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糖肽类抗菌药物的治疗药物监测:液相色谱 - 串联质谱法概述

Therapeutic drug monitoring of glycopeptide antimicrobials: An overview of liquid chromatography-tandem mass spectrometry methods.

作者信息

Cafaro Alessia, Barco Sebastiano, Pigliasco Federica, Russo Chiara, Mariani Marcello, Mesini Alessio, Saffioti Carolina, Castagnola Elio, Cangemi Giuliana

机构信息

Chromatography and Mass Spectrometry Section, Central Laboratory of Analysis, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy.

Division of Infectious Diseases, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.

出版信息

J Mass Spectrom Adv Clin Lab. 2023 Dec 22;31:33-39. doi: 10.1016/j.jmsacl.2023.12.003. eCollection 2024 Jan.

Abstract

Therapeutic drug monitoring (TDM) is a critical clinical tool used to optimize the safety and effectiveness of drugs by measuring their concentration in biological fluids. These fluids are primarily plasma or blood. TDM, together with real-time dosage adjustment, contributes highly to the successful management of glycopeptide antimicrobial therapies. Understanding pharmacokinetic/pharmacodynamic (PK/PD) properties is vital for optimizing antimicrobial therapies, as the efficacy of these therapies depends on both the exposure of the patient to the drug (PK) and pharmacodynamic (PD) parameters such as the in vitro estimated minimum drug concentration that inhibits bacterial growth (MIC). Liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS) is widely recognized as the gold standard for measuring small molecules, such as antibiotics. This review provides a comprehensive overview of LC-MS/MS methods available for TDM of glycopeptide antibiotics, including vancomycin, teicoplanin, dalbavancin, oritavancin, and telavancin.

摘要

治疗药物监测(TDM)是一种关键的临床工具,通过测量生物体液中的药物浓度来优化药物的安全性和有效性。这些体液主要是血浆或血液。TDM与实时剂量调整一起,对糖肽类抗菌治疗的成功管理有很大贡献。了解药代动力学/药效学(PK/PD)特性对于优化抗菌治疗至关重要,因为这些治疗的疗效取决于患者对药物的暴露(PK)和药效学(PD)参数,如体外估计的抑制细菌生长的最低药物浓度(MIC)。液相色谱-串联质谱联用(LC-MS/MS)被广泛认为是测量小分子(如抗生素)的金标准。本综述全面概述了可用于糖肽类抗生素TDM的LC-MS/MS方法,包括万古霉素、替考拉宁、达巴万星、奥利万星和特拉万星。

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