RESUMO
Introduction: Vancomycin (VAN) is an antibiotic used to treat serious infections. Its use is related to adverse effects such as acute facial hyperemia, nephrotoxicity and ototoxicity. By having a very narrow therapeutic range, its monitoring is necessary to maximize efficiency and minimize toxic effects. It is estimated that its concentration in CSF is approximately 10% of the plasma level in patients who receive intravenous treatment and who have meninges inflammation. Plasma concentrations of VAN are not a reliable indicator of those present in CSF. The aim of this study was to validate an immunological method based on the kinetic interaction of microparticles in solution (KIMS) for the determination of VAN in CSF. Materials and Methods: KIMS was validated for the evaluation of VAN in CSF. For this, the parameters of linearity, precision, accuracy, limit of detection, limit of quantification, interference, selectivity and specificity were determined. Results: The method was linear in a range between 0 and 15 µg/mL, the CV% obtained oscillated between 0.7 and 2.5% on the linear range. The LOD and LOQ were 0.4 µg/mL and 1.4 µg/mL respectively. The equation of the line obtained based on the correlation of methods between KIMS and HPLC-UV was y = 0.9151x + 1.1695, R² = 0.9453. Conclusion: The KIMS method demonstrated to have an adequate sensitivity and specificity to determine VAN in CSF and being a useful tool for monitoring patients who present complicated infections at CNS level. Materials and Methods: KIMS was validated for the evaluation of VAN in CSF. For this, the parameters of linearity, precision, accuracy, limit of detection, limit of quantification, interference, selectivity and specificity were determined. Results: The method was linear in a range between 0 and 15 µg/mL, the CV% obtained oscillated between 0.7 and 2.5% on the linear range. The LOD and LOQ were 0.4 µg/mL and 1.4 µg/mL respectively. The equation of the line obtained based on the correlation of methods between KIMS and HPLC-UV was y = 0.9151x + 1.1695, R² = 0.9453. Conclusion: The KIMS method demonstrated to have an adequate sensitivity and specificity to determine VAN in CSF and being a useful tool for monitoring patients who present complicated infections at CNS level.
Introducción: La vancomicina (VAN) es un antibiótico utilizado para el tratamiento de infecciones graves. Su uso está relacionado con efectos adversos como hiperemia facial aguda, nefrotoxicidad y ototoxicidad. Al tener un rango terapéutico muy estrecho, el monitoreo terapéutico resulta necesario para maximizar la eficiencia y minimizar los efectos tóxicos. Se estima que su concentración en LCR es, aproximadamente, un 10% de la plasmática en pacientes que reciben tratamiento endovenoso del mismo y que presentan inflamación de las meninges. Las concentraciones plasmáticas de VAN no son un indicador confiable de las presentes en LCR. El objetivo de este trabajo fue validar un método inmunológico basado en la interacción cinética de micropartículas en solución (KIMS) para la determinación de VAN en LCR. Materiales y Métodos: Se validó el método KIMS para la valoración de VAN en LCR. Para ello, se determinaron los parámetros de linealidad, precisión, exactitud, límite de detección, límite de cuantificación, interferencia, selectividad y especificidad. Resultados: el método fue lineal en un intervalo entre 0 y 15 µg/mL, los CV% obtenidos oscilaron entre 0,7 y 2,5% en el rango lineal. Los LOD y LOQ fueron 0,4 µg/mL y 1,4 µg/mL respectivamente. La ecuación de la recta obtenida en base a la correlación de métodos entre KIMS y HPLC-UV fue y= 0,9151x + 1,1695, R²=0,9453. Conclusión: El método KIMS demostró tener una sensibilidad y especificidad apropiadas para la determinación de VAN en LCR y, ser una herramienta útil para el monitoreo de pacientes que presenten infecciones complicadas a nivel del SNC.
