Introduction : Afin de minimiser la morbidité postopératoire et les échecs du traitement dentaire, plusieurs schémas thérapeutiques antibiotiques ont été proposés. Cependant, l’utilisation intensive des antibiotiques dans les soins de santé a été débattue en raison des effets indésirables et la résistance bactérienne. De plus, l’impact des antibiotiques préopératoires sur le niveau osseux péri-implantaire n’est toujours pas clairement établi. Objectifs : L’objectif primaire de cette étude était d’évaluer si l’administration d’un antibiotique préopératoire (azithromycine 500 mg) avant la pose d’implant avait un impact sur les niveaux d’os crestal péri-implantaire après quatre mois chez les patients en bonne santé subissant une pose d’implant simple de type « platform-switching ». Les objectifs secondaires étaient d’évaluer la sévérité de la douleur postopératoire, la morbidité postopératoire associée à la chirurgie implantaire et le taux de survie des implants à quatre mois. Méthodes : Dix-neuf participants ont été recrutés dans un essai clinique randomisé à double insu en groupes parallèles. Les participants du groupe d’intervention ont reçu 500 mg d’azithromycine une heure avant la pose d’implant. Les participants du groupe contrôle ont reçu un placebo identique une heure avant la chirurgie implantaire. Les changements du niveau de l’os crestal péri-implantaire (résultat primaire) ont été mesurés quatre mois plus tard à l’aide de radiographies standardisées. La sévérité de la douleur et la morbidité postopératoire associées à la chirurgie (résultats secondaires) ont été évaluées par des examens cliniques et des questionnaires autoadministrés à une semaine et quatre mois postopératoires. Le taux de survie des implants et la santé péri-implantaire ont été évalués quatre mois après la pose d’implant, avant la mise en charge prothétique. Des analyses descriptives et bivariées ont été utilisées pour analyser les données. Une valeur de P ≤ 0,05 était considérée statistiquement significative. Résultats : Dix-huit participants ont complété l’étude (âge moyen : 52,8 ± 13,9ans). Les changements moyens du niveau osseux péri-implantaire pour le groupe intervention et le groupe contrôle étaient respectivement de -0,79 ± 0,57mm et de -0,35 ± 0,37mm. Il n’y avait pas de différences statistiquement significatives entre les deux groupes en ce qui concerne le remodelage osseux moyen péri-implantaire (-0,44mm (IC 95% : -0,94, +0,55)) et la sévérité de la douleur (P>0,05). Les interférences avec les activités quotidiennes, plus précisément, l’interférence de la chirurgie à ouvrir grand la bouche étaient significativement plus importante chez le groupe antibiotique comparativement au groupe intervention au cinquième jour postopératoire (P<0,05). Le taux de survie des implants était de 100% dans les deux groupes et la santé des tissus péri-implantaires était similaire entre les deux groupes quatre mois après la chirurgie. Conclusion : Les résultats préliminaires de cette étude clinique suggèrent qu’une dose préopératoire d’antibiotique chez les patients en bonne santé ayant une pose d’implant simple de type « platform-switching » n’apporte pas de bénéfice clinique. Des investigations additionnelles de plus grande envergure sont nécessaires afin de confirmer les résultats de cette étude. / Introduction: In order to minimise postoperative morbidity and failures of dental implant therapy, several antibiotic regimens have been proposed. However, the extensive use of antibiotics in health care has been debated due to the adverse effects and bacterial resistance. Furthermore, the impact of preoperative antibiotics on peri-implant bone level remains unclear. Objectives: The primary objective of this study was to assess whether giving a preoperative antibiotic (azithromycin 500mg) before implant placement would influence peri-implant crestal bone levels after four months in healthy patients undergoing straightforward platform-switched implant placement. The secondary objectives were to evaluate postoperative pain severity, surgery-associated morbidities, and four-month implant survival rate. Methods: Nineteen individuals were recruited in a double-masked two-arm randomised clinical trial. Participants in the intervention group received 500mg of azithromycin one hour before implant placement. Participants in the control group took one identical placebo one hour preoperatively. The changes in mesial and distal crestal bone level (primary outcome) were measured at baseline and four-month follow-up using standardised periapical radiographs. Pain severity and surgery-associated morbidities (secondary outcomes) were evaluated by clinical examinations and self-administered questionnaires at one-week and four-month follow-ups. Implant survival rate was assessed at the four-month follow-up. Descriptive and bivariate analyses were used to analyse the data. A P value ≤ 0.05 was considered statistically significant. Results: Eighteen participants completed the study (mean age: 52,8 ±13,9 years). The mean changes in peri-implant bone level for the intervention group and the control group were 0,79 ±0,57 mm and -0,35 ±0,37mm, respectively. There were no statistically significant differences between the two groups in mean change in peri-implant bone level (-0,44mm (95% CI: -0,94, +0,55)) and pain severity (P>0.05). Interferences with daily activities, more specifically the interference of surgery with opening the mouth larger was significantly higher in the antibiotic group compared to the control group (P<0.05) on the fifth postoperative day. The implant survival rate was 100% in both groups and peri-implant tissue health was similar between groups four months after surgery. Conclusion: The preliminary results of this clinical study demonstrates that giving one preoperative dose of antibiotic in healthy patients undergoing straightforward “platform-switching” implant placement does not provide any clinical benefit. Further larger controlled studies are needed to confirm the results of this study.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

<p>Danas, u raznim analitičkim laboratorijama postoji veći broj analitičkih protokola,<br />zasnovanih bilo na izuzetno sofisticiranim ili jednostavnijim tehnikama, koji služe za<br />određivanje različitih ciljnih analita od farmakolo&scaron;kog značaja. Među tim grupama ciljnih analita pripadaju i antibiotici koji predstavljaju veliko otkriće u oblasti medicine i zahvaljujući njima spa&scaron;eno je vi&scaron;e od sedam miliona života, ali pored navedenih koristi, antibiotici mogu da izazovu&nbsp; veliki broj neželjenih efekata i žučne kiseline zajedno sa svojim derivatima, koji su fiziolo&scaron;ki deterdženti, mogu biti citotoksične za organizam ako se njihova koncentracija ne kontroli&scaron;e. U ovoj doktorskoj disertaciji prikazan je razvoj analitičkih metoda pre svega voltametrijskihmetoda u kombinaciji sa jednostavnim i savremenim elektrodama/senzorima za određivanje&nbsp; odabranih analita kao &scaron;to je antraciklični antibiotik doksorubicin (DOX), makrolidni antibiotici<br />eritromicin-etilsukcinata (EES), azitromicina (AZI), klaritromicina (CLA) i roksitromicina&nbsp; (ROX) i 3-dehidro-deoksiholne kiseline.</p><p>Voltametrijska karakterizacija i određivanje gore navedenih antibiotika primenom obnovljive srebro-amalgam film elektrode (Hg(Ag)FE)rađena je direktnom katodnom&nbsp; voltametrijom sa pravougaonim talasima (SWV) i visoko osetljivom adsorptivnom voltametrijom sa pravougaonim talasima (SW-AdSV) u Briton-Robinson puferu, kao pomoćnom elektrolitu, obuhvatajući &scaron;irok opseg pH vrednosti. Odgovor DOX-a primenom&nbsp; Hg(Ag)FE&nbsp;praćen je u intervalu potencijala od -0,20 do -0,80 V.&nbsp; Za analizu tragova, optimizacija metode ukazuje da su optimalni parametri za analitički pik na potencijalu (Ep ) -0,57 V u odnosu na zasićenu kalomelovu elektrodu (ZKE): pH 6,0, potencijal&nbsp; akumulacije -0,20 V i vreme&nbsp; akumulacije 140 s. U model rastvoru, DOX je određivan u koncentracionom opsegu 4,99-59,64&nbsp; ng mL^-1. Razvijena SW-AdSV metoda je primenjena za određivanje DOX-a u obogaćenom uzorku humanog urina. Niža koncentracija DOX-a 9,89ng mL^-1&nbsp;u voltametrijskoj&nbsp; ćeliji je određivana sa relativnom standardnom devijacijom (RSD) manjom od 6,0%. &Scaron;to se ispitivanih makrolida tiče oni su pokazali redukcione signale u dalekoj negativnoj oblasti potencijala. Ispitivanja direktnom katodnom SWV rađena su u opsegu potencijala od -0,75 V do -2,00 V u odnosu na ZKE, pri čemu su dobijena jedan ili dva redukciona pika u opsegu potencijala od -1,5 V do -1,9 V. Oblik i intenzitet signala zavisi od primenjene pH vrednosti u &scaron;irokoj pH oblasti. Za analitičke svrhe, radi razvoja direktne katodne SWV i adsorptivne inverzne/striping SWV metode, pogodnim su se pokazale neutralna i slabo alkalna sredina tj. pH 7,0 sa&nbsp; E_p na -1,67 V u odnosu na ZKE za ROX i EES i pH 7,2 sa E_p na -1,85 V u odnosu na ZKE za AZI i pH 7,4 sa E_p na -1,64 V u odnosu na ZKE za CLA. Na osnovu snimljenih cikličnih voltamograma na&nbsp; optimalnim pH vrednostima, može se predložiti adsorptivno-kontrolisan kinetički proces na elektrodi u slučaju sva&nbsp; četiri ispitivana jedinjenja. Takođe,&nbsp; ¹H NMR merenja uz potiskivanje&nbsp; signala vode u pH oblasti između pH 6,0 i 10,5 ukazuju na to da su makrolidni molekuli pri optimalnim analitičkim uslovima predominantno u protonovanoj formi preko tercijerne amino grupe &scaron;to potpomaže, u sva&nbsp; četiri slučaja, njihovu adsorpciju na odgovarajuće polarizovanoj Hg(Ag)FE. Optimizovane direktne katodne SWV metode&nbsp; pokazuju dobru linearnost u koncentracionom opsegu 4,81-23,3&nbsp; &micro;g mL^-1 , 4,53-29,8&nbsp; &micro;g mL^-1 , 1,96-28,6&nbsp; &micro;g mL^-1 i 1,48-25,9 &micro;g mL^-1 za AZI, EES, CLA odnosno ROX. Razvijene SW-AdSV metode rezultiraju u linearnom odgovoru pri nižim koncentracionim intervalima 1,0-2,46 &micro;g mL^-1 ,&nbsp; 0,69-2,44&nbsp; &micro;g mL^-1, 0,05-0,99 &micro;g mL^-1 i 0,10-0,99&nbsp; &micro;g mL^-1 , za AZI, EES, CLA i ROX. RSD za sve razvijene metode nije veća od 1,5% izuzev SWV metode u slučaju AZI-a gde je 4,5%. Direktna katodna SWV metoda&nbsp; je uspe&scaron;no primenjena za određivanje EES-a u farmaceutskom proizvodu Eritromicin^&reg; dok SW-AdSV metoda je primenjena u slučaju određivanja EES-a u obogaćenom uzorku humanog urina i&nbsp;za određivanje ROX-a u farmaceutskom proizvodu Runac^&reg; . U svim pomenutim slučajevima, primenjena je metoda standardnog dodatka. Pouzdanost i tačnost elaboriranih procedura u slučaju određivanja EES-a u model sistemu i&nbsp; farmaceutskom proizvodu Eritromicin^&reg; su potvrđena poređenjem sa rezultatima dobijenim primenom HPLC-DAD metode.</p><p>Nakon preliminarnih studija 3-dehidro-deoksiholne&nbsp; kiseline/3-dehidro-deoksiholata primenom elektrode od staklastog ugljenika (GCE), gde je uočeno da ne dolazi do formiranja redukcionog signala u Briton-Robinson puferu između pH 5,0 i 11,8 primenom direktne katodne SWV, bizmut-film je izdvojen&nbsp; <em>ex situ</em> na povr&scaron;ini iste elektrode od staklastog ugljenika (BiF-GCE) iz uobičajeno kori&scaron;ćenog rastvora za elektrodepoziciju (0,02 mol L^-1 Bi(NO₃)₃, 1,0 mol L^-1 HCl i 0,5 mol L^-1 KBr) i tako pripremljena elektroda je primenjena za karakterizaciju i određivanje pomenutog jedinjenja u alkalnoj sredini. Redukcioni signal ispitivanog analita od analitičkog značaja je uočen jedino primenom BiF-GCE u Briton-Robinson puferusa pH vrednostima između 9,5 i 11,8 u režimu adsorptivne inverzne/stripingvoltametrije sa pravougaonim talasima, dok u slučaju direktnih katodnih SWV eksperimentalnih uslova uočen je slab redukcioni pik sa niskom strujom maksimuma pika. Optimizovani eksperimentalni uslovi za određivanje 3-dehidro-deoksiholata obuhvataju odgovarajuće kondicioniranje elektrode uključujući kondicioniranje&nbsp; <em>ex situ</em> pripremljene BiF-GCE u Briton-Robinson pomoćnom elektrolitu pH 11,8 do stabilizacije struje bazne linije elektrohemijskim cikliranjem potencijala radne elektrode u potencijalskom opsegu između -1,00 i -2,00 V u odnosu na ZKE (blizu 15 puta) i primenu dva ključna parametara adsorptivne voltametrije sa pravougaonim talasima: vreme akumulacije od 30 s i potencijal akumulacije&nbsp; -1,00 V u odnosu na ZKE. Zbog relativne asimetričnosti dobijenih redukcionih signala ispitivanog analita sa&nbsp; E_p na -1,35 V u odnosu na ZKE, &scaron;to je takođe prisutno i u slučaju primene SW-AdSV, određivanje ispitivanog analita je zasnovano na linearnoj zavisnosti između povr&scaron;ine pika redukcionog signala&nbsp; spitivanog analita i njegove odgovarajuće koncentracije i postignuta granica detekcije je 1,43 &micro;g mL^-1 sa dva linearna opsega kalibracione krive od 4,76 &micro;g mL^-1 do 13,0 &micro;g mL^-1 i od 13,0 &micro;g mL^-1 do 23,1 &micro;g mL^-1 za razvoj analitičke metode. RSD metode je 3,22%. Dodatni eksperimenti, elektroliza ispitivanog analita na potencijalu -1,55 V (blizu maksimuma pika ciljnog analita) u odnosu na ZKE su rađeni primenom GCE u obliku ploče (povr&scaron;ina 33,52 cm 2 ) modifikovane sa&nbsp; <em>ex situ&nbsp;</em>pripremljenim bizmut-filmom. Rastvor od interesa uzorkovan je na početku eksperimenta, nakon 2,5 h i nakon 4,5 h tretmana. Ovakvi uzorci su analizirani primenom ¹H NMR merenja uz potiskivanje signala vode u puferskom rastvoru pH 11,8. Može se pretpostaviti da tokom elektrolize 3-dehidro-deoksiholata dolazi do redukcije keto grupe prisutne u strukturi ispitivanog analita.</p><p>Na osnovu literaturnih podataka da neki od ciljnihmakrolidnih antibiotika kao &scaron;to je npr. azitromicin pokazuju oksidativno pona&scaron;anje na elektrodi od ugljenične paste i elektrodi od zlata deteljna karakterizacija i određivanje&nbsp; četiri makrolidna antibiotika rađena je primenom&nbsp; asične&nbsp;elektrode od ugljenične paste (CPE) koja se sastoji samo od grafitnog praha i parafinskog ulja sa optimizovanih direktnih anodnih SWV metoda. U slučaju EES-a i AZI-a diferencijalna pulsna voltametrija (DPV) je testirana za iste svrhe. Ključni&nbsp; parametar u slučaju razvoja analitičkih voltametrijskih metoda je odabir pH vrednosti pomoćnog elektrolita gde je oblik/simetričnost i intenzitet oskidacionog pika glavni kriterijum prilikom odabira. Kao odgovarajuće pH vrednosti za voltametrijsko određivanje EES-a primenom SWV metode odabrana je pH 8,0 sa E_p na 0,83<br />V u odnosu na ZKE, dok u slučaju DPV metode pH 12,0 sa&nbsp; E_p na 0,55 V u odnosu na ZKE je bila najpogodnija za analitičke svrhe. Za određivanje AZI-a, u slučaju obe SWV i DPV metode pH 7,0 se pokazala najpogodnijom sa E_p analitičkog signala na 0,85 V odnosno 0,80 V u odnosu na ZKE, dok u slučaju CLA i ROX koji su ispitivani samo primenom SWV metode za analitičke svrhe pH 12,0 je bila najpogodnija sredina sa E_p analitičkog signala na 0,65 V odnosno na 0,63 V&nbsp;u odnosu na ZKE. Postignute granice detkcije primenom nemodifikovane CPE i direktne anodne SWV su uglavnom u submikrogramskom koncentracionom opsegu 0,17 &micro;g mL^-1 , 0,32&nbsp; &micro;g mL^-1 i 0,30&nbsp; &micro;g mL^-1, u slučaju EES-a, AZI-a i ROX-a i u niskom mikrogramskom koncentracionom opsegu 1,43&nbsp; &micro;g mL^-1 za CLA. Razvijena SWV metoda sa jednostavnom CPE pokazala se pogodnom za određivanje ROX-a u komercijalnom proizvodu Runac^&reg; tableti. U slučaju optimizovanih DPV metoda postignute granice detekcije za EES i AZI su u niskom mikrogramskom&nbsp; koncentracionom opsegu 1,03&nbsp; &micro;g mL^-1 odnosno 1,53&nbsp; &micro;g&nbsp; mL^-1 . U želji da se&nbsp;postigne niža granica detekcije za AZI, DPV metoda&nbsp; je testirana u kombinaciji sa&nbsp; CPE radnom elektrodom povr&scaron;inski modifikovanom sa zlatnim nanočesticama&nbsp; prečnika 10 nm (Au-CPE) i&nbsp; postignuta granica detekcije je 0,95&nbsp; &micro;g mL^-1 sa&nbsp; E_p analitičkog signala na 0,80 V u odnosu na&nbsp; ZKE. RSD metode u slučaju Au-CPE je 3,5%, dok je u slučaju nemodifikovane CPE 6,0%.&nbsp; Linearnost analitičke metode zasnovane na primeni Au-CPE je dva puta &scaron;ira nego u slučaju&nbsp; primene nemodifikovane CPE.</p><p>Na osnovu dobijenih rezultata može se zaključiti da&nbsp; odgovarajuće kombinacije&nbsp; optimizovanih voltametrijskih tehnika sa ekolo&scaron;ki prihvatljivim i lako primenljivim radnim&nbsp; elektrodama, kao &scaron;to su Hg(Ag)FE, BiF-GCE i CPE zajedno sa Au-CPE, rezultuju razvojem&nbsp; pouzdanih analitičkih metoda, kako u oksidacionim tako i u redukcionim proučavanjima, koje&nbsp; često omogućuju&nbsp; određivanje tragova analita od farmakolo&scaron;kog značaja u jednostavnim, a u&nbsp;nekim slučajevima i u složenim sistemima.&nbsp;</p> / <p>Nowadays in different analytical laboratories there is the increasing number of analytical protocols, either based on highly sophisticated or simpler measurements techniques, which serving for determination of different target analytes of pharmacological importance. Among such target groups of the analyte belongs the antibiotics which present a great discovery in the field of medicine and thanks to them were saved more than seven million people but beside to the mentioned great benefits, antibiotics can cause a large number of side effects and bile acids together with their derivatives which are physiological detergents but if their concentration is not<br />controlled they can be cytotoxic to the body. In the present doctoral dissertation the development of analytical methods, primarily analytical voltammetric methods in combination with simple and contemporary electrodes/sensors, for the determination of selected analytes as antracycline antibiotic doxorubicin (DOX), macrolide antibiotics erythromycin ethylsuccinate (EES), azithromycin (AZI), clarithromycin (CLA) and roxithromycin (ROX) and 3-dehydrodeoxycholic acid were performed.</p><p>Voltammetric characterization and determination of the above mentioned antibiotics using a renewable silver-amalgam film electrode (Hg(Ag)FE) was performed by direct cathodic square-wave voltammetry (SWV) and by highly sensitive adsorptive square-wave voltammetry (SW-AdSV) in aqueous Britton-Robinson buffer solutions as supporting electrolyte covering the wider pH range. The Hg(Ag)FE response of DOX was monitored in the potential range between -0.20 and -0.80 V. For the trace level analysis the method optimization showed that the optimal conditions for the analytical peak with peak potential (E_p) at -0.57 V vs. SCE were: the pH 6.0, the accumulation potential -0.20 V, and the accumulation time 140 s. In the model solutions, DOX was determined in the concentration range of 4.99-59.64 ng mL^-1. The developed SWAdSV method was applied for the determination of DOX in spiked human urine sample. The lowest concentration of DOX of 9.89 ng mL^-1 in voltammetric vessel was determined with the relative standard deviation (RSD) less than 6%. As for the investigated macrolides, they showed reduction signals in fairly negative potential range. During direct cathodic SWV investigations conducted over the potential range from -0.75 V to -2.00 V vs. SCE, either one or two reduction peaks were obtained in the&nbsp; potential range from -1.5 to -1.9 V. For analytical purposes concerning the development of direct cathodic SWV and adsorptive stripping SWV methods the neutral&nbsp; and slightly alkaline media were suitable as pH 7.0 with E_p at -1.67 V vs.&nbsp; SCE for ROX and EES and pH 7.2 and pH 7.4 with E_p at -1.85 V and -1.64 V vs. SCE for AZI and CLA, respectively. Based on the cyclic voltammograms recorded at these pH values, adsorptioncontrolled electrode kinetics process can be proposed for all four investigated compounds. The water suppressed ¹H NMR measurements in the pH range between 6.0 and 10.5 indicated that the macrolide molecules at the optimal analytical conditions are predominantly in protonated form via their tertiary amino groups which supported in all four cases their adsorption on the appropriately polarized Hg(Ag)FE electrode. The optimized direct cathodic SWV methods showed good linearity in concentration ranges 4.81-23.3 &mu;g mL^-1, 4.53-29.8 &mu;g mL^-1, 1.96-28.6&nbsp; &mu;g mL^-1, and 1.48-25.9 &mu;g mL^-1 for AZI, EES, CLA and ROX, respectively. The SW-AdSV methods resulted in the linear responses at lower concentration ranges as 1.0-2.46 &mu;g mL^-1, 0.69- 2.44 &mu;g mL^-1, 0.05-0.99 &mu;g mL^-1 and 0.10-0.99 &mu;g mL^-1, for AZI, EES, CLA and ROX, respectively. The RSD for all developed methods was not higher than 1.5% except the SWV method for AZI with 4.7%. The direct cathodic SWV method was successfully applied for the determination of EES in the pharmaceutical preparation Eritromicin^&reg;, while SW-AdSV was tested in the case of the spiked urine sample and for determination of ROX in pharmaceutical preparation Runac^&reg;. In all above cases, the standard addition method was used. The reliability and accuracy of the above procedures in the case of EES determination in model system and pharmaceutical preparation Eritromicin^&reg; were validated by comparing them with those obtained by means of HPLC-DAD measurements.</p><p>After initial study of 3-dehydro-deoxycholic acid/3-dehydro-deoxycholate by glassy carbon electrode, where the absence of any reduction peak was observed in the Britton-Robinson buffer solutions between pH 5.0 and 11.8 by direct cathodic SWV, a bismuth-film was electrodeposited ex situ on the same glassy carbon electrode surface (BiF-GCE) from the usually used plating solution (0.02 mol L^-1 Bi(NO₃)₃, 1.0 mol L^-1 HCl and 0.5 mol L^-1 KBr) and such prepared film-electrode was applied for the characterization and determination of the the target analyte in alkaline media. The reduction signal of analytical importance was observed only by BiF-GCE in Britton-Robinson buffer solutions with pH values between 9.5 and 11.8 in adsorptive stripping square-wave voltammetry working regime, while in the case of the direct cathodic SWV experimental protocol only a very poor reduction peak was obtained. The optimized experimental conditions for the 3-dehydro-deoxycholate determination consist of the optimized electrode conditioning including the electrochemical cycling of the <em>ex situ </em>prepared BiF-GCE potentials in the potential span between -1.0 and -2.0 V vs. SCE (nearly 15 times) in the Britton-Robinson supporting electrolyte pH 11.8 till the stabilization of the baseline current, and the application of two key parameters of the adsorptive square-wave voltammetric protocol: the accumulation time as 30 s and accumulation potential as -1.0 V vs. SCE. Because of the relative asymmetry of the obtained reduction signals of the target analyte with peak E_p at -1.35 V vs. SCE, which is still present in the case of the SW-AdSV, the quantification of the target analyte was based on the linear correlation between peak area of the reduction signal and its appropriate concentrations, and reached limit of detection is 1.43 &mu;g mL^-1 and with two linear ranges of calibration curve from 4,76 &mu;g mL^-1 to 13.0 &mu;g mL^-1 and from 13,0 &mu;g mL^-1 to 23,1 &mu;g mL^-1 for the development of analytical method. The RSD of the method&nbsp; was 3.22%. Additional experiments were performed applying GCE with rectangular form (area 35.32 cm²) modified with ex situ prepared bismuth-film for the electrolysis of the target analyte which was performed at the potential -1.55 V (nearly the peak maxima of the target analyte) vs. SCE. The solution of interest was sampled at the beginning of the experiment, after 2.5 h and after 4.5 h of treatment. Such samples were analysed by simply water suppressing ¹H NMR measurements in the buffered solution at pH 11.8. It can be assumed that during electrolysis of 3-dehydrodeoxycholate the reduction of the keto group present in the structure of the target analyte can be occurred.</p><p>Driven by earlier literature data about the fact that some of the target macrolide antibiotics as e.g. azithromycin showed oxidation behavior at a carbon paste and gold working electrodes detailed characterization and determination of four target macrolide antibiotics were performed on classical carbon paste electrode (CPE) constituted only from graphite powder and paraffin oil with optimized direct anodic SWV methods. In the cases of EES and AZI differential pulse voltammetric (DPV) methods were tested for the same purpose as well. The key parameter in the case of the development of the analytical voltammetric methods is the selection of the pH value of the supporting electrolyte where the shape/simmetry and intensity of the oxidation peak were the criteria. As the appropriate pH value for determination of EES by SWV method the pH 8.0 was selected with E_p at 0.83 V vs. SCE while in the case of the DPV method the pH 12.0 with E_p at 0.55 V vs. SCE was the most suitable for analytical&nbsp; purpose. As for AZI determination, in the case of both SWV and DPV methods the pH 7.0 was the most appropriate supporting electrolyte with the Ep of analytical signal at 0.85 V and 0.80 V vs. SCE, respectively, while in the case of CLA and ROX which were investigated only with SWV method for the analytical purposes the pH 12.0 was the most suitable with E_p at 0.65 V and at 0.63 V vs. SCE. The obtained detection limits applying the bare CPE and the direct anodic SWV are mainly&nbsp; in submicrogram concentration range as 0.17 &mu;g mL^-1; 0.32 &mu;g mL^-1 and 0.30 &mu;g mL^-1 for EES, AZI, and ROX and in the low microgram concentration range as 1.43 &mu;g mL^-1 for the CLA, respectively. The developed method succesfully tested for the determination of ROX in the commercial formulation, Runac^&reg; tablet. In the case of the optimized DPV methods the obtained detection limits for EES and AZI are in the low microgram concentration range 1.03 &mu;g mL^-1 and 1.53 &mu;g mL^-1, respectively. For the improvement of the sensitivity for AZI the DPV method was tested in combination with a&nbsp; CPE working electrode surface modified with gold nanoparticles with diameter of 10 nm (Au-CPE) and reached the limit of detection was 0.95 &mu;g mL^-1 at E_p of 0.80 V vs. SCE. The RSD of the method in the case of the Au-CPE is 3.5% while in the case of the native CPE 6.0%. The linearity of the Au-CPE based analytical method is twice wider then it is case with the bare CPE applying protocol.</p><p>Based on the obtained results it can be conclude that the appropriate combination of the optimized voltammetric pulse techniques and the environmentally friendly and easy to use working electrodes as Hg(Ag)FE, BiF-GCE and CPE together with Au-CPE resulted in the development of reliable analytical method either in the oxidation or reduction studies, often allowing trace level determination of pharmacological importance target analytes in simpler and in some case complexes systems.</p>