Therapeutic drug monitoring of piperacillin and tazobactam by RP-HPLC of residual blood specimens
| Autor: | Matthew S. Shotwell, Pratish Patel, Jennifer M. Colby, Alain Verstraete, Joseph J. Groszek, Sylvia M. Verhoven, William H. Fissell, Adam C. Seegmiller |
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| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Tazobactam medicine.medical_specialty medicine.drug_class 030106 microbiology Clinical Biochemistry Antibiotics Penicillanic Acid 01 natural sciences Biochemistry Article law.invention Sepsis 03 medical and health sciences Pharmacokinetics law medicine Humans Intensive care medicine Chromatography High Pressure Liquid Piperacillin Volume of distribution Blood Specimen Collection Chromatography Reverse-Phase medicine.diagnostic_test business.industry 010401 analytical chemistry Biochemistry (medical) General Medicine medicine.disease Intensive care unit 0104 chemical sciences Piperacillin Tazobactam Drug Combination Therapeutic drug monitoring Drug Monitoring business medicine.drug |
| Zdroj: | Clinica Chimica Acta. 482:60-64 |
| ISSN: | 0009-8981 |
| Popis: | Background Sepsis is a common diagnosis in critical care with inpatient mortality rates up to 50%. Sepsis care is organized around source control, antibiotics, and supportive care. Drug disposition is deranged by changes in volume of distribution and regional blood flow, as well as multiple organ failure. Thus, assuring that each patient with sepsis attains pharmacokinetic targets is challenging. There is currently no commercially available FDA-approved assay to measure piperacillin-tazobactam, very commonly used as a beta-lactam/beta-lactamase inhibitor combination antibiotic in the intensive care unit (ICU). Methods Samples were prepared by ultrafiltration of plasma collected in lithium heparin Vacutainers. Separation was achieved by gradient elution on a C-18 column followed by UV detection at 214 nm. The method is validated in residual blood samples allowing investigators to exploit a waste product to develop insight into beta-lactam pharmacokinetics in the ICU. Results Accuracy and precision were within the 25% CLIA error standard for other antibiotic assays. Free piperacillin concentrations were also in good agreement with total piperacillin concentrations measured in the same plasma by an assay in clinical use outside the United States. Conclusion We describe a method for measuring piperacillin and tazobactam that meets clinical validation standards. Quick turnaround time and excellent accuracy on a low-cost platform make this method more than adequate for use as a routine therapeutic drug monitoring tool. |
| Databáze: | OpenAIRE |
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