for the determination of cefepime and vancomycin in plasma and CSF collected after intravenous administration of the drugs in patients with meningitis was demonstrated.

Indirect spectrophotometric determination of gentamicin and vancomycin antibiotics based on their oxidation by potassium permanganate

Four simple, accurate, sensitive and economical procedures (A–D) for the estimation of gentamicin sulphate and vancomycin hydrochloride, both in pure form and in pharmaceutical formulations have been developed. The methods are based on the oxidation of the studied drugs by a known excess of potassium permanganate in sulphuric acid medium and subsequent determination of unreacted oxidant by reacting it with amaranth dye (method A), acid orange II (method B), indigocarmine (method C) and methylene blue (method D), in the same acid medium at a suitable λmax=521, 485, 610 and 664 nm, respectively. The reacted oxidant corresponds to the drug content. Regression analysis of Beer-Lambert plots showed good correlations in the concentration ranges 4–8, 3–8, 4–9 and 5–9 µg ml−1 with gentamicin and 4–8, 1.5–4, 1.5–4 and 3.5–5.5 µg ml−1 with vancomycin for methods A, B, C, and D, respectively. The molar absorptivity, sandell sensitivity, detection and quantification limits were calculated. The stoichiometric ratios for the cited drugs were studied. The optimum reaction conditions and other analytical parameters were evaluated. The influence of the substance commonly employed as excipients with these drugs were studied. The proposed methods were applied to the determination of these drugs in pharmaceutical formulations. The results have demonstrated that the methods are equally accurate and reproducible as the official methods.

Successful management of discovered pH dependence in vancomycin recovery studies: novel HPLC method for microdialysis and plasma samples

Vancomycin is a glycopeptide antibiotic approved for the treatment of serious infections or patients allergic to beta-lactams. A rapid HPLC assay using UV detection for the determination in microdialysate and human plasma was developed. After sample preparation, using methanol and trichloroacetic acid for plasma and water for microdialysate, 20 microL were injected and separated on a RP(18) column. Overall, the assay exhibited good precision and accuracy. The diffusion properties of vancomycin investigated in in vitro microdialysis experiments revealed an unfavourable concentration dependence avertable by keeping a constant pH using phosphate buffer as perfusate. The mean relative recoveries were 27.8% [coefficient of variation (CV) 11.1%] and 33.2% (CV 8.3%) for retrodialysis and recovery experiments, respectively. Following characterization of vancomycin in in vitro microdialysis, the developed setting is suitable for application in (pre-)clinical studies.

Restricted access materials and large particle supports for on-line sample preparation: an attractive approach for biological fluids analysis

An analytical process generally involves four main steps: (1) sample preparation; (2) analytical separation; (3) detection; and (4) data handling. In the bioanalytical field, sample preparation is often considered as the time-limiting step. Indeed, the extraction techniques commonly used for biological matrices such as liquid-liquid extraction (LLE) and solid-phase extraction (SPE) are achieved in the off-line mode. In order to perform a high throughput analysis, efforts have been engaged in developing a faster sample purification process. Among different strategies, the introduction of special extraction sorbents, such as the restricted access media (RAM) and large particle supports (LPS), allowing the direct and repetitive injection of complex biological matrices, represents a very attractive approach. Integrated in a liquid chromatography (LC) system, these extraction supports lead to the automation, simplification and speeding up of the sample preparation process. In this paper, RAM and LPS are reviewed and particular attention is given to commercially available supports. Applications of these extraction supports, are presented in single column and column-switching configurations, for the direct analysis of compounds in various biological fluids.

An automated analyzer for vancomycin in plasma samples by column-switching high-performance liquid chromatography with UV detection

An automated analyzer for vancomycin in rat plasma by column-switching high-performance liquid chromatography (HPLC) with UV detection was developed. The method includes in-line extraction of vancomycin by ion-exchange cartridge column and a separation on a reversed-phase column with UV detection at 215 nm. Plasma samples were diluted by mobile phase solution and directly injected to HPLC. Vancomycin was quantitatively recovered from rat plasma samples. The separation was completed within 15 min. The calibration curve was linear over the range from 0.5 to 100 microg/mL with the detection and quantification limits of 0.5 microg/mL (2.5 ng on column; signal-to-noise ratio = 3). The values of precision in intra- and inter-day assays (n = 3) were less than 1.92 and 3.69%, respectively. This method does not require time-consuming pre-treatment and is suitable for the routine assay of plasma samples.

Highly sensitive quantification of vancomycin in plasma samples using liquid chromatography-tandem mass spectrometry and oral bioavailability in rats

We developed a highly sensitive liquid chromatography-tandem mass spectrometry assay (LC-MS-MS) for a glycopeptide antibacterial drug, vancomycin (VCM), in rat plasma. After precipitating 100 micro l of plasma with 300 micro l of 10% trifluoroacetic acid-methanol (2:1, v/v), the supernatant was diluted with 300 micro l of distilled water and was passed through a filter. LC-MS-MS equipped with electrospray ionization in the positive ion mode used a pair of ions at 725/144 m/z for VCM in the multiple reaction-monitoring mode with a sample injection volume of 20 micro l. The calibration curve had a linear range from 0.01 to 20 micro g/ml when linear least square regression was applied to the concentration versus peak area plot. The drug in the sample was detected within 5 min. Precision, accuracy and limit of quantitation indicated that this method was suitable for the quantitative determination of VCM in rat plasma. Using this method, we defined for the first time that the oral bioavailability of VCM in rats was 0.069%. This method can be applied to basic pharmacokinetic and pharmaceutical studies in rats.

Determination of vancomycin in human serum by micellar electrokinetic capillary chromatography with direct sample injection

BACKGROUND

Vancomycin (VCM) has a bacteriostatic effect on gram-positive bacteria such as the methicillin-resistant Staphylococcus aureus.

METHODS

A new assay for measuring vancomycin concentration by micellar electrokinetic capillary chromatography using direct serum injection was developed. A borate buffer (pH 10.0) containing 100 mmol/l sodium dodecyl sulfate was used as an electrophoresis buffer, and the detection was at 210 nm. The migration time of vancomycin was approximately 7 min.

RESULTS

The linearity was from 0 to 100 microg/ml, with the limit of detection of 1.0 microg/ml (S/N=3). The within-run CV was 3.99-5.53%, and the recovery rate was 91-103% for a concentration range of 6.5-45.5 microg/ml. The between-day CV was 6.76% at 22.2 microg/ml. There was no interference from 32 other antibiotics. The correlation coefficient between the assay and fluorescence polarization immunoassay and direct injection HPLC was 0.982 and 0.985, respectively. The assay required no sample preparation of serum and used only microquantities of an electrophoresis buffer and samples.

CONCLUSIONS

This assay is cost-effective and suitable for routine clinical use.