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Stability and compatibility of vancomycin for administration by continuous infusion

francisliu 添加于 2013-1-31 10:37 | 1822 次阅读 | 0 个评论

作者
Raverdy V, Ampe E, Hecq J-D, Tulkens PM
摘要
BACKGROUND: Vancomycin is increasingly used by continuous infusion, but few specific data are available about stability under practical conditions of preparation and use, and compatibility with other intravenous drugs commonly used in the routine hospital setting. METHODS: Vancomycin stability [defined as recovery >/= 93% of the original content (validated HPLC assay)] was examined throughout the whole process of centralized preparation, storage and use in the ward by infusion for up to 48 h, with allowances for deviations from recommended practice [exposure to high temperature; use of concentrated solutions (up to 83 g/L)]. Compatibility was assessed by mimicking co-administration in a single line via Y-shaped connectors with contact of 1 h at 25 degrees C, followed by visual inspection (professional viewer), detection of particulate matter (particle analyser) and HPLC assay of vancomycin. RESULTS: Vancomycin was stable during the whole process and also during 72 h exposure of concentrated solutions at temperatures up to 37 degrees C. Major incompatibilities were seen with beta-lactams (temocillin, piperacillin/tazobactam, ceftazidime, imipenem, cefepime and flucloxacillin) and moxifloxacin, but not with ciprofloxacin, aminoglycosides and macrolides. Propofol, valproic acid, phenytoin, theophylline, methylprednisolone and furosemide were also incompatible, whereas ketamine, sufentanil, midazolam, morphine, piritramide, nicardipine, urapidil, dopamine, dobutamine and adrenaline were compatible. No effect or incompatibility with N-acetyl-cysteine or amino acid solutions was detected. CONCLUSIONS: Centralized preparation of vancomycin and its use by continuous infusion in wards is safe concerning stability, but careful attention must be paid to incompatibilities. Several drugs (including all beta-lactams) require distinct intravenous lines or appropriate procedures to avoid undue contact.
详细资料
- 文献种类:期刊
- 期刊名称: The Journal of Antimicrobial Chemotherapy
- 期刊缩写: J Antimicrob Chemother
- 期卷页: 2013年
- 地址: Pharmacologie cellulaire et moleculaire et Centre de pharmacie clinique, Louvain Drug Research Institute, Universite catholique de Louvain, Brussels, Belgium
- ISBN: 0305-7453
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