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Assessment of Meropenem Stability in Meropenem Admixtures Using 2 g Vials and Normal Saline Prepared Using addEASE®
Christian M Gill1,2, Teresa Sierra3, Nicholas Kovarik1
1SSM Health Saint Louis University Hospital, MO, USA.
Background:
Pharmacokinetic and pharmacodynamic optimization of β-lactams, including meropenem, using extended infusion are recommended by contemporary guidance to overcome elevated MICs and high interpatient pharmacokinetic variability associated with severe illness. Logistical challenges including drug stability must be considered when employing extended infusion meropenem. Although meropenem stability has been determined in a variety of settings to allow for extended infusion, confirmation for use of ready to use dispensing devices would be of interest. The purpose of this study was to assess meropenem concentrations using commercially available 2 g vials when diluted in 100 mL normal saline prepared via addEASE connectors.
Methods:
Five replicate bags were prepared and sampled at 0, 1, 2, 3, 4, 5, and 6 hours. Samples were stored frozen at ~-70ºC until meropenem concentrations determination using validated HPLC-UV and LC-MS/MS methods. Stability was defined as >90% recovery at the individual time point relative to the 0-hour concentration.
Results:
Starting concentrations were similar across all five replicates with an average (range) of 21.2 (20.2-21.9) and 19.4 mg/mL (17.7-20.5 mg/mL) for HPLC-UV and LC/MS-MS, respectively. No time point resulted in < 90% meropenem recovery from the starting concentration as determined by either assay method.
Conclusion:
These data demonstrated meropenem concentrations using 2 g vials diluted in 100 mL normal saline when prepared using addEASE connectors remained >90% of the initial concentration over 6 hours at room temperature. This supports extended infusion administration of meropenem per contemporary guidance when prepared using this methodology. Since this method allows storage of doses in automated dispensing cabinets and bedside preparation, this may streamline pharmacy workflows and potentially reduce time to administration.
Insights
Extended infusion meropenem stability was confirmed for ready-to-use dispensing devices. This supports current guidelines for optimizing meropenem (a beta-lactam antibiotic) in severe illness, streamlining pharmacy workflows.
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.
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