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

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Abstract
The precision and accuracy of 5 methods used to measure the concentration of vancomycin [frequently used to treat gram-positive infections] in serum were compared: bioassay, high-pressure liquid chromatography, fluorescence polarization immunoassay (FPIA), radioimmunoassay (RIA) and fluorescence immunoassay. Based on an analysis of 7 standards and of 106 patient samples, all 5 methods were accurate, and 4 (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 2 methods were 0.9-3.0% vs. 8.9-14.5%, and interrun coefficients of variation were 2.8-8.1% vs. 12.2-16.2%, respectively. The RIA was inconvenient because it required an extra dilution of the specimen being tested and an additional (64 .mu.g/ml) vancomycin standard for specimens with 32-64 .mu.g of vancomycin/ml. Based on its rapid turnaround time and the stability of its standard curve, the FPIA is the best method currently available to quantitate vancomycin in the clinical laboratory.

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