Stability of benzylpenicillin potassium and ampicillin in an elastomeric infusion pump
Tomomi Nakamura1, Yuki Enoki1, Shunsuke Uno2
1Division of Pharmacodynamics, Keio University Faculty of Pharmacy, 1-5-30 Shibakoen, Minato-ku, Tokyo, 105-8512, Japan.
Abstract:
Some infectious diseases, such as infective endocarditis, osteomyelitis, and abscesses, require treatment with long-term intravenous antimicrobial treatment. Therefore, the patient is required to stay in the hospital to receive therapy, which lowers their quality of life. Establishing an outpatient parenteral antimicrobial therapy (OPAT) by continuous infusion pump is desired in Japan to overcome these issues. However, the 24-h stability of antimicrobial agents dissolved in infusion solutions is unclear. Thus, we investigated the stability of antimicrobial agents in five different infusion solutions in a clinical setting. Benzylpenicillin potassium (PCG) and ampicillin (ABPC) were dissolved separately in five different infusion solutions and kept at 25 or 31.1 °C for 24 h. The residual ratios were determined by high-performance liquid chromatography (HPLC). Dissolved PCG in acetate ringer solution remained stable for 24 h at temperatures of 25 and 31.1 °C (101.7 ± 1.4% and 92.9 ± 1.3%, respectively). In addition, the PCG solution did not adsorb onto the elastomeric infusion pump after 24 h at 31.1 °C. PCG dissolved in acetate ringer solution was also stable for 10 days after being kept in an elastomeric infusion pump at 4 °C (99.7 ± 0.5%). ABPC was unstable in all of the tested infusion solutions and temperatures. Based on our results, PCG in acetate ringer solution can be used in OPAT with continuous infusion pumps.
Insights
Benzylpenicillin potassium (PCG) in acetate ringer solution is stable for outpatient parenteral antimicrobial therapy (OPAT) using infusion pumps. Ampicillin (ABPC) was found to be unstable, limiting its use in OPAT.
Area of Science:
- Pharmacology
- Infectious Diseases
- Clinical Pharmacy
Background:
- Long-term intravenous antimicrobial treatment is necessary for serious infections like endocarditis, osteomyelitis, and abscesses.
- Current treatment requires hospitalization, negatively impacting patient quality of life.
- Outpatient parenteral antimicrobial therapy (OPAT) using continuous infusion pumps is desirable in Japan to improve patient care.
Purpose of the Study:
- To evaluate the 24-hour stability of antimicrobial agents in various infusion solutions for OPAT.
- To determine the suitability of benzylpenicillin potassium (PCG) and ampicillin (ABPC) for continuous infusion pumps in an outpatient setting.
Main Methods:
- Benzylpenicillin potassium (PCG) and ampicillin (ABPC) were dissolved in five different infusion solutions.
- Solutions were stored at 25°C and 31.1°C for 24 hours.
- Antimicrobial stability was assessed using high-performance liquid chromatography (HPLC).
- Adsorption to elastomeric infusion pumps was also evaluated.
Main Results:
- Benzylpenicillin potassium (PCG) in acetate ringer solution demonstrated stability for 24 hours at both 25°C (101.7±1.4%) and 31.1°C (92.9±1.3%).
- PCG in acetate ringer solution showed no significant adsorption to elastomeric infusion pumps after 24 hours at 31.1°C.
- PCG remained stable for 10 days in an elastomeric infusion pump at 4°C (99.7±0.5%).
- Ampicillin (ABPC) was unstable in all tested infusion solutions and temperatures.
Conclusions:
- Benzylpenicillin potassium (PCG) in acetate ringer solution is a viable option for OPAT utilizing continuous infusion pumps.
- Ampicillin (ABPC) is not suitable for OPAT with continuous infusion pumps due to instability.
- These findings support the implementation of PCG-based OPAT in Japan.
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