In this study, we introduce the first capillary electrophoresis method that combines cation-selective exhaustive injection and sweeping micellar electrokinetic chromatography (CSEI-sweeping-MEKC) for the simultaneous and sensitive quantification of voriconazole (VRC), posaconazole (PSC), and isavuconazole (ISV) levels in human plasma. The sensitivity was remarkably improved, with a 5374-fold enhancement compared to the traditional MEKC method. We systematically optimized key parameters affecting sensitivity, resolution, and efficiency. The separation buffer included 100 mM NaH2PO4, 13 % acetonitrile, and 13 % tetrahydrofuran. This was followed by a high-conductivity buffer zone (1 psi, 50 s) of 100 mM NaH2PO4, an extended electrokinetic sample injection (10 kV, 600 s), and analyte sweeping with 100 mM sodium dodecyl sulfate micelles at −20 kV. Under these optimized conditions, the method allowed for an analytical run in 10 min and was validated for linearity (r ≥ 0.9997), precision (%RSD ≤ 8.8 %), and accuracy (%RE ≤ 2.20 %), delivering satisfactory results. The limit of detection was 2.55 ng/mL for ISV, 0.89 ng/mL for PSC, and 1.04 ng/mL for VRC. This method was successfully applied to analyze plasma samples from patients undergoing triazole antifungal treatment, demonstrating its feasibility for clinical testing.
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