JAC Advance Access originally published online on June 12, 2003
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Journal of Antimicrobial Chemotherapy (2003) 52, 78-82
© 2003 The British Society for Antimicrobial Chemotherapy
Evaluation of commercial assays for vancomycin and aminoglycosides in serum: a comparison of accuracy and precision based on external quality assessment
1 Department of Pharmacology, Therapeutics & Toxicology, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XN; 2 Bristol Centre for Antimicrobial Research and Evaluation, Department of Microbiology, Southmead Hospital, Westbury-on-Trym, Bristol, UK
Received 19 December 2002; returned 18 January 2003; revised 17 February 2003; accepted 23 April 2003
Objective: To compare the accuracy and precision of commercial assay techniques in the measurement of gentamicin, tobramycin, amikacin, netilmicin and vancomycin in serum.
Methods: Data from the measurement of 40 external quality assessment samples from 358 laboratories providing a therapeutic drug monitoring service were analysed.
Results: Significant differences between techniques in accuracy and precision were observed for all drugs. Coefficients of variation ranged from 4.1% to 9.8% for the aminoglycosides and from 6.7% to 11.7% for vancomycin. The percentage difference in measurements from the weighed-in drug concentration ranged from –10.1% to +4.0% for the aminoglycosides and from –3.5% to +5.7% for vancomycin. The Dade Behring Emit immunoassay was notable in producing significantly more outliers (>4 S.D. from the weighed-in concentration) than other techniques in the measurement of gentamicin, amikacin and vancomycin.
Conclusions: All assays performed to a satisfactory standard for measurement in non-renal patients, but none met the more stringent standards desirable for monitoring patients with renal impairment.
Keywords: gentamicin, tobramycin, amikacin, netilmicin, immunoassays
* Corresponding author. Tel: +44-29-2074-2068; Fax: +44-29-2074-8316; E-mail: wilsonjf@cardiff.ac.uk
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