Development and validation of a measurement procedure based on ultra-high performance liquid chromatography-tandem mass spectrometry for simultaneous measurement of β-lactam antibiotic concentration in human plasma

Background: The administration of beta-lactam antibiotics in continuous infusion could let optimize the pharmacokinetic/pharmacodynamic parameters, especially in the treatment of serious bacterial infections. In this context, and also due to variability in their plasmatic concentrations, therapeutic drug monitoring (TDM) may be useful to optimize dosing and, therefore, be useful for the clinicians. Material and methods: We developed and validated a measurement procedure based on ultra-high performance liquid chromatography-tandem mass spectrometry for simultaneous measurement of amoxicillin, ampicillin, cloxacillin, piperacillin, cefepime, ceftazidime, cefuroxime, aztreonam and meropenem concentrations in plasma. The chromatographic separation was achieved using an Acquity (R)-UPLC (R) BEH (TM) (2.1 x 100 mm id, 1.7 pm) reverse-phase C-18 column, with a water/acetonitrile linear gradient containing 0.1% formic acid at a 0.4 mL/min flow rate. beta-Lactam antibiotics and their internal standards were detected by electrospray ionization mass spectrometry in multiple reaction monitoring mode. Results: Chromatography run time was 7.0 min and beta-lactam antibiotics eluted at retention times ranging between 1.08 and 1.91 min. The lower limits of quantification were between 0.50 and 1.00 mg/L. Coefficients of variation and relative bias absolute values were <13.3% and 14.7%, respectively. Recovery values ranged from 55.7% to 84.8%. Evaluation of the matrix effect showed ion enhancement for all antibiotics. No interferences or carryover were observed. Conclusions: Our measurement procedure could be applied to daily clinical laboratory practice to measure the concentration of beta lactam antibiotics in plasma, for instance in patients with bone and joint infections and critically ill patients. 2017 Elsevier B.V. All rights reserved.