JAC Advance Access published online on June 12, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg296
© 2003 by The British Society for Antimicrobial Chemotherapy
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Original article
1 Department of Pharmacology,
Therapeutics & Toxicology, University of Wales College
of Medicine, Heath Park, Cardiff CF14 4XN
Received 19 December 2002
; 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
Evaluation of commercial assays for vancomycin
and aminoglycosides in serum: a comparison of accuracy and precision
based on external quality assessment
2 Bristol Centre for Antimicrobial Research and Evaluation,
Department of Microbiology, Southmead Hospital, Westbury-on-Trym,
Bristol, UK
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