High-performance Liquid Chromatography based Methods for Determination of Antitubercular Drugs in Urine Samples: A Scoping Review

Abstract

Introduction: Tuberculosis (TB) is a contagious disease and is one of the leading causes of death worldwide. TB is primarily caused by Mycobacterium Tuberculosis (MTB) and the percentage of Multi-Drug Resistance TB (MDR-TB) and Extensively Drug Resistance TB (XDR-TB) is increasing daily in many developing countries. Aim: To summarise different High-performance Liquid Chromatography (HPLC)-based methods for checking treatment adherence and drug monitoring of patients by estimating the amount of Anti-tubercular (Anti-TB) drugs in urine samples. Materials and Methods: The authors conducted a search and screened various databases (PubMed, Scopus, Web of Science, Google Scholar) using different keywords between April 2023 and June 2023. The authors included original research articles, clinical trials, and observational studies that focused on estimating anti-TB drugs in urine samples using HPLC. The authors excluded articles that employed methods other than HPLC for drug estimation in urine samples. A total of 13 articles were included in this review. Results: The authors identified 296 articles from different electronic databases and four articles from other sources (Google Scholar, ResearchGate, etc.). Ultimately, 13 articles were included describing HPLC-based methods for determining anti-TB drugs in urine samples. Data was extracted focusing on mobile phases and sample preparation/extraction procedures. Two articles of 2004 and 2014 reported simple mobile phases and sample preparation methods for estimating rifampicin and isoniazid. Additionally, articles published in the last five years have employed simple mobile phases with minimal or no extraction procedures. Conclusion: The present review summarises various HPLCbased methods reported in the literature, as it is considered the gold standard method for checking treatment adherence in TB patients. Urine samples were chosen for ease of collection, particularly from patients of different age groups, including the paediatric population. This review highlights the need for more HPLC-based methods with simple mobile phases and extraction procedures for early detection of anti-TB drugs in resource-poor settings.