Vancomycin causes dangerous precipitation when infused with gelatin fluid

Ng, Huey-Ping; Koh, Kwong-Fah; Tham, Lai-San

doi:10.1046/j.1365-2044.2000.01727-30.x

Cited by 12 publications

(7 citation statements)

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“…It is documented that vancomycin has precipitative properties with different substances, especially those in gelatinous form [2]. Aurovisc® is hydroxyl propyl methyl cellulose viscoelastic solution of 3000–4500 cps at 27°C containing no sodium carbonate.…”

Section: Discussionmentioning

confidence: 99%

“…However, the precipitation was documented regardless of sodium carbonate presence, favouring alkaline pH as the major element in the precipitation process [5, 10]. The vancomycin–ceftazidime precipitate manifested pH of 6.2, while vancomycin itself, as a salt of hydrochloric acid, is set to pH range 2.5–4.5 [2, 10]. In addition, the study that is more recent evidenced no precipitation of the two drugs, when the drugs were administered in the media one after the complete diffusion of the other [5].…”

Section: Discussionmentioning

confidence: 99%

“…Vancomycin hydrochloride is a glycopeptide antibiotic used in ophthalmic surgery for postoperative endophthalmitis prophylaxis [1]. It precipitates with gelatine fluid, ciprofloxacin, cloxacillin, and ceftazidime [2–5]. According to medical literature this is the first publication of precipitation of vancomycin with residual viscoelastic (hydroxypropyl methylcellulose IP 2% w/v, Aurovisc®, Madurai, India) in anterior chamber.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Physical Incompatibility between Vancomycin and Viscoelastic Mimicking Acute Endophthalmitis: The First Report

Elabjer

Šarić

Bušić

et al. 2019

Case Reports in Ophthalmological Medicine

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This is the first documentation of vancomycin precipitation with viscoelastic in the anterior chamber of the eye. A 34-year-old white male underwent uneventful penetrating keratoplasty. Intracameral instillation of 1 mg/0.1 mL of vancomycin followed no attempts of meticulous viscoelastic irrigation. Six hours later thick white material in the anterior chamber was sedimented. The following criteria excluded the diagnosis of endophthalmitis and TASS: clear and transparent anterior chamber and vitreous body, the absence of ciliary injection and corneal oedema, and unremarkable laboratory tests’ results. This iatrogenic complication mimicking endophthalmitis does not require any specific management and should be acknowledged in guidelines for prevention and treatment of endophthalmitis. The objective of this paper is to alert colleagues to this iatrogenic complication of vancomycin mimicking endophthalmitis. Whether this condition should be labelled as positive or negative demands further investigation. As vancomycin is a time-dependent antibiotic, it is possible that this precipitate could serve as a slowly releasing drug depot and viscoelastic as a vehicle for precipitation. This being the case, investigation is needed to analyse its potential to precipitate with another dispersive and cohesive viscoelasticity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Physical Incompatibility between Vancomycin and Viscoelastic Mimicking Acute Endophthalmitis: The First Report

Elabjer

Šarić

Bušić

et al. 2019

Case Reports in Ophthalmological Medicine

View full text Add to dashboard Cite

show abstract

“…We wish to remind anaesthetists of a physical incompatibility between vancomycin and Gelofusine ® (B. Braun, Medical Ltd., Sheffield, UK), as previously reported in Anaesthesia in 2000 .…”

mentioning

confidence: 98%

“…Physical incompatibility appears to relate to the low pH of vancomycin (2.5–4.5) compared with the higher pH of Gelofusine (7.1–7.7) , and it is recommended that vancomycin be infused through a dedicated line. If this is not possible, then we have established by experiment that 75 ml (preferably 100 ml) of saline 0.9% is the minimum safe volume that should be used to flush a line containing Gelofusine, before vancomycin can be administered without precipitation.…”

mentioning

confidence: 99%