Effects of Broad Spectrum Antibiotics on Measurement of Immunosuppressant Drugs
Autor: | Idris Kirhan, Ataman Gönel |
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Rok vydání: | 2021 |
Předmět: |
Imipenem
Immunology Pharmacology 01 natural sciences Tazobactam 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Tandem Mass Spectrometry Cyclosporin a Blood drug polycyclic compounds medicine Humans Immunology and Allergy Everolimus 010405 organic chemistry business.industry General Medicine Sulbactam Anti-Bacterial Agents 0104 chemical sciences chemistry 030220 oncology & carcinogenesis Drug Therapy Combination Drug Monitoring business Ertapenem Immunosuppressive Agents Chromatography Liquid Piperacillin medicine.drug |
Zdroj: | Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry. 20:101-105 |
ISSN: | 1871-5230 |
Popis: | Background: Antibiotics used parenterally can affect blood drug level measurements, as measured in diagnostic tests. Objective: To investigate the effect of six different antibiotics commonly used in intensive care units on tacrolimus, sirolimus, everolimus and cyclosporin A levels measured by mass spectrometry. Methods: Ampicillin + sulbactam (AB1, IV, 1 g), imipenem + cilastatin sodium (AB2, IV, 500 mg), piperacillin + tazobactam (AB3, 4.5 g, IV), ertapenem (AB4, IV, 1 g), meropenem trihydrate (AB5, 500 mg, IV) and ceftriaxone (AB6, 1 g, IV) antibiotics were used for the interference assay. Measurements were performed on the Shimadzu 8045 (Japan) LC-MS/MS instrument. Bias values were calculated. Results: The least affected immunosuppressant was cyclosporine A (between -6.88% and 3.40%). The most affected were everolimus and sirolimus. Ertapenem caused negative interference on the level of everolimus at the rate of -27.34% and sirolimus at the rate of -26.79%. Piperacillin + tazobactam and imipenem + cilastatin sodium caused positive interferences on sirolimus at the rate of 24.24% and 22.73%, respectively. Ampicillin + sulbactam, meropenem trihydrate and ceftriaxone affected the sirolimus levels at lower rates (-4.49%, 5.93% and 9.86%). Everolimus levels deviated at the rate of -11.21% to -16.99% due to imipenem + cilastatin sodium, meropenem trihydrate and ceftriaxone. Conclusion: This study demonstrated the potential of antibiotic use affecting immunosuppressant levels. Antibiotic interference, especially in transplant patients, may cause erroneous immunosuppression, increasing the likelihood of rejection. |
Databáze: | OpenAIRE |
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