Growth of Microorganisms in Propofol, Thiopental, and a 1

Crowther, John A.; Hrazdil, Jiri; Jolly, Donald T.; Galbraith, John C.; Greacen, Maria; Grace, Michael

doi:10.1213/00000539-199603000-00008

Cited by 5 publications

(20 citation statements)

References 6 publications

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“…1,5 The absence of preservatives in the propofol preparation may support microbial growth. [6][7][8][9][10][11][12][13][14] Admixture of thiopentone, 15 lidocaine [16][17][18][19] or disodium edetate 20 diminishes microbial growth in propofol, although microbial destruction is not achieved. Because of this risk, the manufacturer's specific recommendations (Fresenius Kabi Pharmaceutical.…”

Section: [Le Maniement D'usage Du Propofol Prévient La Contamination mentioning

confidence: 99%

Le maniement d’usage du propofol prévient la contamination aussi effectivement que la stricte adhésion aux recommandations du fabricant

Lorenz

Kolbitsch

Lass‐Flörl

et al. 2002

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : Propofol is a potential vector of infection, because it contains no preservative. Thus, the manufacturer's specific recommendations for preparing injections or infusions go beyond the guidelines commonly used in our operating rooms for preparing other iv drugs. The purpose of the present study was to determine whether in the daily routine of an operating theatre a modified propofol handling technique can prevent contamination as effectively as do the manufacturer's handling recommendations. M Me et th ho od ds s: : A total of 160 consecutive neurosurgical patients were allocated to either Group I (manufacturer's handling recommendations: i.e., 1) disinfecting propofol vials and ampoules before filling syringes; 2) replacing empty syringes; 3) discarding all material at the end of surgery); or Group II (modified propofol handling protocol: i.e., 1) refilling empty syringes; 2) renewing only the infusion line to the patient). R Re es su ul lt ts s: : Total contamination rates were comparable in both groups (Group I: 14/160 (8.75%), Group II: 13/160 (8.13%) (P 2 =0.074; P=0.96). Frequency of contamination was not different between groups; either in sample 1 taken at the beginning of the procedure, (Group I: 5/80 (6.25%) vs Group II: 6/80 (7.5%); P 2 =0.098; P=0.76) or in sample 2, taken at the end, (Group I: 9/80 (11.25%) vs Group II: 7/80 (8.75%); P 2 =0.278; P=0.598). C Co on nc cl lu us si io on n: : We conclude that in the daily routine of the operating theatre following a modified propofol handling protocol prevents contamination of propofol syringes as effectively as does adhering to the manufacturer's specific handling recommendations. However, neither of the tested guidelines completely prevented contamination. Groupe I et 13/160 (8,13 %) dans le Groupe II (P 2 = 0,074; P = 0,96). La fréquence de contamination ne diffère pas d'un groupe à l'autre, pour l'échantillon 1 prélevé au début de l'opération (Groupe I : 5/80 (6,25 %) vs Groupe II : 6/80 (7,5 %); P 2 = 0,098; P = 0,76) ou l'échantillon 2 à la fin (Groupe I : 9/80 (11,25 %)vs Groupe II : 7/80 (8,75 %); P 2 = 0,278; P = 0,598 Objectif : Le propofol, ne contenant aucun agent de conservation, est un vecteur potentiel d'infection. C'est pourquoi les recommandations spécifiques du fabricant au sujet de la préparation d'injections ou de perfusions vont au delà des directives habituellement suivies dans nos salles d'opération pour la préparation d'autres médicaments intraveineux. Nous avons voulu déterminer si, en modifiant le maniement du propofol en salle d'opération, nous pouvions prévenir la contamination aussi efficacement qu'en suivant à la lettre les recom

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Section: [Le Maniement D'usage Du Propofol Prévient La Contamination mentioning

confidence: 99%

Le maniement d’usage du propofol prévient la contamination aussi effectivement que la stricte adhésion aux recommandations du fabricant

Lorenz

Kolbitsch

Lass‐Flörl

et al. 2002

Can J Anesth/J Can Anesth

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“…Propofol due to its formulation stimulates the growth of bacteria and yeasts 6 . It is formulated in an isotonic emulsion of glycerol, egg phosphatide, sodium hydroxide and soya bean oil in water 13 .…”

Section: Introductionmentioning

confidence: 99%

“…It is formulated in an isotonic emulsion of glycerol, egg phosphatide, sodium hydroxide and soya bean oil in water 13 . The Centres for Disease Control in the United States have indicated that propofol has played a role in small outbreaks of sepsis in human patients 6 . An increase in wound infections in veterinary medicine has been associated with the use of propofol 12 .…”

Section: Introductionmentioning

confidence: 99%

“…A heavy growth of Enterobacter aerogens was isolated from all the organs of the cat and from the remaining fluid in the propofol vial (Bacteriology results, Department of Veterinary Tropical Diseases, University of Pretoria, 1996). Manufacturers recommend that an aseptic technique be used when handling the drug; the contents should be used immediately after being drawn up into a sterile syringe and the contents of an open ampoule should discarded within 6 hours 6 .…”

Section: Introductionmentioning

confidence: 99%

“…Thiopentone is a strongly alkalotic (pH 10) barbiturate anaesthetic agent with bactericidal properties 6 . Thiopentone (2.5 %) and propofol (1 %) were combined in 1:1 mixture for the induction of anaesthesia in humans 21 .…”

Section: Introductionmentioning

confidence: 99%

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Inhibition of bacterial growth by different mixtures of propofol and thiopentone

Joubert¹,

Picard²,

Sethusa³

2005

J. S. Afr. Vet. Assoc.

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Propofol is, as a result of its formulation, an ideal bacterial and yeast culture medium. An outbreak of sepsis in humans and an increase in wound infections in dogs has been ascribed to the use of propofol. It has been previously reported that a 1:1 mixture of propofol and thiopentone has bactericidal properties. This study was undertaken to determine if further serial mixtures of propofol and thiopentone maintained the bactericidal properties. Mixtures of 1:1 (solution A), 5:1 (solution B), 10:1 (solution C), 50:1 (solution D) and 100:1 (solution E) of 1 % propofol to 2.5 % thiopentone, 2.5 % thiopentone (solution T), 1 % propofol (solution P) and saline (solution S) were prepared and inoculated with between 105 and 106 colony-forming units of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Candida albicans. A sample was withdrawn from each solution at 0, 1, 6, 12, 48 and 120 hours after inoculation and a bacterial count was performed. This study showed that thiopentone and solution A behaved in similar fashion by inhibiting bacterial growth and was bactericidal after 48 hours. Solution B was not bactericidal against S. aureus and C. albicans. Propofol and solutions D and E all supported growth of all the organisms tested. These data indicate that mixtures of propofol and thiopentone at a ratio less than 1:1 do not maintain the bactericidal properties

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Pharmacokinetics and Pharmacodynamics of GPI 15715 or Fospropofol (Aquavan Injection) — A Water-Soluble Propofol Prodrug

Fechner

Schwilden

Schüttler

Handbook of Experimental Pharmacology

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Propofol (2,6-diisopropylphenol) is inadequably soluble in water and is therefore formulated as a lipid emulsion. This may have disadvantages when propofol is used to provide total intravenous anaesthesia or especially during long-term sedation. There has been considerable interest in the development of new propofol formulations or propofol prodrugs. GPI 15715 or fospropofol (Aquavan injection; Guilford Pharmaceutical, Baltimore, MD) is the first water-soluble prodrug that has been thoroughly studied in human volunteers and patients. GPI 15751 or fospropofol is cleaved by alkaline phosphatase to phosphate, formaldehyde and propofol. Formaldehyde is rapidly metabolised to formate. Although a formate accumulation is the principal pathomechanism responsible for the toxicity of methanol ingestion, so far there has been no report of toxicity due to the administration of fospropofol or other phosphate ester prodrugs, such as fosphenytoin. Fosphenytoin has been successfully introduced into the market for the treatment of status epilepticus in 1996. The main side-effects were a feeling of paraesthesia after rapid i.v. administration of GPI 15715 or fospropofol, which has also been described for fosphenytoin. The pharmacokinetics of GPI 15715 or fospropofol could be described by a combined pharmacokinetic model with a submodel of two compartments for GPI 15715 and of three compartments for propofol(G). The liberated propofol(G) compared to lipid-formulated propofol showed unexpected pharmacokinetic and pharmacodynamic differences. We found a significantly greater V(c), V(dss), significantly shorter alpha- and beta-half-life and a longer MRT (mean residence time) for propofol(G). The pharmacodynamic potency of propofol(G) appears to be higher than propofol when measured by EEG and clinical signs of hypnosis. In summary, GPI 15715 or fospropofol was well suited to provide anaesthesia or conscious sedation.

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Growth of Microorganisms in Propofol, Thiopental, and a 1

Cited by 5 publications

References 6 publications

Le maniement d’usage du propofol prévient la contamination aussi effectivement que la stricte adhésion aux recommandations du fabricant

Le maniement d’usage du propofol prévient la contamination aussi effectivement que la stricte adhésion aux recommandations du fabricant

Inhibition of bacterial growth by different mixtures of propofol and thiopentone

Pharmacokinetics and Pharmacodynamics of GPI 15715 or Fospropofol (Aquavan Injection) — A Water-Soluble Propofol Prodrug

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