A simple ultra-high-performance liquid chromatography-high resolution mass spectrometry assay for the simultaneous quantification of 15 antibiotics in plasma

- An LC-HRMS method was developed to quantify fifteen antibiotics in plasma samples.
- The assay fulfilled acceptance criteria for bio-analytical method validation.
- A fast and reliable method suitable for antibiotic therapeutic drug monitoring.
- Single method considering different antibiotic classes to ensure an easy analysis.
- Antibiotics analysis must carefully take in account their lack of stability.

Antibiotic (ATB) treatment of critically ill patients with pathophysiological injuries remains a challenge due to the constant increase in antimicrobial resistance. Therapeutic drug monitoring (TDM) is advised for ATB dose adjustments to avoid suboptimal concentrations and dose-related adverse effects. Therefore, a single and reliable analytical method for a broad selection of ATBs was developed using a high-resolution mass spectrometry (HRMS) platform for frequent use in intensive care units.An UHPLC assay coupled to high resolution accurate mass acquisition has been developed for the quantification of penicillins (amoxicillin, oxacillin, piperacillin, and ticarcillin), cephalosporines (cefepime, cefotaxime, ceftazidime, and ceftriaxone), carbapenems (ertapenem, imipenem, and meropenem), lincosamide (clindamycin), quinolones (ofloxacin and ciprofloxacin) and tazobactam. Plasma samples (100 μL) were spiked with an internal standard solution followed by protein precipitation. Separation was achieved on an Accucore C18 column, which enabled sample analysis every 9 min.All compounds were detected in electrospray positive ion mode and quantified with a linear regression between 0.5 and 32 mg/L (r2 > 0.998). Overall precision and accuracy did not exceed 15%. No significant matrix effect was observed for the studied ATBs. Stored stock solutions at −20 °C were stable for 6 months, except for amoxicillin and imipenem. Analytes in plasma were stable for 24 h under ambient conditions as well as in post-preparation in an autosampler, except for amoxicillin and imipenem.This HRMS assay provides the simultaneous quantification of 15 ATB; it fulfills the usual quality criteria and was successfully applied for routine TDM of ATBs. The method is based on a full scan acquisition, and it would be easy to add other compounds to the present panel in the future, as this assay has already been proven to be efficient for different classes of compounds.