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Updated: Mar 7, 2026
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Simultaneous assay of multiple antibiotics in human plasma by LC-MS/MS: importance of optimizing formic acid
Feng Chen1, Zhe-Yi Hu1, S Casey Laizure1
1Department of Clinical Pharmacy, College of Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
Aim:
Optimal dosing of antibiotics in critically ill patients is complicated by the development of resistant organisms requiring treatment with multiple antibiotics and alterations in systemic exposure due to diseases and extracorporeal drug removal. Developing guidelines for optimal antibiotic dosing is an important therapeutic goal requiring robust analytical methods to simultaneously measure multiple antibiotics.
Methods:
An LC-MS/MS assay using protein precipitation for cleanup followed by a 6-min gradient separation was developed to simultaneously determine five antibiotics in human plasma.
Results:
The precision and accuracy were within the 15% acceptance range. The formic acid concentration was an important determinant of signal intensity, peak shape and matrix effects.
Conclusion:
The method was designed to be simple and successfully applied to a clinical pharmacokinetic study.
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