Long-term stability of vancomycin hydrochloride in intravenous infusions

Abstract

From a chemical stability viewpoint, the antibiotic may be prepared in advance by a centralized intravenous admixture service for use within the limits described.

Stability of Commonly Used Antibiotic Solutions in an Elastomeric Infusion Device

“…Previously published studies for cefazolin, [15][16][17][18][19][20][21] ceftazidime, 7,18,20,22 ceftriaxone, 6,18,20,[23][24][25][26] clindamycin, 17,21,[26][27][28] and vancomycin 8,[29][30][31] all reported stability data and expiration dates that were in general agreement with the results reported here. In some cases, the recommended expiry dates in those previously studies were longer than those determined in the current study, largely because the beyond-use dates calculated here were based on 95% CIs, whereas 95% CIs were not calculated in most of the earlier studies.…”

“…[6][7][8][15][16][17][18][19][20][21][22][23][24][26][27][28][29][30] Previously published studies often used only linear regression to calculate the percent remaining on the last study day. The time to reach 90% of the initial concentration (T-90%) can be calculated on the basis of the observed concentration remaining as reported in previous publications [6][7][8][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] and compared to the T-90% determined for each drug in the current study (Table 7, Figure 1). Calculation of T-90% yields a better overall estimate of expiry date because it minimizes the effect of study duration and day-to-day variability in the estimates of concentration.…”

Evaluation of the stability of vancomycin solutions at concentrations used in clinical services

“…As previously mentioned, several studies7–10 have been conducted on physicochemical vancomycin stability but at low concentrations or in trials that do not reflect current use in care units. All published studies have been performed on solutions stocked in containers rather than in continuous infusion, with sampling at the end of the infusion line.…”

“…Some studies on vancomycin stability have already been performed. Solutions at 5 and 10 mg/mL were stable for 58 days at +4°C in 100 mL polyvinyl chloride (PVC) infusion bags with no specification with regard to protection from light 8. Vancomycin was stable at 5 mg/mL in PVC bags for 48 hours at +22°C without protection from light and for 7 days at +4°C with protection from light 9.…”

Stability and compatibility of vancomycin for administration by continuous infusion

“…These studies reproduced exactly the projected conditions of use of vancomycin by continuous infusion in our hospital. Hence, vancomycin (Vancocin w ; Lilly, Illkirch, France) solutions (10 g/L in 5% glucose) were prepared in 250 mL VIAFLO w polyolefin bags (coextruded layers of polyethylene, polyamide, polypropylene; Baxter s.a., Lessines, Belgium) and stored at 48C (for a maximum of 58 days; tested previously for stability 11 ) until transferred to the ward where they were maintained in a domestic refrigerator ( 48C) until about 15 min before use. Patients were infused at a rate of 11 mL/h if they had normal renal function (lower and higher rates were used in case of decreased or increased calculated CL CR ).…”