Therapeutic drug monitoring of cefepime with micellar electrokinetic capillary chromatography: Assay improvement, quality assurance, and impact on patient drug levels

Theurillat, Regula; Joneli, Jeannine; Wanzenried, Ursula; Schiess, Jeannette; Hurni, Monika; Weber, Thomas; Sendi, Parham; Thormann, Wolfgang (2016). Therapeutic drug monitoring of cefepime with micellar electrokinetic capillary chromatography: Assay improvement, quality assurance, and impact on patient drug levels. Journal of separation science, 39(13), pp. 2626-2632. Wiley-VCH 10.1002/jssc.201600271

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The improvement and performance of a micellar electrokinetic capillary chromatography assay for cefepime in human serum and plasma with a 50 μm id fused-silica capillary elongated from 40 to 60 cm is reported. Sample preparation with dodecylsulfate protein precipitation at pH 4.5, the pH 9.1 separation medium and the applied voltage were as reported previously[16]. The change resulted in a significant lower current, higher resolution and increased detection time intervals. The performance of the assay with multi-level internal calibration was assessed with calibration and control samples. Quality assurance data of a two year period assessed under the new conditions demonstrated the robustness of the assay. In serum samples of patients who received both cefepime and sulfamethoxazole, cefepime could not be detected due to the inseparability of the two compounds. The presence of an interference can be recognized by an increased peak width (width > 0.2 min), the appearance of a shoulder or an unresolved double peak. The patient data gathered during a three year period reveal that introduction of therapeutic drug monitoring led to a 50% reduction of the median drug level. The data suggest that therapeutic drug monitoring can help to minimize the risk of major adverse reactions and to increase drug safety on an individual basis. This article is protected by copyright. All rights reserved.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases > Laboratory for Clinical Pharmacology
04 Faculty of Medicine > Service Sector > Institute of Clinical Pharmacology and Visceral Research [discontinued]
04 Faculty of Medicine > Service Sector > Institute for Infectious Diseases
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

UniBE Contributor:

Theurillat, Regula; Joneli, Jeannine; Wanzenried, Ursula; Schiess, Jeannette; Hurni, Monika; Weber, Thomas; Sendi, Parham and Thormann, Wolfgang

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

1615-9306

Publisher:

Wiley-VCH

Language:

English

Submitter:

Annelies Luginbühl

Date Deposited:

12 Jul 2016 11:39

Last Modified:

14 Jul 2016 02:05

Publisher DOI:

10.1002/jssc.201600271

PubMed ID:

27130081

Uncontrolled Keywords:

Capillary electrophoresis; Cefepime; Micellar electrokinetic capillary chromatography; Therapeutic drug monitoring

BORIS DOI:

10.7892/boris.82115

URI:

https://boris.unibe.ch/id/eprint/82115

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