Contamination of liposomal bupivacaine during multi-dose usage in a clinical setting evaluated by culture and PCR

Area of Science:

• Veterinary Medicine
• Pharmacology
• Microbiology

Background:

• Liposomal bupivacaine is a costly, long-acting local anesthetic supplied in single-dose vials.
• Veterinary practices often use multi-dose protocols for cost savings, raising contamination concerns.
• This study addresses the safety of multi-dose liposomal bupivacaine use in veterinary settings.

Purpose of the Study:

• To describe an institutional protocol for multi-dose use of single-dose liposomal bupivacaine vials.
• To evaluate bacterial and fungal contamination in clinically used liposomal bupivacaine vials.
• To assess the efficacy of aseptic handling in preventing contamination.

Main Methods:

• Collected first (Control) and last (Sample B) 0.5 mL from multi-use vials.
• Submitted samples for bacterial and fungal PCR, aerobic/anaerobic bacterial culture, and opportunistic fungal culture.
• Evaluated contamination using both molecular and traditional bacteriological methods.

Main Results:

• No bacterial growth was observed in any cultures.
• Bacterial or fungal DNA was detected in 50% of samples via PCR, but cultures remained negative.
• PCR was not effective in detecting contamination in liposomal bupivacaine.

Conclusions:

• The described aseptic handling protocol successfully prevents detectable bacterial and fungal contamination.
• Multi-dose use of liposomal bupivacaine vials is safe for up to 7 punctures and 5 days.
• This supports cost-effective, safe use of liposomal bupivacaine in veterinary practice.