A High Sensitivity LC/MS/MS Method for Quantitative Analysis of Eight Antifungal Drugs in Human Serum

Triazoles and echinocandins are commonly used for the treatment of invasive fungal infections via systemic antifungal chemotherapy. However, these drugs exhibit substantial pharmacokinetic variability in patients such as bioavailability and drug-drug interactions [1,2]. Clinicians often find it challenging to select proper drug doses and evaluate the potential toxicity effects. Therapeutic drug monitoring (TDM) of antifungals is essential to maximise the efficacy and minimise drug overdose risk in patients, hence individualising the treatment [3]. In this study, we aim at developing a fast and reliable LC/MS/MS method with high sensitivity and simple sample pre-treatment. The method is established for simultaneous determination of two classes of antimycotic compounds, five triazoles and three echinocandins in human serum. The method performance is evaluated with spiked serum samples thoroughly before further implementation and validation with clinical samples.