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Physical Compatibility of Ceftazidime and Ceftazidime/Avibactam in 0.45% Sodium Chloride and Plasma-Lyte A
Hanna Rowell1, Ronnae M Johnson1, Gabriella Baki1
1University of Toledo College of Pharmacy and Pharmaceutical Sciences, Toledo, Ohio.
Background:
Ensuring the integrity of intravenous medication administration is a vitally important role for pharmacists and correlates directly to patient safety and outcomes. Information about the physical compatibility of medications with intravenous fluids may be unknown or conflicting, leading to issues that may delay, complicate, or prohibit care at the bedside. The objective of this study was to determine the physical compatibility of ceftazidime and ceftazidime/avibactam in 0.45% sodium chloride (NaCl) and Plasma-Lyte A (PLA).
Methods:
An in vitro analysis of ceftazidime 10 mg/mL, 20 mg/mL, and 40 mg/mL and ceftazidime/avibactam 8 mg/mL, 15 mg/mL, and 20 mg/mL was conducted in 0.45% NaCl and PLA to align with clinically utilized concentrations of the drugs. Compounded aliquots were evaluated in triplicate at hours 0, 1, 5, 8, and 24. Physical compatibility was assessed by a standardized visual inspection process, spectrophotometry, and pH analysis.
Results:
While none of the admixtures had demonstrable visual or spectrophotometry changes, all samples had a demonstrable change in pH at various time points. None of the evaluated ceftazidime concentrations were physically compatible beyond initial use when mixed in 0.45% NaCl, and beyond 1 hour when mixed in PLA. Ceftazidime/avibactam at concentrations of 8 mg/mL and 15 mg/mL were physically incompatible beyond 1 hour in 0.45% NaCl and PLA, and beyond 5 hours for the 15 mg/mL concentration in both IV fluids.
Conclusions:
This analysis provides new information related to the physical compatibility of ceftazidime and ceftazidime/avibactam in 0.45% NaCl and PLA. Chemical analysis of the admixtures is warranted to support these results.
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