Simultaneous determination of trimethoprim and sulfamethoxazole in dried plasma and urine spots

Daniel Gonzalez, Chiara Melloni, Brenda B Poindexter, Ram Yogev, Andrew M Atz, Janice E Sullivan, Susan R Mendley, Paula Delmore, Amy Delinsky, Kanecia Zimmerman, Andrew Lewandowski, Barrie Harper, Kenneth C Lewis, Daniel K Benjamin Jr, Michael Cohen-Wolkowiez, Best Pharmaceuticals for Children Act--Pediatric Trials Network Administrative Core Committee, K Y Berezny, E Capparelli, G L Kearns, M Laughon, A Muelenaer, T M O'Shea, I M Paul, P B Smith, J van den Anker, K Wade, T J Walsh, D Siegel, P Taylor-Zapata, A Zajicek, Z Ren, K Tsilou, A Pagan, R Anand, G Simone, A Lewandowski, B Harper, B Poindexter, L Smiley, R Yogev, L Fern, Andrew Atz, H Al Nasiri, J Sullivan, T Bratton, Susan Mendley, Donna Cannonier, Paula Delmore, Daniel Gonzalez, Chiara Melloni, Brenda B Poindexter, Ram Yogev, Andrew M Atz, Janice E Sullivan, Susan R Mendley, Paula Delmore, Amy Delinsky, Kanecia Zimmerman, Andrew Lewandowski, Barrie Harper, Kenneth C Lewis, Daniel K Benjamin Jr, Michael Cohen-Wolkowiez, Best Pharmaceuticals for Children Act--Pediatric Trials Network Administrative Core Committee, K Y Berezny, E Capparelli, G L Kearns, M Laughon, A Muelenaer, T M O'Shea, I M Paul, P B Smith, J van den Anker, K Wade, T J Walsh, D Siegel, P Taylor-Zapata, A Zajicek, Z Ren, K Tsilou, A Pagan, R Anand, G Simone, A Lewandowski, B Harper, B Poindexter, L Smiley, R Yogev, L Fern, Andrew Atz, H Al Nasiri, J Sullivan, T Bratton, Susan Mendley, Donna Cannonier, Paula Delmore

Abstract

Background: Trimethoprim-sulfamethoxazole (TMP-SMX) is an antimicrobial drug combination commonly prescribed in children and adults. The study objectives were to validate and apply an HPLC-MS/MS method to quantify TMP-SMX in dried plasma spots (DPS) and dried urine spots (DUS), and perform a comparability analysis with liquid matrices.

Results: For TMP the validated range was 100-50,000 ng/ml for DPS and 500-250,000 ng/ml for DUS; for SMX, the validated range was 1000-500,000 ng/ml for both DPS and DUS. Good agreement was noted between DPS/DUS and liquid plasma and urine samples for TMP, while only modest agreement was observed for SMX in both matrices.

Conclusion: A precise, accurate and reproducible method was developed to quantify TMP-SMX in DPS and DUS samples.

Conflict of interest statement

Financial & competing interest disclosure This work was funded under National Institute of Child Health and Human Development (NICHD) contract HHSN201000003I for the Pediatric Trials Network (PI: Benjamin) and HHSN27500006 (PI: Melloni, Cohen-Wolkowiez) for the Pharmacokinetics of Understudied Drugs Administered to Children per Standard of Care Study (POPS; protocol NICHD-2011-POP01). Research reported in this publication also was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH) under award number UL1TR001117. The assay measuring TMP-SMX concentrations was performed at OpAns Laboratory (Durham, NC, USA). D Gonzalez is funded by training grant T32GM086330 from the National Institute of General Medical Sciences (NIGMS). D K Benjamin Jr receives support from the US government for his work in pediatric and neonatal clinical pharmacology (2K24HD058735–06, UL1TR001117, NICHD contract HHSN275201000003I and NIAID contract HHSN2722015000061); he also receives research support from Cempra Pharmaceuticals (subaward to HHSO100201300009C) for neonatal and pediatric drug development (www.dcri.duke.edu/research/coi.jsp). M Cohen-Wolkowiez receives support for research from the NIH (1R01-HD076676–01A1), the National Center for Advancing Translational Sciences of the NIH (UL1TR001117), the National Institute of Allergy and Infectious Disease (HHSN272201500006I and HHSN272201300017I), the National Institute for Child Health and Human Development of the NIH (HHSN275201000003I), the FDA (1U01FD004858–01), the Biomedical Advanced Research and Development Authority (HHSO100201300009C), the nonprofit organization Thrasher Research Fund (www.thrasherresearch.org) and from industry (CardioDx and Durata Therapeutics) for drug development in adults and children (www.dcri.duke.edu/research/coi.jsp). The remaining authors have no funding to disclose. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. The authors thank A McMillan for her editorial assistance. A McMillan was funded by HHSN27500006 (PI: Melloni, Cohen-Wolkowiez).

Figures

Figure 1. . Study drugs and IS.
Figure 1.. Study drugs and IS.
Figure 2. . Plot of the dried…
Figure 2.. Plot of the dried matrix sample to liquid sample concentration ratio versus the mean of the paired concentration.
(A) Plot of dried plasma spot-to-liquid plasma sample ratios versus the mean of the dried plasma spot and liquid plasma sample concentrations. (B) Plot of dried urine spot-to-liquid urine sample ratios versus the mean of the dried urine spot and liquid urine sample concentrations.The dark solid line represents the observed mean ratio, and the dashed lines reference the limits of agreement between the samples. DPS: Dried plasma spot; DUS: Dried urine spot; LPS: Liquid plasma sample; LUS: Liquid urine sample; SMX: Sulfamethoxazole; TMP: Trimethoprim.
Figure 3. . Passing-Bablock regression of trimethoprim…
Figure 3.. Passing-Bablock regression of trimethoprim and sulfamethoxazole dried plasma and urine spots versus liquid plasma and urine sample concentrations (gray line represents line of unity; black line is the regression line; dashed lines represent 95% CI).
(A) Liquid plasma sample versus dried plasma spot concentrations for trimethoprim and sulfamethoxazole. (B) Liquid urine sample versus dried urine spot concentrations for trimethoprim and sulfamethoxazole. DPS: Dried plasma spot; DUS: Dried urine spot; LPS: Liquid plasma sample; LUS: Liquid urine sample; SMX: Sulfamethoxazole; TMP: Trimethoprim.

Source: PubMed

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