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Published on: December 8, 2012
Physical Compatibility of Meropenem and Vaborbactam With Select Intravenous Drugs During Simulated Y-site
James M Kidd1, Lindsay M Avery1, Tomefa E Asempa1
1Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, Connecticut.
Purpose:
Meropenem/vaborbactam is a novel intravenous antibiotic combining the carbapenem, meropenem, with a novel β-lactamase inhibitor, vaborbactam. Meropenem/vaborbactam is administered as a 3-hour infusion given every 8 hours, thereby potentially restricting an intravenous line for 9 h/d. Intravenous medications may be given concurrently via Y-site when compatibility data are available. Herein, physical compatibility was determined for the identification which medications can be coadministered with meropenem/vaborbactam via Y-site.
Methods:
Y-site administration was simulated in vitro by admixing 5 mL of meropenem 8 mg/mL and vaborbactam 8 mg/mL with an equal volume of 88 other diluted intravenous medications, including 34 antimicrobials. All other medications were diluted with 0.9% sodium chloride to the upper range of concentrations considered standard for intravenous infusion. Visual inspection, turbidity measurement, and pH measurement were performed prior to admixture, directly after admixture, and at time points up to 3 hours after admixture.
Findings:
Of the 88 medications tested, meropenem/vaborbactam was compatible with 73 (83%), including many antibiotics such as aminoglycosides (amikacin, gentamicin, and tobramycin), colistin, fosfomycin, linezolid, tedizolid, tigecycline, and vancomycin. Physical incompatibility was observed with albumin, amiodarone, anidulafungin, calcium chloride, caspofungin, ceftaroline, ciprofloxacin, daptomycin, diphenhydramine, dobutamine, isavuconazole, midazolam, nicardipine, ondansetron, and phenytoin.
Implications:
The majority of intravenous medications tested were found to be physically compatible with meropenem/vaborbactam. These data will help pharmacists and nurses to improve line access in patients receiving meropenem/vaborbactam.
Insights
Meropenem/vaborbactam is compatible with most IV drugs, aiding clinical practice. This study determined which medications can be coadministered with meropenem/vaborbactam via Y-site, improving patient care.
Area of Science:
- Pharmacology
- Infectious Diseases
- Clinical Pharmacy
Background:
- Meropenem/vaborbactam is a novel intravenous antibiotic combination.
- Administration requires a 3-hour infusion every 8 hours, potentially limiting IV line access.
- Concurrent Y-site administration requires compatibility data.
Purpose of the Study:
- To determine the physical compatibility of meropenem/vaborbactam with other intravenous medications for Y-site coadministration.
- To identify medications that can be safely administered together with meropenem/vaborbactam.
Main Methods:
- In vitro simulation of Y-site administration.
- Admixing meropenem/vaborbactam with 88 other diluted intravenous medications.
- Visual inspection, turbidity, and pH measurements up to 3 hours post-admixture.
Main Results:
- Meropenem/vaborbactam was compatible with 73 (83%) of the 88 tested medications.
- Compatible drugs include aminoglycosides, colistin, fosfomycin, linezolid, tedizolid, tigecycline, and vancomycin.
- Incompatibilities were noted with albumin, amiodarone, calcium chloride, and others.
Conclusions:
- The majority of tested intravenous medications are physically compatible with meropenem/vaborbactam.
- These findings support optimized IV line management for patients receiving this antibiotic.
- Data aids pharmacists and nurses in coadministering medications safely.
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