Investigation of early antibiotic use in pediatric patients with acute respiratory infections by high-performance liquid chromatography |
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Authors: | Pham Van Toi Khanh V Doan Ngo Ngọc Quang Minh Pham Nguyen Phuong Menno D de Jong H Rogier van Doorn Thomas Pouplin |
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Institution: | 1. Oxford University Clinical Research Unit, Wellcome Trust Major Oversea Programme, Ho Chi Minh City—in Partnership with Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam;2. Department of Pharmacology, School of Medicine, Tan Tao University, Long An, Vietnam;3. Children's Hospital 1, Ho Chi Minh City, Viet Nam;4. Department of Medical Microbiology, Academic Medical Centre, Amsterdam, The Netherlands;5. Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand |
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Abstract: | In this study, we developed and validated two reliable high-performance liquid chromatography (HPLC) methods for the qualitative detection of six oral β-lactams, which are commonly used in pediatric patients with acute respiratory infections (ARIs). Two distinct reverse-phase chromatographic separations of six β-lactams were obtained. Four β-lactams (cefadroxil, cephalexin, cefaclor and cefixime) in urine were separated using a gradient program with a mobile phase consisting of K2HPO4 buffer (20 mm , pH 2.8) and acetonitrile on a LichroCART 250 × 4.6 mm, Purospher STAR C18 end-capped (5 μm) column. Two remained β-lactams (amoxicillin and cefuroxime) were analyzed using a gradient elution with the mobile phase containing K2HPO4 buffer (20 mm , pH 3.0) and acetonitrile on a LichroCart® Purospher Star C8 end-capped column (5 μm, 125 × 4.6 mm). Good linearity within the range of 0.3–30 μg/ml for cefadroxil, cephalexin, cefaclor and cefixime, and 0.2–20 μg/ml for amoxicillin and cefuroxime, was attained. The precisions were <14%. The accuracies ranged from 85.87 to 102.8%. The two validated methods were then applied to determine these six antibiotics in 553 urine samples of pediatric patients with ARIs. As a result, 32.2% were positive with one or more of six tested β-lactams. Cefixime was the most commonly detected agent, accounting for 9.8% of enrolled patients. |
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Keywords: | high-performance liquid chromatography β-Lactams antibiotic misuse pediatric patients urine |
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