Homogeneous Immunoassays—Therapeutic Drug Monitoring
Innofluor®—Fluorescence Polarization Immunoassays To view and print the files below you will need Adobe Acrobat Reader®,
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INNOFLUOR® Vancomycin Assay System
The INNOFLUOR® VANCOMYCIN Assay System is intended for the quantitative determination of total vancomycin in serum for therapeutic drug monitoring by fluorescence polarization immunoassay (FPIA). The assay system is for use on the TDx® or the TDxFlxTM (TDx®/TDxFLx®) analyzer.
The emergence of antibiotic-resistant strains of Staphylococcus aureus in hospitalized patients led to the development of vancomycin, a water soluble, tricyclic glycopeptide.1,2 the drug acts by blocking cell wall synthesis, is bactericidal against most gram positive organisms except entercocci, and is frequently used to treat infections caused by penicillin-resistant staphylococci.3,4 Extensive review articles have been published which fully examine vancomycin’s effectiveness and pharmacokinetics.5-12
Vancomycin is absorbed minimally from the gastrointestinal tract. In the first 24 hours after intravenous dosing, the usual route of administration, about 90% of the vancomycin is excreted unchanged by the kidneys. The average half-life in patients with normal renal function is about 6 hours. Vancomycin is approximately 55% bound to plasma proteins. Therapeutic serum levels vary depending on the microorganism involved and the patient’s tolerance of the drug.4,9 Vancomycin serum concentrations are monitored to guide therapy, since individual patient differences require dose changes which are difficult to predict. Monitoring serum levels of vancomycin decreases the frequency of serious toxic effects.4,5 Immunoassays for vancomycin using a fluorescence polarization technique have been described.13
Griffith RS. Introduction to vancomycin. Reviews of Infectious Diseases, Nov-Dec 1981; 3[suppl]: S201.
Pfeiffer, RR. Structural features of vancomycin. Reviews of Infectious Diseases, Now-Dec 1981[suppl]: S205.
Barnhart ER. Publ In: Physicians’ Desk Reference. Oradell, NJ: Medical Economics Co., Inc., 1993: 1341-1346.
Wilhelm MP. Vancomycin. Mayo Clin Proc 1991; 66: 1165-1170.
Birt JK, Chandler MH. Short communication. Using clinical data to determine vancomycin dosing parameters. Therapeutic Drug Monitoring 1990; 12: 206-209.
Watanakunakorn C. The antibacterial action of vancomycin. Reviews of Infectious Diseases, Nov-Dec 1981; 3[suppl]: S210.
Cook FV, Farrer, WE, Jr. Vancomycin revisited. Anals of Internal Medicine 1978; 88(6): 813.
Krogstead DJ, Moellering WE, Jr. Greenblatt DJ. Single dose kinetics of intravenous vancomycin. Journal of Clinical Pharmacology, April, 1980: 197.
Moellering RC, Krogstead DJ, Greenblatt DJ. Pharmacokinetics of vancomycin in normal subjects and in patients with reduced renal function. Reviews of Infectious Diseases, Nov-Dec 1981; 3[suppl]: S230.
Kirby WM. Vancomycin therapy in severe staphylococcal infections. Reviews of Infectious Diseases, Nov – Dec 1981; 3[suppl]: S236.
Schaad UB, Nelson JD, McCracken GH. Pharmacology and efficacy of vancomycin for staphylococcal infections in children. Reviews of Infectious Diseases, Nov-Dec, 1981; 3[suppl]: S282.
Cooper GL, Given DB. Vancomycin: A comprehensive review of 30 years of clinical experience. Eli Lilly Research Laboratories: Indianapolis, IN, 1985.
Schwenzer KS, Chao-Huei JW, Anhalt JP. Automated fluorescence polarization immunoassay for monitoring vancomycin. Therapeutic Drug Monitoring 1983; 5: 341-345.
