Dejaco, Alexander and Paal, Michael and Gruber, Michael and Drettwan, Diana and Marquardt, Christian and Helou, Michael and Wagner, Tobias and Kees, Martin G. and Graf, Bernhard M. and Barthelmes, Dominic (2025) Therapeutic drug monitoring of piperacillin: Agreement between quantitative nuclear magnetic resonance spectroscopy and liquid chromatography with tandem mass spectrometry. CLINICA CHIMICA ACTA, 577: 120448. ISSN 0009-8981, 1873-3492
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Background: In clinical practice, therapeutic drug monitoring (TDM) typically relies on specialized immunoassays or chromatography-based methods. These approaches require drug-specific setups and are limited to batch measurements, which can restrict their availability. Recent advances in quantitative nuclear magnetic resonance spectroscopy (qNMR) have made it suitable for rapid and reliable quantification of small molecules in human plasma. However, no qNMR-based method has yet been developed specifically for TDM. Methods: A qNMR method for quantification of piperacillin (PIP) in human plasma was developed. Plasma samples were collected from 15 patients receiving PIP treatment in an intensive care unit. A total of 126 samples were subjected to analysis using 1H-NMR spectroscopy and isotope dilution liquid chromatography- tandem mass spectrometry. Measurements were compared within the common quantifiable range of 10 to 100 mg/L. The degree of agreement between the methods was assessed using linear regression with post-hoc bootstrapping and Bland-Altman analysis. Results: The concordance correlation coefficient between methods was 0.895, suggesting good alignment. Linear regression showed agreement with an intercept of -0.50 mg/L and a slope of 1.03. Bland-Altman analysis revealed a mean bias of -0.85 mg/L, with limits of agreement from -18.67 mg/L to +16.97 mg/L. Conclusion: This study demonstrates the potential of qNMR as a viable alternative for therapeutic drug monitoring, with a promising level of agreement supporting further validation in larger patient cohorts.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | QUANTIFICATION; MEROPENEM; Piperacillin; Quantitative nuclear magnetic resonance; spectrometry; Therapeutic drug monitoring; Liquid chromatography with tandem mass |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Sep 2026 07:44 |
| Last Modified: | 23 Sep 2026 07:44 |
| URI: | https://pred.uni-regensburg.de/id/eprint/66551 |
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