16 results on '"Carlos Ezquer"'
Search Results
2. Optimizing ceftolozane-tazobactam dosage during continuous renal replacement therapy: some nuances
- Author
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Gerardo Aguilar, Rafael Ferriols, Sara Martínez-Castro, Carlos Ezquer, Ernesto Pastor, Jose A. Carbonell, Manuel Alós, and David Navarro
- Subjects
Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Published
- 2020
- Full Text
- View/download PDF
3. Optimal doses of caspofungin during continuous venovenous hemodiafiltration in critically ill patients
- Author
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Gerardo Aguilar, Rafael Ferriols, Angels Lozano, Carlos Ezquer, José A. Carbonell, Ana Jurado, Juan Carrizo, Ferran Serralta, Jaume Puig, David Navarro, Manuel Alos, and F. Javier Belda
- Subjects
Echinocandins ,Continuous renal replacement therapy ,Invasive candidiasis ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Published
- 2017
- Full Text
- View/download PDF
4. Plasma concentrations of caspofungin in a critically ill patient with morbid obesity
- Author
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Rafael Ferriols-Lisart, Gerardo Aguilar, Alejandro Pérez-Pitarch, Jaume Puig, Carlos Ezquer-Garín, and Manuel Alós
- Subjects
Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Published
- 2017
- Full Text
- View/download PDF
5. Ceftolozane Pharmacokinetics in a Septic Critically Ill Patient under Different Extracorporeal Replacement Therapies
- Author
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Carlos Ezquer, Rotzel Huerta, Mar Juan, Gerardo Aguilar, Javier Colomina, José Ferreres, M. Luisa Blasco, Marisa Calabuig, Nieves Carbonell, and Rafael Ferriols
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Adult ,medicine.medical_specialty ,medicine.drug_class ,Critical Illness ,Urinary system ,Cephalosporin ,Hemodiafiltration ,Microbial Sensitivity Tests ,Off-label use ,medicine.disease_cause ,Extracorporeal ,Pharmacokinetics ,polycyclic compounds ,medicine ,Humans ,Pseudomonas Infections ,Pharmacology (medical) ,Intensive care medicine ,Letter to the Editor ,Pharmacology ,Critically ill ,business.industry ,Pseudomonas aeruginosa ,Precursor Cell Lymphoblastic Leukemia-Lymphoma ,bacterial infections and mycoses ,Anti-Bacterial Agents ,Cephalosporins ,Infectious Diseases ,Female ,Ceftolozane ,business - Abstract
Ceftolozane-tazobactam (C/T), a novel fifth-generation cephalosporin/β-lactamase inhibitor combination active against multidrug-resistant (MDR) Pseudomonas aeruginosa, is currently approved by the U.S. Food and Drug Administration (FDA) to treat complicated intra-abdominal and urinary tract
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- 2019
6. Validated HPLC-UV detection method for the simultaneous determination of ceftolozane and tazobactam in human plasma
- Author
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Rafael Ferriols-Lisart, Javier F Belda-Nacher, Carlos Ezquer-Garin, Gerardo Aguilar-Aguilar, Manuel Alós-Almiñana, and Jose-Antonio Carbonell
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0301 basic medicine ,Tazobactam ,030106 microbiology ,Clinical Biochemistry ,Penicillanic Acid ,01 natural sciences ,High-performance liquid chromatography ,Analytical Chemistry ,Plasma ,03 medical and health sciences ,medicine ,Humans ,Sample preparation ,General Pharmacology, Toxicology and Pharmaceutics ,Chromatography, High Pressure Liquid ,Reproducibility ,Chromatography ,Plasma samples ,medicine.diagnostic_test ,Chemistry ,010401 analytical chemistry ,General Medicine ,Anti-Bacterial Agents ,Cephalosporins ,0104 chemical sciences ,Medical Laboratory Technology ,Therapeutic drug monitoring ,Human plasma ,Ceftolozane ,medicine.drug - Abstract
Aim: A simple, rapid, economical and sensitive HPLC-UV method was developed for the simultaneous quantification of ceftolozane and tazobactam in plasma samples. Methodology: After deproteinization followed by a liquid–liquid back-extraction, the compounds were separated on a C18 column (150 mm × 4.6 mm, 5 μm) with UV-visible detection at 220 nm. The mobile phase consisted of acetonitrile and potassium dihydrogenphosphate buffer at pH 3.0 (8:92, v/v), delivered isocratically at a flow rate of 1.0 ml/min and at a column oven temperature of 30°C. Cefepime was used as an internal standard. Results: Linearity was achieved in the concentration range of 0.50–100.00 μg/ml for ceftolozane and 0.25–50.00 μg/ml for tazobactam. The intra- and interday precision showed good reproducibility with coefficients of variation of less than 9.26% for ceftolozane and 9.62% for tazobactam. Conclusion: The sample preparation procedure avoids expensive or time-consuming steps used by other previously published methods. The methodology was validated according to standard guidelines and was used for quantification of ceftolozane and tazobactam in plasma samples from critically ill patients.
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- 2018
7. Stability of tacrolimus ophthalmic solution
- Author
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Rafael Ferriols-Lisart, Carlos Ezquer-Garin, and Manuel Alós-Almiñana
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Drug Storage ,medicine.medical_treatment ,Administration, Ophthalmic ,chemical and pharmacologic phenomena ,030226 pharmacology & pharmacy ,High-performance liquid chromatography ,Tacrolimus ,03 medical and health sciences ,0302 clinical medicine ,Drug Stability ,medicine ,Humans ,Chromatography, High Pressure Liquid ,Pharmacology ,Chromatography ,Chemistry ,Health Policy ,Temperature ,Eye drop ,Pharmaceutical Solutions ,surgical procedures, operative ,Ophthalmic solutions ,Anesthesia ,030221 ophthalmology & optometry ,Aseptic processing ,Ophthalmic Solutions ,Immunosuppressive Agents - Abstract
Purpose The stability of 0.3-mg/mL tacrolimus ophthalmic solution at different storage temperatures was studied. Methods A sterile ophthalmic solution of 0.3 mg/mL tacrolimus was prepared in triplicate under aseptic conditions by diluting tacrolimus in eye drops. Three aliquots of this solution were transferred into polypropylene bottles and stored at 25, 2–8, or −15 to −25 °C. Samples were collected immediately after preparation and at selected time points and assayed in triplicate using high-performance liquid chromatography (HPLC). Samples were also visually examined for macroscopic changes. The 0.3-mg/mL tacrolimus solution was also exposed to acidic treatment and heat to force its degradation and to evaluate the selectivity of the analytic method. The tacrolimus ophthalmic solution was considered stable if at least 90% of the mean initial concentration remained when analyzed by HPLC. Results When stored at 2–8 °C and between −15 and −25 °C, at least 90% of the initial tacrolimus concentration remained throughout the 85-day study period. There were no significant differences in tacrolimus concentrations between the starting and ending points ( p > 0.05). However, when tacrolimus solution was stored at 25 °C, the percentage of the initial tacrolimus concentration remaining had decreased to less than 90% on day 28. Conclusion Tacrolimus diluted to 0.3 mg/mL in eye drop solution was stable for 20 days when stored at 25 °C and for at least 85 days when stored at 2–8 °C or between −15 and −25 °C in polypropylene bottles and protected from light.
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- 2017
8. Optimizing ceftolozane-tazobactam dosage during continuous renal replacement therapy: some nuances
- Author
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Rafael Ferriols, Manuel Alós, Gerardo Aguilar, Sara Martínez-Castro, Carlos Ezquer, David Navarro, Ernesto Pastor, and José A. Carbonell
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,CEFTOLOZANE/TAZOBACTAM ,MEDLINE ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,lcsh:RC86-88.9 ,Critical Care and Intensive Care Medicine ,Tazobactam ,medicine ,Renal replacement therapy ,Intensive care medicine ,business ,medicine.drug - Published
- 2020
9. Pharmacokinetic/pharmacodynamic analysis of voriconazole against Candida spp. and Aspergillus spp. in allogeneic stem cell transplant recipients
- Author
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Juan C. Hernández-Boluda, Carlos Solano, Rafael Ferriols-Lisart, David Navarro, Carlos Ezquer-Garin, Beatriz Guglieri-López, José Luis Piñana, Manuel Alós-Almiñana, Ariadna Pérez, and Alejandro Pérez-Pitarch
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Adult ,Male ,Antifungal Agents ,Population ,Administration, Oral ,Aspergillosis ,030226 pharmacology & pharmacy ,03 medical and health sciences ,0302 clinical medicine ,Pharmacokinetics ,Medicine ,Humans ,Pharmacology (medical) ,Dosing ,education ,Aged ,Candida ,Pharmacology ,Voriconazole ,education.field_of_study ,Aspergillus ,biology ,Dose-Response Relationship, Drug ,business.industry ,Candidiasis ,Middle Aged ,medicine.disease ,biology.organism_classification ,Allografts ,Immunology ,Candida spp ,Female ,Stem cell ,business ,Monte Carlo Method ,medicine.drug ,Stem Cell Transplantation - Abstract
Background: To evaluate the adequacy of different dosing regimens of voriconazole for the prophylaxis of invasive candidiasis and aspergillosis in adult allogeneic stem cell transplant recipients by means of population pharmacokinetic (PK) modelling and simulation. Methods: Allogeneic stem cell transplant recipients receiving voriconazole were included in this observational study. A population PK model was developed. Three oral voriconazole-dosing regimens were simulated: 200, 300, and 400 mg twice daily. The pharmacodynamic target was defined as fAUC(0.24)/0.7. A probability of target attainment >= 90% was considered optimal. The cumulative fraction of response was defined as the fraction of patients achieving the pharmacodynamic target when a population of simulated patients is matched with a simulated population of different Candida spp. and Aspergillus spp. The percentage of patients with trough plasma concentrations at steady state (C-trough ) within the reference range (1-5.5 mg/L) was also calculated. Results: A 2-compartment PK model was developed using data from 40 patients, which contributed 237 voriconazole plasma samples, including trough and maximum concentrations. Voriconazole 200, 300, and 400 mg twice daily achieved probability of target attainment >= 90% for minimal inhibitory concentration values 10% when increasing voriconazole dose from 200 to 400 mg twice daily (from 72.5% to 89.5% for A. niger; from 77.7% to 88.7% for A. versicolor; and from 82.4% to 94.9% for A flavus). The percentage of patients with C-trough within the reference range increased 15% when voriconazole dose was increased from 200 to 300 mg twice daily. Conclusions: The PK simulations in this study suggest that transplant recipients on voriconazole prophylaxis against invasive candidiasis or aspergillosis are likely to achieve the target concentrations associated with the desired treatment outcomes if the maintenance dose is 200 mg twice daily. However, Aspergillus spp. with high minimal inhibitory concentrations could require higher maintenance doses.
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- 2019
10. Stability of mycophenolate mofetil in polypropylene 5% dextrose infusion bags and chemical compatibility associated with the use of the Equashield
- Author
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Carlos, Ezquer-Garin, Rafael, Ferriols-Lisart, and Manuel, Alós-Almiñana
- Subjects
Drug Delivery Systems ,Glucose ,Drug Stability ,Mycophenolic Acid ,Polypropylenes ,Chromatography, High Pressure Liquid - Abstract
Stability studies are necessary in healthcare settings as they facilitate fast, cost-effective and efficient work related to batch manufacturing and availability of supplies. We studied the stability of 1-10 mg/mL mycophenolate mofetil (MMF) in polypropylene 5% dextrose infusion bags prepared from Cellcept
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- 2018
11. Plasma concentrations of caspofungin in a critically ill patient with morbid obesity
- Author
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Manuel Alós, Rafael Ferriols-Lisart, Alejandro Pérez-Pitarch, Carlos Ezquer-Garin, Jaume Puig, and Gerardo Aguilar
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0301 basic medicine ,medicine.medical_specialty ,Letter ,business.industry ,Critically ill ,030106 microbiology ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,030208 emergency & critical care medicine ,lcsh:RC86-88.9 ,Critical Care and Intensive Care Medicine ,Morbid obesity ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,chemistry ,Plasma concentration ,Medicine ,Caspofungin ,business ,Intensive care medicine - Published
- 2017
12. Optimal doses of caspofungin during continuous venovenous hemodiafiltration in critically ill patients
- Author
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Juan Carrizo, Jaume Puig, Ferran Serralta, Manuel Alós, Angels Lozano, Gerardo Aguilar, Ana Jurado, Rafael Ferriols, F. Javier Belda, Carlos Ezquer, David Navarro, and José A. Carbonell
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0301 basic medicine ,Continuous renal replacement therapy ,medicine.medical_specialty ,Letter ,Critical Illness ,030106 microbiology ,Hemodiafiltration ,Critical Care and Intensive Care Medicine ,Echinocandins ,Lipopeptides ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Caspofungin ,Humans ,Medicine ,Intensive care medicine ,business.industry ,Critically ill ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,030208 emergency & critical care medicine ,lcsh:RC86-88.9 ,Invasive candidiasis ,Continuous venovenous hemodiafiltration ,Acute Kidney Injury ,medicine.disease ,Renal Replacement Therapy ,chemistry ,Adsorption ,business - Published
- 2017
13. Dosing of caspofungin based on a pharmacokinetic/pharmacodynamic index for the treatment of invasive fungal infections in critically ill patients on continuous venovenous haemodiafiltration
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Beatriz Guglieri-López, Rafael Ferriols-Lisart, Gerardo Aguilar, F. Javier Belda, Carlos Ezquer-Garin, and Alejandro Pérez-Pitarch
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0301 basic medicine ,Microbiology (medical) ,Male ,Antifungal Agents ,Candida parapsilosis ,Critical Illness ,030106 microbiology ,Population ,Candida glabrata ,Hemodiafiltration ,Microbial Sensitivity Tests ,Pharmacology ,Aspergillosis ,03 medical and health sciences ,chemistry.chemical_compound ,Echinocandins ,Lipopeptides ,0302 clinical medicine ,Pharmacokinetics ,Caspofungin ,Candida albicans ,Medicine ,Humans ,Pharmacology (medical) ,Candidiasis, Invasive ,030212 general & internal medicine ,Dosing ,education ,Aged ,Aged, 80 and over ,Invasive Pulmonary Aspergillosis ,education.field_of_study ,Maintenance dose ,business.industry ,Candidiasis ,General Medicine ,Middle Aged ,medicine.disease ,Regimen ,Infectious Diseases ,Aspergillus ,chemistry ,Pharmacodynamics ,Female ,business - Abstract
Introduction The study objective was to evaluate the efficacy of different dosages of caspofungin in the treatment of invasive candidiasis and aspergillosis, in relation to the probability of pharmacokinetic/pharmacodynamic (PK/PD) target attainment, using modelling and Monte Carlo simulations in critically ill adult patients on continuous haemodiafiltration. Methods Critically ill adult patients on continuous venovenous haemodiafiltration treated with caspofungin were analysed. A population PK model was developed. Four caspofungin dosing regimens were simulated: the licensed regimen, 70 mg/day, 100 mg/day or 200 mg/day. A PK/PD target was defined as the ratio between the area under the caspofungin concentration-time curve over 24 hours and the minimal inhibitory concentration (AUC/MIC) for candidiasis or the minimal effective concentrations (AUC/MEC) for Aspergillus spp. Target attainment based on preclinical target for Candida and Aspergillus was assessed for different MIC or MEC, respectively. Results Concentration-time data were described by a two-compartment model. Body–weight and protein concentration were the only covariates identified by the model. Goodness-of-fit plots and bootstrap analysis proved the model had a satisfactory performance. As expected, a higher maintenance dose resulted in a higher exposure. Target attainment was >90% for candidiasis (MIC≤0.06 mg/L) and aspergillosis (MEC≤0.5 mg/L), irrespective of the dosing regimen, but not for C. parapsilosis. Standard regimen was insufficient to reach the target for C. albicans and C. parapsilosis with MIC≥0.1 mg/L. Conclusion The licensed regimen of caspofungin is insufficient to achieve the PK/PD targets in critically ill patients on haemodiafiltration. The determination of MICs will enable dose scheme selection.
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- 2017
14. Pharmacokinetics of anidulafungin during venovenous extracorporeal membrane oxygenation
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Gerardo Aguilar, Abigail Villena, Rafael Ferriols, José Miguel Alonso, Manuel Alós, F. Javier Belda, David Navarro, Jaume Puig, José A. Carbonell, and Carlos Ezquer
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0301 basic medicine ,Drug ,ARDS ,Letter ,media_common.quotation_subject ,medicine.medical_treatment ,030106 microbiology ,Critical Care and Intensive Care Medicine ,law.invention ,03 medical and health sciences ,Echinocandins ,0302 clinical medicine ,Pharmacokinetics ,Rescue therapy ,law ,Hemofiltration ,Extracorporeal membrane oxygenation ,Medicine ,030212 general & internal medicine ,media_common ,Acute respiratory distress syndrome ,business.industry ,medicine.disease ,Intensive care unit ,Anesthesia ,Anidulafungin ,business ,medicine.drug - Abstract
Echinocandins are currently considered the first-line treatment for invasive candidiasis (IC) in the intensive care unit (ICU) [1, 2]. However, extracorporeal membrane oxygenation (ECMO), a rescue therapy used in patients with severe acute respiratory distress syndrome (ARDS) [3], could alter the pharmacokinetics of certain drugs [4]. We prescribed anidulafungin for suspected IC in a patient with severe ARDS on ECMO and measured the plasma concentrations of the drug using high-performance liquid chromatography (HPLC).
- Published
- 2016
15. Stability of mycophenolate mofetil in polypropylene 5% dextrose infusion bags and chemical compatibility associated with the use of the Equashield ® closed‐system transfer device
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Manuel Alós-Almiñana, Rafael Ferriols-Lisart, and Carlos Ezquer-Garin
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Pharmacology ,Polypropylene ,Drug transfer ,Chromatography ,010401 analytical chemistry ,Clinical Biochemistry ,Sorption ,General Medicine ,Mycophenolate ,Batch manufacturing ,030226 pharmacology & pharmacy ,01 natural sciences ,Biochemistry ,Work related ,0104 chemical sciences ,Analytical Chemistry ,Chemical compatibility ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,chemistry ,Drug Discovery ,5 dextrose ,Molecular Biology - Abstract
Stability studies are necessary in healthcare settings as they facilitate fast, cost-effective and efficient work related to batch manufacturing and availability of supplies. We studied the stability of 1-10 mg/mL mycophenolate mofetil (MMF) in polypropylene 5% dextrose infusion bags prepared from Cellcept® and with a generic brand name (Micofenolato de Mofetilo Accord) at different storage temperatures. To ensure chemical compatibility during preparation, we also tested MMF sorption to the Equashield® closed-system drug transfer device used in this step. For this, a validated stability-indicating high-performance liquid chromatography method was developed for the quantification and identification of MMF in the infusion bags. The analytical selectivity of the assay was determined by subjecting an MMF sample to extreme values of pH, oxidative stress and heat conditions to force degradation. Protected from light, 1-10 mg/mL MMF in infusion polypropylene bags prepared from reconstituted Cellcept® 500 mg or Accord 500 mg in 5% dextrose was stable for at least 35 days when stored at 2-8°C or between -15 and -25°C, and for 14 days when stored at 25°C. MMF loss owing to chemical sorption to the Equashield® closed-system drug transfer device set was negligible.
- Published
- 2019
16. Fit-for-purpose chromatographic method for the determination of amikacin in human plasma for the dosage control of patients
- Author
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Carlos Ezquer-Garin, Laura Escuder-Gilabert, R. Ferriols Lisart, Yolanda Martín-Biosca, Salvador Sagrado, and M.J. Medina-Hernández
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Quality Control ,Correlation coefficient ,Analytical chemistry ,Derivative ,01 natural sciences ,Fluorescence spectroscopy ,Analytical Chemistry ,chemistry.chemical_compound ,medicine ,Humans ,Fluorometry ,Derivatization ,Acetonitrile ,Amikacin ,Chromatography, High Pressure Liquid ,Chromatography ,Dose-Response Relationship, Drug ,Plasma samples ,010405 organic chemistry ,010401 analytical chemistry ,Bacterial Infections ,Anti-Bacterial Agents ,0104 chemical sciences ,chemistry ,Human plasma ,Spectrophotometry, Ultraviolet ,medicine.drug - Abstract
In this paper, a simple, rapid and sensitive method based on liquid chromatography with fluorimetric detection (HPLC-FLD) for the determination of amikacin (AMK) in human plasma is developed. Determination is performed by pre-column derivatization of AMK with ortho-phtalaldehyde (OPA) in presence of N-acetyl-L-cysteine (NAC) at pH 9.5 for 5 min at 80 °C. In our knowledge, this is the first time that NAC has been used in AMK derivatization. Derivatization conditions (pH, AMK/OPA/NAC molar ratios, temperature and reaction time) are optimized to obtain a single and stable, at room temperature, derivative. Separation of the derivative is achieved on a reversed phase LC column (Kromasil C18, 5 μm, 150 × 4.6 i.d. mm) with a mobile phase of 0.05 M phosphate buffer:acetonitrile (80:20, v/v) pumped at flow rate of 1.0 mL/min. Detection is performed using 337 and 439 nm for excitation and emission wavelengths, respectively. The method is fitted for the purpose of being a competitive alternative to the currently used method in many hospitals for AMK dosage control: fluorescence polarization immunoassay (FPIA). The method exhibits linearity in the 0.17-10 µg mL(-1) concentration range with a squared correlation coefficient higher than 0.995. Trueness and intermediate precision are estimated using spiked drug free plasma samples, which fulfill current UNE-EN ISO15189:2007 accreditation schemes. Finally, for the first time, statistical comparison against the FPIA method is demonstrated using plasma samples from 31 patients under treatment with AMK.
- Published
- 2016
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