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Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1984 Sep;20(3):311–316. doi: 10.1128/jcm.20.3.311-316.1984

Laboratory evaluation of five assay methods for vancomycin: bioassay, high-pressure liquid chromatography, fluorescence polarization immunoassay, radioimmunoassay, and fluorescence immunoassay.

M A Pfaller, D J Krogstad, G G Granich, P R Murray
PMCID: PMC271319  PMID: 6386852

Abstract

We compared the precision and accuracy of five methods used to measure the concentration of vancomycin in serum: bioassay, high-pressure liquid chromatography, fluorescence polarization immunoassay (FPIA [TDX; Abbott Laboratories, North Chicago, Ill.]), radioimmunoassay (RIA), and fluorescence immunoassay. Based on an analysis of seven standards and of 106 patient samples, all five methods were accurate, and four (bioassay, high-pressure liquid chromatography, FPIA, and RIA) were also precise. The FPIA was the most precise and the fluorescence immunoassay was the least precise of the methods tested; intrarun coefficients of variation for these two methods were 0.9 to 3.0% versus 8.9 to 14.5%, and interrun coefficients of variation were 2.8 to 8.1% versus 12.2 to 16.2%, respectively. The RIA was inconvenient because it required an extra dilution of the specimen being tested and an additional (64 micrograms/ml) vancomycin standard for specimens with 32 to 64 micrograms of vancomycin per ml. Based on its rapid turnaround time and the stability of its standard curve, we believe that the FPIA is the best method currently available to quantitate vancomycin in the clinical laboratory.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Carmel R. Artifactual radioassay results due to serum contamination by intravenous radioisotope administration. Falsely low serum vitamin B12 and folic acid results. Am J Clin Pathol. 1978 Sep;70(3):364–367. doi: 10.1093/ajcp/70.3.364. [DOI] [PubMed] [Google Scholar]
  2. Cook F. V., Farrar W. E., Jr Vancomycin revisited. Ann Intern Med. 1978 Jun;88(6):813–818. doi: 10.7326/0003-4819-88-6-813. [DOI] [PubMed] [Google Scholar]
  3. Craven D. E., Kollisch N. R., Hsieh C. R., Connolly M. G., Jr, McCabe W. R. Vancomycin treatment of bacteremia caused by oxacillin-resistant Staphylococcus aureus: comparison with beta-lactam antibiotic treatment of bacteremia caused by oxacillin-sensitive Staphylococcus aureus. J Infect Dis. 1983 Jan;147(1):137–143. doi: 10.1093/infdis/147.1.137. [DOI] [PubMed] [Google Scholar]
  4. Crossley K. B., Rotschafer J. C., Chern M. M., Mead K. E., Zaske D. E. Comparison of a radioimmunoassay and a microbiological assay for measurement of serum vancomycin concentrations. Antimicrob Agents Chemother. 1980 Apr;17(4):654–657. doi: 10.1128/aac.17.4.654. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Farber B. F., Moellering R. C., Jr Retrospective study of the toxicity of preparations of vancomycin from 1974 to 1981. Antimicrob Agents Chemother. 1983 Jan;23(1):138–141. doi: 10.1128/aac.23.1.138. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Filburn B. H., Shull V. H., Tempera Y. M., Dick J. D. Evaluation of an automated fluorescence polarization immunoassay for vancomycin. Antimicrob Agents Chemother. 1983 Aug;24(2):216–220. doi: 10.1128/aac.24.2.216. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Fong K. L., Ho D. H., Bogerd L., Pan T., Brown N. S., Gentry L., Bodey G. P., Sr Sensitive radioimmunoassay for vancomycin. Antimicrob Agents Chemother. 1981 Jan;19(1):139–143. doi: 10.1128/aac.19.1.139. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Geraci J. E., Hermans P. E. Vancomycin. Mayo Clin Proc. 1983 Feb;58(2):88–91. [PubMed] [Google Scholar]
  9. Jolley M. E., Stroupe S. D., Schwenzer K. S., Wang C. J., Lu-Steffes M., Hill H. D., Popelka S. R., Holen J. T., Kelso D. M. Fluorescence polarization immunoassay. iii. an automated system for therapeutic drug determination. Clin Chem. 1981 Sep;27(9):1575–1579. [PubMed] [Google Scholar]
  10. Moellering R. C., Jr, Krogstad D. J., Greenblatt D. J. Vancomycin therapy in patients with impaired renal function: a nomogram for dosage. Ann Intern Med. 1981 Mar;94(3):343–346. doi: 10.7326/0003-4819-94-3-343. [DOI] [PubMed] [Google Scholar]
  11. Murray B. E., Karchmer A. W., Moellering R. C., Jr Diphtheroid prosthetic valve endocarditis. A study of clinical features and infecting organisms. Am J Med. 1980 Dec;69(6):838–848. doi: 10.1016/s0002-9343(80)80009-x. [DOI] [PubMed] [Google Scholar]
  12. Newsom S. W. Vancomycin. J Antimicrob Chemother. 1982 Oct;10(4):257–259. doi: 10.1093/jac/10.4.257. [DOI] [PubMed] [Google Scholar]
  13. Rotschafer J. C., Crossley K., Zaske D. E., Mead K., Sawchuk R. J., Solem L. D. Pharmacokinetics of vancomycin: observations in 28 patients and dosage recommendations. Antimicrob Agents Chemother. 1982 Sep;22(3):391–394. doi: 10.1128/aac.22.3.391. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Schiffman G. Immune responses to pneumococcal polysaccharide antigens: a comparison of the murine model and the response in humans. Rev Infect Dis. 1981 Mar-Apr;3(2):224–232. doi: 10.1093/clinids/3.2.224. [DOI] [PubMed] [Google Scholar]
  15. Schwenzer K. S., Wang C. H., Anhalt J. P. Automated fluorescence polarization immunoassay for monitoring vancomycin. Ther Drug Monit. 1983;5(3):341–345. doi: 10.1097/00007691-198309000-00017. [DOI] [PubMed] [Google Scholar]
  16. Sorrell T. C., Packham D. R., Shanker S., Foldes M., Munro R. Vancomycin therapy for methicillin-resistant Staphylococcus aureus. Ann Intern Med. 1982 Sep;97(3):344–350. doi: 10.7326/0003-4819-97-3-344. [DOI] [PubMed] [Google Scholar]
  17. Traber P. G., Levine D. P. Vancomycin Ototoxicity in patient with normal renal function. Ann Intern Med. 1981 Oct;95(4):458–460. doi: 10.7326/0003-4819-95-4-458. [DOI] [PubMed] [Google Scholar]
  18. Uhl J. R., Anhalt J. P. High performance liquid chromatographic assay of vancomycin in serum. Ther Drug Monit. 1979;1(1):75–83. doi: 10.1097/00007691-197901000-00008. [DOI] [PubMed] [Google Scholar]
  19. Van Scoy R. E., Cohen S. N., Geraci J. E., Washington J. A., 2nd Coryneform bacterial endocarditis: difficulties in diagnosis and treatment, presentation of three cases, and review of literature. Mayo Clin Proc. 1977 Apr;52(4):216–219. [PubMed] [Google Scholar]
  20. Walker C. A., Kopp B. Sensitive bioassay for vancomycin. Antimicrob Agents Chemother. 1978 Jan;13(1):30–33. doi: 10.1128/aac.13.1.30. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Walker C. N. Bioassay for determination of vancomycin in the presence of rifampin or aminoglycosides. Antimicrob Agents Chemother. 1980 Apr;17(4):730–731. doi: 10.1128/aac.17.4.730. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Westgard J. O., Hunt M. R. Use and interpretation of common statistical tests in method-comparison studies. Clin Chem. 1973 Jan;19(1):49–57. [PubMed] [Google Scholar]

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