Antibiotic stability related to temperature variations in elastomeric pumps used for outpatient parenteral antimicrobial therapy (OPAT).

Details

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State: Public
Version: Author's accepted manuscript
Serval ID
serval:BIB_672825AA2CDB
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Antibiotic stability related to temperature variations in elastomeric pumps used for outpatient parenteral antimicrobial therapy (OPAT).
Journal
The Journal of antimicrobial chemotherapy
Author(s)
Voumard R., Van Neyghem N., Cochet C., Gardiol C., Decosterd L., Buclin T., de Valliere S.
ISSN
1460-2091 (Electronic)
ISSN-L
0305-7453
Publication state
Published
Issued date
01/05/2017
Peer-reviewed
Oui
Volume
72
Number
5
Pages
1462-1465
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Elastomeric pumps can be used for the continuous administration of antimicrobials in the outpatient setting. A potentially limiting factor in their use is the stability of antimicrobials.
To investigate under real-life conditions the temperature variations of antibiotic solutions contained in elastomeric pumps, and to examine under such conditions the stability of five antibiotics.
Healthy volunteers carried the elastomeric pumps in carry pouches during their daily activities. A thermologger measured the temperatures every 15 min over 24 h. Antibiotic concentrations were measured by HPLC coupled to tandem MS.
During daytime, the temperature of solutions in the pumps increased steadily, warming to >30°C. During the night, when the pumps were kept attached to the waist, the temperatures reached up to 33°C. The use of white carry pouches avoided excessive temperature increases. Over seven experiments, cefazolin, cefepime, piperacillin and tazobactam were found to be stable over 24 h. Flucloxacillin showed a mean decrease in concentration of 11% ( P  = 0.001).
Real-life situations can cause significant temperature rises in elastomeric pumps, thereby potentially increasing the risk of antibiotic degradation. Patients should be instructed to avoid situations causing excessive temperature increases. Despite these temperature variations, cefazolin, cefepime, piperacillin and tazobactam were found to be stable over 24 h. A moderate degradation was noticed for flucloxacillin, albeit most probably not to an extent that might impair anti-infective efficacy.

Keywords
Anti-Bacterial Agents/chemistry, Cefazolin/chemistry, Cefazolin/metabolism, Cephalosporins/chemistry, Drug Stability, Female, Floxacillin/chemistry, Healthy Volunteers, Humans, Infusion Pumps, Male, Piperacillin/chemistry, Polymers, Temperature
Pubmed
Web of science
Open Access
Yes
Create date
14/02/2017 12:14
Last modification date
20/08/2019 15:22
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