Assessment of Meropenem Stability in Meropenem Admixtures Using 2 g Vials and Normal Saline Prepared Using addEASE^®...

Area of Science:

• Pharmacology
• Clinical Pharmacy
• Drug Stability

Background:

• Contemporary guidance recommends extended infusion of beta-lactam antibiotics, including meropenem, to manage high minimum inhibitory concentrations (MICs) and interpatient pharmacokinetic variability in severe illness.
• Drug stability is a critical logistical consideration for extended infusion meropenem.
• Confirmation of meropenem stability in ready-to-use dispensing devices is of interest.

Purpose of the Study:

• To assess meropenem concentrations in commercially available 2g vials diluted in 100mL normal saline.
• To evaluate meropenem stability when prepared using addEASE connectors for potential extended infusion.

Main Methods:

• Five replicate bags of meropenem (2g in 100mL normal saline) were prepared using addEASE connectors.
• Samples were collected at 0, 1, 2, 3, 4, 5, and 6 hours and stored frozen.
• Meropenem concentrations were determined using validated High-Performance Liquid Chromatography with Ultraviolet detection (HPLC-UV) and Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) methods.
• Stability was defined as >90% recovery of meropenem concentration relative to the 0-hour concentration.

Main Results:

• Average starting concentrations were 21.2 mg/mL (HPLC-UV) and 19.4 mg/mL (LC-MS/MS).
• No time point showed less than 90% meropenem recovery from the initial concentration over the 6-hour study period, as determined by both assay methods.
• Meropenem concentrations remained stable (>90% of initial) for 6 hours at room temperature when prepared using this method.

Conclusions:

• Meropenem concentrations in 2g vials diluted in 100mL normal saline, prepared with addEASE connectors, remain stable (>90% initial) for 6 hours at room temperature.
• This preparation method supports the extended infusion administration of meropenem as recommended by current guidelines.
• Utilizing this method may streamline pharmacy workflows by allowing for storage in automated dispensing cabinets and bedside preparation, potentially reducing time to drug administration.