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Evaluation of the sterility of single-dose medications used in a multiple-dose fashion

Elizabeth P Martin1, Jean Mukherjee1, Claire R Sharp1

  • 1Cape Cod Veterinary Specialists, 11 Bourne Bridge Approach, Buzzards Bay, Massachusetts 02532, USA (Martin); Tufts University Cummings School of Veterinary Medicine, 200 Westboro Road, North Grafton, Massachusetts 01536, USA (Mukherjee); College of Veterinary Medicine, School of Veterinary and Life Sciences, Murdoch University, 90 South Street, Murdoch, Western Australia 6150 (Sharp); Angell Animal Medical Center, 350 S Huntington Avenue, Boston, Massachusetts 02130, USA (Sinnott-Stutzman).

The Canadian Veterinary Journal = La Revue Veterinaire Canadienne
|November 2, 2017
PubMed

Insights

Bacterial contamination risks were assessed for multi-dose medications. Hydroxyethyl starch and heparinized saline should not be used in multi-dose vials due to microbial growth potential.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pharmaceutical Science

Background:

  • Single-dose medications are sometimes used in multi-dose formats, raising concerns about contamination.
  • Previous studies have not fully evaluated the microbial growth potential of specific intravenous solutions when repurposed for multi-dose use.

Purpose of the Study:

  • To investigate bacterial proliferation in commonly used intravenous solutions when administered in a multi-dose fashion.
  • To assess the risk of contamination and microbial growth in specific medications, including hydroxyethyl starch and heparinized saline.

Main Methods:

  • Experimental puncture of five different single-dose medications.
  • Intentional inoculation of selected intravenous solutions (hydroxyethyl starch, heparinized saline, 50% dextrose) with bacteria.
  • Incubation and monitoring for bacterial growth over a defined period.

Main Results:

  • One out of 75 experimentally punctured vials (50% dextrose) showed contamination.
  • Hydroxyethyl starch and heparinized saline demonstrated significant support for microbial growth when intentionally inoculated.
  • 50% dextrose showed a lower risk of contamination in experimental puncture compared to the other tested solutions.

Conclusions:

  • Hydroxyethyl starch and heparinized saline pose a significant risk of bacterial proliferation and should not be used in multi-dose regimens.
  • Healthcare professionals should exercise caution when considering the multi-dose use of intravenous medications, especially those supporting microbial growth.
  • Further research into safe multi-dose practices for intravenous solutions is warranted.

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