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Therapeutic drug monitoring of piperacillin and tazobactam by RP-HPLC of residual blood specimens.
- Source :
-
Clinica chimica acta; international journal of clinical chemistry [Clin Chim Acta] 2018 Jul; Vol. 482, pp. 60-64. Date of Electronic Publication: 2018 Mar 26. - Publication Year :
- 2018
-
Abstract
- 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).<br />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.<br />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.<br />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.<br /> (Copyright © 2018 Elsevier B.V. All rights reserved.)
- Subjects :
- Blood Specimen Collection
Chromatography, Reverse-Phase
Drug Monitoring economics
Humans
Penicillanic Acid analysis
Penicillanic Acid pharmacokinetics
Piperacillin pharmacokinetics
Piperacillin, Tazobactam Drug Combination
Sepsis drug therapy
Tazobactam
Chromatography, High Pressure Liquid methods
Drug Monitoring methods
Penicillanic Acid analogs & derivatives
Piperacillin analysis
Subjects
Details
- Language :
- English
- ISSN :
- 1873-3492
- Volume :
- 482
- Database :
- MEDLINE
- Journal :
- Clinica chimica acta; international journal of clinical chemistry
- Publication Type :
- Academic Journal
- Accession number :
- 29596815
- Full Text :
- https://doi.org/10.1016/j.cca.2018.03.021