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Stability and compatibility of vancomycin for administration by continuous infusion
Violeta Raverdy1, Els Ampe, Jean-Daniel Hecq
1Pharmacologie cellulaire et moléculaire et Centre de pharmacie clinique, Louvain Drug Research Institute, Université catholique de Louvain, Brussels, Belgium.
The Journal of Antimicrobial Chemotherapy
|January 11, 2013
Summary
Vancomycin stability is confirmed during centralized preparation and continuous infusion. However, careful attention is needed for drug incompatibilities, especially with beta-lactams, to ensure safe vancomycin administration.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Drug Stability
Background:
- Continuous infusion vancomycin is increasingly utilized.
- Limited data exist on its stability and compatibility in clinical settings.
Purpose of the Study:
- To assess vancomycin stability during preparation, storage, and continuous infusion.
- To evaluate vancomycin compatibility with commonly co-administered intravenous drugs.
Main Methods:
- Vancomycin stability assessed via HPLC assay after preparation, storage, and simulated ward use (up to 48h).
- Compatibility tested by co-administration in a single line, followed by visual inspection and particulate matter analysis.
- Stability evaluated under stressed conditions (high temperature, concentrated solutions).
Main Results:
- Vancomycin demonstrated stability throughout the preparation and infusion process, including 72h exposure of concentrated solutions up to 37°C.
- Major incompatibilities observed with beta-lactams and moxifloxacin.
- Incompatibilities also noted with propofol, valproic acid, phenytoin, theophylline, methylprednisolone, and furosemide.
- Compatible with ciprofloxacin, aminoglycosides, macrolides, ketamine, opioids, nicardipine, urapidil, and catecholamines.
Conclusions:
- Centralized preparation and continuous infusion of vancomycin are safe regarding stability.
- Significant drug incompatibilities necessitate careful administration protocols, particularly avoiding co-administration with beta-lactams in the same line.
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