Rapid and sensitive determination of vancomycin using an AIE-active fluorescent probe for clinical monitoring

Vancomycin (Van) is the preferred drug for clinically treating severe infections caused by Gram-positive bacteria, especially in the intensive care unit (ICU). However, due to safety concerns, strict management and administration of Van are required in clinical practice. Hence, there is a need to develop a rapid and accurate method for determining the concentration of Van. In this study, a cyanostilbene-based fluorescent probe, Cy-KAA, is designed for the rapid, highly sensitive and selective detection of Van. In the probe, the L-Lys-D-Ala-D-Ala polypeptide moiety can interact with Van, resulting in a rapid fluorescence response that reaches a plateau within 2 minutes. Cy-KAA can be employed for the detection of Van in clinical ICU samples, demonstrating a strong correlation with the traditional HPLC method (consistency up to 0.99). These findings highlight the high accuracy and potential utility of Cy-KAA as a powerful tool for real-time monitoring of Van levels in clinical practice, thereby providing valuable guidance for precise drug administration.