Toxicity Profile and Pharmacokinetic Study of Antibiotic Mixtures, Gentamicin and Vancomycin, in Rat Plasma by Ecofriendly Liquid Chromatography Coupled Tandem Mass Spectrometry

The development of a bioanalytical method for the simultaneous analysis of gentamicin and tacrolimus in Rat whole blood using UHPLC-MS/MS

Tacrolimus (TAC) is commonly administered to patients who have undergone organ transplantation to prevent the immune system from rejecting the transplanted organ. Multidrug-resistant bacterial infections are the most frequent complications during the first-month post-transplantation. Old antimicrobial agents such as gentamicin (GEN) are widely used to treat opportunistic nosocomial infections in immunosuppressed TAC patients. Nephrotoxicity is a significant side effect of GEN and TAC, but some studies indicated their concurrent administration. However, there is no information on whether the combination of the two drugs may result in a more significant impairment of kidney function than either drug used separately. To investigate this, both drugs should be monitored in blood. Sample preparation was carried out using protein precipitation, requiring only 50 µL of WB sample with an extraction recovery of not less than 95.2% (GEN) and 93.2% (TAC). Analytes and internal standard (IS) were monitored using mass spectrometry (MS) in positive ion mode by multiple reaction monitoring (MRM). Chromatographic analysis was performed on an Acquity UPLC BEH C18 column (50 mm × 2.1 mm, 1.7 μm), kept at 50 °C and using gradient elution. Mobile phase A contained 2 mmol/L ammonium formate acidified with 0.1% formic acid in water, and mobile phase B was a mixture of 2 mmol/L ammonium formate and 0.1% formic acid in methanol, pumped at a flow rate of 0.25 mL/min. The analysis time was only 6 min. The method was verified according to the European Medicines Agency (EMA) guidelines over a concentration range of 19.5-2500 ng/mL for GEN and 1.95-250 ng/mL for TAC. Determination coefficients for the calibration curves were found to be ≥ 0.999. Within- and between-run precision and accuracy were evaluated for both drugs with relative standard deviations (RSD) ≤ 6.5% and inaccuracy ≤ 6.6%. The proposed method was successfully applied to analyze the WB samples at different time points after the co-administration of GEN and TAC to Wistar rats. In this work, a new bioanalytical UHPLC-MS/MS method was developed and validated for simultaneous quantification of total GEN congeners (C1, C1a, and C2/C2a) and TAC in Wistar rats whole blood (WB). The protein precipitation method has been chosen to extract the drug from the WB sample. The assay method has been successfully used to estimate the concentration of TAC and GEN after co-administration in rats.

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.

Preanalytical Stability of 13 Antibiotics in Biological Samples: A Crucial Factor for Therapeutic Drug Monitoring

The stability of antibiotic preanalytical samples is a critical factor in therapeutic drug monitoring (TDM), a practice of undoubted importance for the proper therapeutic use of antibiotics, especially in complex management patients, such as pediatrics. This review aims to analyze the data in the literature regarding the preanalytical stability of some of the antibiotics for which TDM is most frequently requested. The literature regarding the preanalytical stability of amikacin, ampicillin, cefepime, ceftazidime, ciprofloxacin, daptomycin, gentamicin, levofloxacin, linezolid, meropenem, piperacillin, teicoplanin, and vancomycin in plasma, serum, whole blood, and dried blood/plasma spot samples was analyzed. Various storage temperatures (room temperature, 4 °C, -20 °C, and -80 °C) and various storage times (from 1 h up to 12 months) as well as subjecting to multiple freeze-thaw cycles were considered. The collected data showed that the non-beta-lactam antibiotics analyzed were generally stable under the normal storage conditions used in analytical laboratories. Beta-lactam antibiotics have more pronounced instability, particularly meropenem, piperacillin, cefepime, and ceftazidime. For this class of antibiotics, we suggest that storage at room temperature should be limited to a maximum of 4 h, storage at 2-8 °C should be limited to a maximum of 24 h, and storage at -20 °C should be limited to a maximum of 7 days; while, for longer storage, freezing at -80 °C is suggested.

Fortified Dual-Spectral Overlap with Enhanced Colorimetric/Fluorescence Dual-Response Immunochromatography for On-Site Bimodal-Type Gentamicin Monitoring

Immunochromatography (ICA) remains untapped toward enhanced sensitivity and applicability for fulfilling the nuts and bolts of on-site food safety surveillance. Herein, we report a fortified dual-spectral overlap with enhanced colorimetric/fluorescence dual-response ICA for on-site bimodal-type gentamicin (Gen) monitoring by employing polydopamine (PDA)-coated AuNPs (APDA) simultaneously serving as a colorimetric reporter and a fluorescence quencher. Availing of the enhanced colorimetric response that originated from the PDA layer, the resultant APDA exhibits less required antibody and immunoprobes in a single immunoassay, which facilitates improved antibody utilization efficiency and immuno-recognition in APDA-ICA. Further integrated with the advantageous features of fortified excitation and emission dual-spectral overlap for the Arg/ATT-AuNCs, this APDA-ICA with a "turn on/off" pattern achieves the visual limits of detection of 1.0 and 0.5 ng mL-1 for colorimetric and fluorescence patterns (25- and 50-fold lower than standard AuNPs-ICA). Moreover, the excellent self-calibration and satisfactory recovery of 79.03-118.04% were shown in the on-site visual colorimetric-fluorescence analysis for Gen in real environmental media (including real river water, an urban aquaculture water body, an aquatic product, and an animal byproduct). This work provides the feasibility of exploiting fortified dual-spectral overlap with an enhanced colorimetric/fluorescence dual response for safeguarding food safety and public health.

Development of a sensitive direct competitive chemiluminescent enzyme immunoassay for gentamicin based on the construction of a specific single-chain variable fragment-alkaline phosphatase fusion protein

A sensitive chemiluminescent enzyme immunoassay (CLEIA) was established for the determination of gentamicin (GEN) residue levels in animal tissue. This assay is based on a fusion protein of single-chain variable fragment (scFv) and alkaline phosphatase (AP). Initially, VL and VH derived from anti-gentamicin monoclonal antibody were linked by a short peptide to construct a scFv. Subsequently, the constructed scFv sequence was accessed into the pLIP6/GN vector, and a soluble scFv-AP fusion protein was generated. The scFv-AP fusion protein was used to develop a direct competitive CLEIA (dcCLEIA) for the determination of gentamicin. In the dcCLEIA, the half inhibitory concentration (IC50) and limit of detection (LOD) were 1.073 ng/mL and 0.380 ng/mL, respectively. The average recoveries of gentamicin spiked in animal tissue samples ranged from 78% to 96%. These results showed a strong correlation with ultra performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). The above results suggest that the anti-GEN scFv-AP fusion protein is suitable for detecting gentamicin residues in edible animal tissues.

Surface molecularly imprinted solid-phase extraction for the determination of vancomycin in plasma samples using HPLC-MS/MS

Vancomycin is a glycopeptide antibiotic used to treat infections caused by Gram-positive bacteria. Due to the narrow therapeutic index of vancomycin, it is necessary to develop a sensitive and reliable analytical method to monitor the drug concentration in plasma. A novel method based on surface molecularly imprinted solid-phase extraction combined with liquid chromatography-tandem mass spectrometry for the determination of vancomycin in plasma sample was developed. The plasma sample was cleaned up through the solid-phase extraction process before the analysis. The calibration standard of vancomycin in plasma ranged between 1 and 100 ng/mL, and the correlation coefficient (r) was 0.9993. The average recoveries were from 94.3 to 104.0%, and the precision was less than 10.5%. The limit of detection and limit of quantification were 0.5 ng/mL and 1 ng/mL, respectively. The method validated was successfully used for the detection of vancomycin in mice after oral administration.

Utility of Silver-nanoparticles for Nano-fluorimetric Determination of Vancomycin Hydrochloride in Pharmaceutical Formulation and Biological Fluids: Greenness Assessment

Vancomycin hydrochloride (VANH) is a glycopeptide antibiotic commonly employed in the prophylaxis and therapy of various gram-positive bacterial life-threatening infections. Due to the narrow therapeutic window of VANH, its serum levels should be well-monitored to avoid its toxicity and to optimize its therapy. Herein, an innovative silver-nanoparticles enhanced fluorescence technique was designed for VANH rapid analysis in its pharmaceutical formulation and biological fluids. This technique is based on reinforcement of VANH fluorescence intensity with silver-nanoparticles that were synthesized by a redox reaction between VANH and silver nitrate in NaOH alkaline medium using polyvinylpyrrolidone as a stabilizer. The produced silver-nanoparticles were characterized by using UV-visible spectroscopy where they have an intense absorption maximum at 415 nm and transmission electron microscope (TEM) micrograph where they are spherical in shape with smooth surface morphology and size of 10.74 ± 2.44 nm. The fluorescence intensity was measured at 394 nm after excitation at 259 nm. Under optimum conditions, a good linear relationship was accomplished between the VANH concentration and the fluorescence intensity in a range of (1-36) ng/mL with a limit of detection of 0.29 ng/mL. Greenness assessment was performed using two assessment tools namely; eco-scale scoring and green analytical procedure index revealing excellent greenness of the proposed technique. The proposed technique was validated according to the International Conference on Harmonisation (ICH) recommendations and statistically compared with the reported HPLC method revealing no significant difference concerning accuracy and precision at p = 0.05. The proposed technique depended primarily on water as a cheap and eco-friendly solvent.