serval:BIB_672825AA2CDB
Antibiotic stability related to temperature variations in elastomeric pumps used for outpatient parenteral antimicrobial therapy (OPAT).
10.1093/jac/dkw582
000402632400030
28158637
Voumard
R.
author
Van Neyghem
N.
author
Cochet
C.
author
Gardiol
C.
author
Decosterd
L.
author
Buclin
T.
author
de Valliere
S.
author
article
review
2017-05-01
The Journal of antimicrobial chemotherapy
1460-2091
0305-7453
journal
72
5
1462-1465
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.
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
eng
60_published
true
peer-reviewed
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
University of Lausanne
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