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Estimation of Plasma Meropenem Concentrations in Patients with Severe Infections Using Ultraviolet and Visible Range Spectrophotometry : A Pilot Study

Skorup, Paul ; Sjövall, Fredrik LU orcid ; Huss, Fredrik and Lipcsey, Miklos (2026) In European Journal of Drug Metabolism and Pharmacokinetics 51(4). p.413-420
Abstract

BACKGROUND AND OBJECTIVE: Achieving adequate concentrations of beta-lactam antibiotics in patients with severe infections is challenging, and therefore therapeutic drug monitoring (TDM) would be optimal for guiding beta-lactam dosing, but is often limited by availability. UV/VIS spectrophotometry can quantify drug levels in saline, and if those levels truly reflect plasma concentrations, it could enable bedside TDM. We set out to determine whether ultraviolet and visible light range (UV/VIS) spectrophotometry can accurately estimate plasma meropenem concentrations in patients with severe infections compared with liquid chromatography with tandem mass spectrometry (LC‑MS/MS).

METHODS: Blood samples were collected before the first... (More)

BACKGROUND AND OBJECTIVE: Achieving adequate concentrations of beta-lactam antibiotics in patients with severe infections is challenging, and therefore therapeutic drug monitoring (TDM) would be optimal for guiding beta-lactam dosing, but is often limited by availability. UV/VIS spectrophotometry can quantify drug levels in saline, and if those levels truly reflect plasma concentrations, it could enable bedside TDM. We set out to determine whether ultraviolet and visible light range (UV/VIS) spectrophotometry can accurately estimate plasma meropenem concentrations in patients with severe infections compared with liquid chromatography with tandem mass spectrometry (LC‑MS/MS).

METHODS: Blood samples were collected before the first meropenem dose, or if not possible, at least 24 h after the last meropenem dose (baseline), and 2 h after administration. Total plasma concentrations were determined by LC‑MS/MS.

RESULTS: A total of 36 patients and 59 samples were included. The correlation between absorbance and meropenem concentrations was r2 = 0.44 in after administration samples and r2 = 0.18 for the difference between after administration and baseline samples. In Bland-Altman plots the bias and limits of agreement were 0.00 (-29.7 to 29.7) mg/L when meropenem concentrations were estimated using the equation on the basis of the correlation between absorbances and meropenem concentrations, 1.32 (-28.5 to 31.2) mg/L when the standard curve in saline was used to estimate meropenem concentrations, and 2.6 (-23.8 to 29) mg/L when using the correlation between the difference in absorbance versus meropenem concentrations between after administration and baseline samples.

CONCLUSIONS: In patients with severe infections, UV/VIS spectrophotometric estimation of plasma meropenem concentrations currently lacks the precision to estimate meropenem measured by LC‑MS/MS.

TRIAL REGISTRATION: NCT04282785, 25/02/2020.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Drug Metabolism and Pharmacokinetics
volume
51
issue
4
pages
413 - 420
publisher
Adis
external identifiers
  • pmid:42087051
  • scopus:105037836335
ISSN
0378-7966
DOI
10.1007/s13318-026-01008-y
language
English
LU publication?
yes
id
11c0b682-9974-4529-a529-b8eb6b440ac2
date added to LUP
2026-05-06 08:56:36
date last changed
2026-09-10 07:16:34
@article{11c0b682-9974-4529-a529-b8eb6b440ac2,
  abstract     = {{<p>BACKGROUND AND OBJECTIVE: Achieving adequate concentrations of beta-lactam antibiotics in patients with severe infections is challenging, and therefore therapeutic drug monitoring (TDM) would be optimal for guiding beta-lactam dosing, but is often limited by availability. UV/VIS spectrophotometry can quantify drug levels in saline, and if those levels truly reflect plasma concentrations, it could enable bedside TDM. We set out to determine whether ultraviolet and visible light range (UV/VIS) spectrophotometry can accurately estimate plasma meropenem concentrations in patients with severe infections compared with liquid chromatography with tandem mass spectrometry (LC‑MS/MS).</p><p>METHODS: Blood samples were collected before the first meropenem dose, or if not possible, at least 24 h after the last meropenem dose (baseline), and 2 h after administration. Total plasma concentrations were determined by LC‑MS/MS.</p><p>RESULTS: A total of 36 patients and 59 samples were included. The correlation between absorbance and meropenem concentrations was r2 = 0.44 in after administration samples and r2 = 0.18 for the difference between after administration and baseline samples. In Bland-Altman plots the bias and limits of agreement were 0.00 (-29.7 to 29.7) mg/L when meropenem concentrations were estimated using the equation on the basis of the correlation between absorbances and meropenem concentrations, 1.32 (-28.5 to 31.2) mg/L when the standard curve in saline was used to estimate meropenem concentrations, and 2.6 (-23.8 to 29) mg/L when using the correlation between the difference in absorbance versus meropenem concentrations between after administration and baseline samples.</p><p>CONCLUSIONS: In patients with severe infections, UV/VIS spectrophotometric estimation of plasma meropenem concentrations currently lacks the precision to estimate meropenem measured by LC‑MS/MS.</p><p>TRIAL REGISTRATION: NCT04282785, 25/02/2020.</p>}},
  author       = {{Skorup, Paul and Sjövall, Fredrik and Huss, Fredrik and Lipcsey, Miklos}},
  issn         = {{0378-7966}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{413--420}},
  publisher    = {{Adis}},
  series       = {{European Journal of Drug Metabolism and Pharmacokinetics}},
  title        = {{Estimation of Plasma Meropenem Concentrations in Patients with Severe Infections Using Ultraviolet and Visible Range Spectrophotometry : A Pilot Study}},
  url          = {{http://dx.doi.org/10.1007/s13318-026-01008-y}},
  doi          = {{10.1007/s13318-026-01008-y}},
  volume       = {{51}},
  year         = {{2026}},
}