Time Required by Pharmacy Technicians to Reconstitute New versus Old Piperacillin/Tazobactam Formulations

Abstract

s VOLUME 23 s J PHARM TECHNOL 203Piperacillin/tazobactam (Zosyn, Wyeth Pharmaceuticals, Collegeville, PA) is a parenteral β-lactam antibiotic commonly used in hospitals due to its broad-spectrum antimicrobial activity, which includes gram-positive, gramnegative, and anaerobic bacteria. 1 It is supplied as a powder for reconstitution in conventional vials, the ADD-Vantage system (Abbott Laboratories), and the Galaxy Bag (Baxter International, Inc.), which is a frozen, iso-osmotic, sterile, nonpyrogenic solution in single-dose plastic containers. 2 Use of the conventional vial requires reconstitution and therefore entails pharmacy technician labor costs associated with preparation time. Previous time-motion studies have been conducted with several antibiotics, including piperacillin/tazobactam, to assess the time and labor costs associated with the preparation and administration of various dosages as well as administration techniques. 3,4Piperacillin/tazobactam has now been reformulated 5 as a result of new United States Pharmacopeia (USP) guidelines on particulate standards (USP 788), which were tightened after initial approval of the drug. Reformulated piperacillin/tazobactam contains 2 new components, edetate disodium dehydrate (EDTA) and sodium citrate, and is now compatible with lactated Ringer's solution and certain aminoglycosides.The purpose of this study was to evaluate and compare the time required for pharmacy technicians to reconstitute the reformulated piperacillin/tazobactam solution with that of the original formulation. A formulation currently used in Europe that also contains EDTA and sodium citrate (Vial X, Tazocin) was added for comparison. These results were then used to determine labor costs associated with preparing the reformulation based on reconstitution time.Background: Piperacillin/tazobactam, an intravenous broad-spectrum antibiotic commonly used in the hospital setting, has recently been reformulated with edetate disodium dehydrate (EDTA) and sodium citrate due to new guidelines on particulate standards. This reformulation is now compatible with lactated Ringer's solution and certain aminoglycosides.