Development of a UHPLC-UV/Vis Method for Simultaneously Determining Six Beta-Lactam Antibiotics in Plasma: A Tool for the Clinical Implementation of Therapeutic Monitoring of Beta-Lactams

<b>Background/Introduction:</b> Beta-lactam antibiotics are among the most frequently prescribed drugs in clinical practice, yet their therapeutic drug monitoring remains underutilized despite high interindividual pharmacokinetic variability, especially in critically ill patients. <b&...

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Main Authors: Iria Varela-Rey, Marta Martínez-Guitián, Gonzalo Hermelo-Vidal, Enrique Bandín-Vilar, Ignacio Novo-Veleiro, Pablo Manuel Varela-García, Irene Zarra-Ferro, Miguel González-Barcia, Cristina Mondelo-García, Anxo Fernández-Ferreiro
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Antibiotics
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Online Access:https://www.mdpi.com/2079-6382/14/6/613
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author Iria Varela-Rey
Marta Martínez-Guitián
Gonzalo Hermelo-Vidal
Enrique Bandín-Vilar
Ignacio Novo-Veleiro
Pablo Manuel Varela-García
Irene Zarra-Ferro
Miguel González-Barcia
Cristina Mondelo-García
Anxo Fernández-Ferreiro
author_facet Iria Varela-Rey
Marta Martínez-Guitián
Gonzalo Hermelo-Vidal
Enrique Bandín-Vilar
Ignacio Novo-Veleiro
Pablo Manuel Varela-García
Irene Zarra-Ferro
Miguel González-Barcia
Cristina Mondelo-García
Anxo Fernández-Ferreiro
author_sort Iria Varela-Rey
collection DOAJ
description <b>Background/Introduction:</b> Beta-lactam antibiotics are among the most frequently prescribed drugs in clinical practice, yet their therapeutic drug monitoring remains underutilized despite high interindividual pharmacokinetic variability, especially in critically ill patients. <b>Methods:</b> To address this, we developed and validated an ultra-high-performance liquid chromatography (UHPLC-UV/Vis) method for the simultaneous quantification of six beta-lactams (cefepime, ceftolozane, ceftazidime, meropenem, ampicillin, and ertapenem) in plasma. <b>Results:</b> This method uses a single gradient mobile phase and a photodiode array detector, ensuring accurate separation, minimal interference, and robust analyte identification. Validation followed EMA bioanalytical guidelines, demonstrating selectivity, precision, accuracy, and linearity within clinically relevant ranges (1.0–50.0 mg/L). Stability tests showed that the analytes were stable in plasma for up to seven days at 4 °C and one month at −20 °C. Pilot clinical implementation in 35 patients revealed significant interindividual variability, supporting the need for routine beta-lactam monitoring. Approximately 26% of trough concentrations were below the minimal inhibitory concentration, while others exceeded thresholds associated with potential toxicity. <b>Discussion</b>: This study represents the first UHPLC-UV/Vis method for the simultaneous determination of these six beta-lactams, overcoming limitations of prior methods that required different mobile phases or excluded clinically relevant antibiotics. The method is universally applicable and easily transferable to routine clinical practice. <b>Conclusions:</b> These findings underline the importance of beta-lactam monitoring in optimizing treatment outcomes and combating antibiotic resistance in vulnerable populations. Further studies to assess free drug concentrations are warranted to enhance clinical applicability.
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spelling doaj-art-e577d56fbab24104ab495596073a1f962025-08-20T03:26:57ZengMDPI AGAntibiotics2079-63822025-06-0114661310.3390/antibiotics14060613Development of a UHPLC-UV/Vis Method for Simultaneously Determining Six Beta-Lactam Antibiotics in Plasma: A Tool for the Clinical Implementation of Therapeutic Monitoring of Beta-LactamsIria Varela-Rey0Marta Martínez-Guitián1Gonzalo Hermelo-Vidal2Enrique Bandín-Vilar3Ignacio Novo-Veleiro4Pablo Manuel Varela-García5Irene Zarra-Ferro6Miguel González-Barcia7Cristina Mondelo-García8Anxo Fernández-Ferreiro9FarmaCHUSLab, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, SpainFarmaCHUSLab, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, SpainFarmaCHUSLab, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, SpainFarmaCHUSLab, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, SpainHome Hospitalization Unit, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, SpainInternal Medicine Department, University Clinical Hospital of Santiago de Compostela (SERGAS), 15706 Santiago de Compostela, SpainFarmaCHUSLab, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, SpainFarmaCHUSLab, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, SpainFarmaCHUSLab, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, SpainFarmaCHUSLab, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain<b>Background/Introduction:</b> Beta-lactam antibiotics are among the most frequently prescribed drugs in clinical practice, yet their therapeutic drug monitoring remains underutilized despite high interindividual pharmacokinetic variability, especially in critically ill patients. <b>Methods:</b> To address this, we developed and validated an ultra-high-performance liquid chromatography (UHPLC-UV/Vis) method for the simultaneous quantification of six beta-lactams (cefepime, ceftolozane, ceftazidime, meropenem, ampicillin, and ertapenem) in plasma. <b>Results:</b> This method uses a single gradient mobile phase and a photodiode array detector, ensuring accurate separation, minimal interference, and robust analyte identification. Validation followed EMA bioanalytical guidelines, demonstrating selectivity, precision, accuracy, and linearity within clinically relevant ranges (1.0–50.0 mg/L). Stability tests showed that the analytes were stable in plasma for up to seven days at 4 °C and one month at −20 °C. Pilot clinical implementation in 35 patients revealed significant interindividual variability, supporting the need for routine beta-lactam monitoring. Approximately 26% of trough concentrations were below the minimal inhibitory concentration, while others exceeded thresholds associated with potential toxicity. <b>Discussion</b>: This study represents the first UHPLC-UV/Vis method for the simultaneous determination of these six beta-lactams, overcoming limitations of prior methods that required different mobile phases or excluded clinically relevant antibiotics. The method is universally applicable and easily transferable to routine clinical practice. <b>Conclusions:</b> These findings underline the importance of beta-lactam monitoring in optimizing treatment outcomes and combating antibiotic resistance in vulnerable populations. Further studies to assess free drug concentrations are warranted to enhance clinical applicability.https://www.mdpi.com/2079-6382/14/6/613beta-lactamUHPLC-UV/Vistherapeutic monitoringsimultaneous quantification
spellingShingle Iria Varela-Rey
Marta Martínez-Guitián
Gonzalo Hermelo-Vidal
Enrique Bandín-Vilar
Ignacio Novo-Veleiro
Pablo Manuel Varela-García
Irene Zarra-Ferro
Miguel González-Barcia
Cristina Mondelo-García
Anxo Fernández-Ferreiro
Development of a UHPLC-UV/Vis Method for Simultaneously Determining Six Beta-Lactam Antibiotics in Plasma: A Tool for the Clinical Implementation of Therapeutic Monitoring of Beta-Lactams
Antibiotics
beta-lactam
UHPLC-UV/Vis
therapeutic monitoring
simultaneous quantification
title Development of a UHPLC-UV/Vis Method for Simultaneously Determining Six Beta-Lactam Antibiotics in Plasma: A Tool for the Clinical Implementation of Therapeutic Monitoring of Beta-Lactams
title_full Development of a UHPLC-UV/Vis Method for Simultaneously Determining Six Beta-Lactam Antibiotics in Plasma: A Tool for the Clinical Implementation of Therapeutic Monitoring of Beta-Lactams
title_fullStr Development of a UHPLC-UV/Vis Method for Simultaneously Determining Six Beta-Lactam Antibiotics in Plasma: A Tool for the Clinical Implementation of Therapeutic Monitoring of Beta-Lactams
title_full_unstemmed Development of a UHPLC-UV/Vis Method for Simultaneously Determining Six Beta-Lactam Antibiotics in Plasma: A Tool for the Clinical Implementation of Therapeutic Monitoring of Beta-Lactams
title_short Development of a UHPLC-UV/Vis Method for Simultaneously Determining Six Beta-Lactam Antibiotics in Plasma: A Tool for the Clinical Implementation of Therapeutic Monitoring of Beta-Lactams
title_sort development of a uhplc uv vis method for simultaneously determining six beta lactam antibiotics in plasma a tool for the clinical implementation of therapeutic monitoring of beta lactams
topic beta-lactam
UHPLC-UV/Vis
therapeutic monitoring
simultaneous quantification
url https://www.mdpi.com/2079-6382/14/6/613
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