Related Experiment Video
Updated: Oct 5, 2025
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Compatibility of prolonged infusion antibiotics during Y-site administration
María Nunez-Nunez1,2, Manuel Murillo-Izquierdo3, Marisa Moya-Martin3
1Pharmacy Department, University Hospital Clínico San Cecilio, Granada, Spain.
Background:
Antimicrobial resistance is a threat to global public health. The use of prolonged infusions in the hospital setting for certain antimicrobials is widely increasing in order to improve their efficacy and safety, including resistance development. Due to limited vascular access, it is important to clarify whether they can be infused through the same line with other drugs during Y-site administration.
Aim:
The aim of this review is to update and summarize the evidence on Y-site compatibility of antibacterial agents administered as prolonged infusions in intensive care units (ICUs).
Study Design:
A literature review of PubMed, EMBASE and Trissel's Handbook on Injectable Drugs databases was conducted on the compatibility of selected antimicrobials administered simultaneously at a Y-site connection with parenteral nutrition and other widely used drugs in ICUs. All articles published up to October 30, 2021, in English or Spanish were included, regardless of the type of publication (original articles, case reports, letters, etc.). Eligible antimicrobials were those that can be administered as prolonged infusions: ceftazidime, cefepime, piperacillin/tazobactam, meropenem, ceftolozane/tazobactam, ceftaroline, cloxacillin, ceftobiprole, vancomycin and fosfomycin.
Results:
A total of 1302 drug-to-drug potential combinations were explored, 196 (15.05%) were found to be incompatible, and in 541 (41.55%), data were not available. The results were presented in a simple 2-dimensional consultation chart as a quick reference for health care professionals.
Conclusions:
This review provides useful and reliable information on the compatibility of antimicrobials administered as Y-site infusion with other drugs commonly used in the critical setting. This review contributes to patient safety in nursing practice.
Relevance To Clinical Practice:
To our knowledge, this is the first review on Y-site compatibility of antimicrobials used as prolonged infusions with other commonly used drugs, including anti-emetics, analgesics and anti-epileptic and parenteral nutrition. The results of the current review need to be addressed to promote the knowledge sharing between health professionals and improve the quality and safety of patients. We believe that this review may serve as a simple and effective 2-dimensional updated drug-to-drug compatibility reference chart for critical care nurses.
Insights
This review summarizes Y-site compatibility for prolonged antimicrobial infusions in ICUs, finding many drug combinations are incompatible or lack data. This information is crucial for improving patient safety in critical care settings.
Area of Science:
- Pharmacology
- Critical Care Medicine
- Infectious Diseases
Background:
- Antimicrobial resistance poses a significant global public health threat.
- Prolonged infusions of certain antimicrobials are increasingly used in hospitals to enhance efficacy and safety, potentially impacting resistance.
- Ensuring safe co-administration of these antimicrobials with other medications via Y-site is vital due to limited vascular access.
Purpose of the Study:
- To update and consolidate evidence regarding the Y-site compatibility of antibacterial agents administered via prolonged infusions in intensive care units (ICUs).
- To provide a readily accessible reference for healthcare professionals managing complex medication regimens in critical care.
Main Methods:
- A comprehensive literature review was performed using PubMed, EMBASE, and Trissel's Handbook on Injectable Drugs.
- Searched for compatibility data of specific antimicrobials (e.g., ceftazidime, meropenem, vancomycin) administered as prolonged infusions with other ICU drugs and parenteral nutrition.
- Included all publication types in English or Spanish up to October 30, 2021.
Main Results:
- Analysis of 1302 potential drug-to-drug combinations revealed 196 (15.05%) incompatibilities.
- Data on compatibility were unavailable for 541 (41.55%) combinations.
- Results are presented in a user-friendly 2-dimensional chart for quick clinical reference.
Conclusions:
- The review offers reliable data on Y-site compatibility for antimicrobials used in prolonged infusions within critical care settings.
- This information directly supports enhanced patient safety in nursing practice.
- The findings highlight the need for improved knowledge sharing among healthcare professionals to optimize patient care quality and safety.
More Related Videos
Related Concept Videos
01:19Dosage Interval and Administration Route: Determination Methods
01:24Drug Accumulation During Multiple Dosing: Intermittent IV Infusions
01:15Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations
01:22Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence
01:27Combined Effects of Drugs: Synergism
Such synergistic combinations...
01:09One-Compartment Model: IV Infusion
The one-compartment model for IV infusion uses mathematical equations to describe the rate of change in drug quantity in the body. At steady-state or infusion equilibrium, the drug input...