Laboratory Medicine, University Hospital Basel, University Basel, Petersgraben 4, 4031 Basel, Switzerland.
Laboratory Medicine, University Hospital Basel, University Basel, Petersgraben 4, 4031 Basel, Switzerland.
Clin Chim Acta. 2020 Dec;511:360-367. doi: 10.1016/j.cca.2020.11.001. Epub 2020 Nov 5.
TDM of antibiotics can bring benefits to patients and healthcare systems by providing better treatment and saving healthcare resources. We aimed to develop a multi-analyte method for several diverse antibiotics using LC-MS/MS.
Sample preparation consisted of protein precipitation with methanol, dilution and online extraction using a Turboflow Cyclone column. Separation was performed on a Synergi 4 µm Max RP column and deuterated forms of three antibiotics were used as internal standards.
We present a LC-MS/MS method for the quantitative determination of nine antibiotics, including five cephalosporins, the carbapenem ertapenem, the fluoroquinolone ciprofloxacin as well as the combination drug trimethoprim-sulfamethoxazole from plasma. Additionally, unbound ertapenem and cefazolin were analyzed in plasma water after ultrafiltration using plasma calibrators. Results from routine TDM show the applicability of the method.
The presented method is precise and accurate and was introduced in a university hospital, permitting fast TDM of all nine analytes. It was also used in a clinical study for measuring cefazolin free and total concentrations.
抗生素治疗药物监测（TDM）通过提供更好的治疗效果和节省医疗资源，可为患者和医疗系统带来益处。本研究旨在建立一种使用 LC-MS/MS 分析多种不同抗生素的多分析物方法。
样品制备包括用甲醇沉淀蛋白、稀释和在线提取，采用 Turboflow Cyclone 柱。分离在 Synergi 4μm Max RP 柱上进行，三种抗生素的氘代形式作为内标。
本研究建立了一种 LC-MS/MS 方法，用于定量测定血浆中的九种抗生素，包括五种头孢菌素、碳青霉烯厄他培南、氟喹诺酮环丙沙星以及复方药物甲氧苄啶-磺胺甲噁唑。此外，还使用超滤法，从血浆水中超滤未结合的厄他培南和头孢唑林，并用血浆校准器分析。常规 TDM 的结果表明该方法具有适用性。
所建立的方法准确、精确，已在一所大学医院中引入，可快速检测所有九种分析物。该方法还用于一项临床研究，以测量头孢唑林游离和总浓度。
