Microsampling Assays for Pharmacokinetic Analysis and Therapeutic Drug Monitoring of Antimicrobial Drugs in Children: A Critical Review
Moorthy et al.
The finding, in our words
This review summarises liquid chromatography with tandem mass spectrometry assays using dried blood spots and volumetric absorptive microsampling for quantifying antimicrobial drugs in children, highlighting that VAMS reduces haematocrit bias and offers a viable alternative to traditional plasma sampling for therapeutic drug monitoring.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
A VAMS-LC-MS/MS method was developed and validated for measuring four antibiotics in 10 microlitres of human blood, showing that VAMS provided accurate quantification unaffected by haematocrit, unlike dried blood spots. The method was applied to paediatric patient samples, supporting its use for therapeutic drug monitoring in children.
The study developed and validated a rapid LC-MS/MS method for quantifying cefazolin in capillary whole blood collected via VAMS, plasma, and plasma ultrafiltrate, showing robust performance across matrices and successful application in a pediatric pilot cohort for therapeutic drug monitoring.
A validated LC-MS method quantified multiple antibiotics from a single volumetric absorptive microsample, with stability up to 90 days for most analytes and minimal haematocrit effect except vancomycin, enabling pharmacokinetic and pharmacodynamic studies in decentralised settings.
The validated LC-MS/MS method showed similar pharmacokinetic profiles for albendazole and its metabolites across plasma, whole blood, dried blood spots and Mitra microsamples from hookworm-infected adolescents, supporting microsampling for paediatric pharmacokinetic studies. Mitra extraction proved more robust than dried blood spots during validation and is recommended for future albendazole pharmacokinetic work, despite higher albendazole sulfone concentrations observed in both microsampling devices compared with wet matrices.
This review found that volumetric microsampling devices, such as Mitra, HemaPEN, HemaXis DB10, and Tasso-M20, overcome haematocrit bias, whilst Telimmune plasma separation cards enable direct plasma collection without centrifugation. These technologies support patient-centric, decentralised sampling, though the authors note that clinical validation remains limited across different drugs and patient populations.