Stability and compatibility study of cefepime in comparison with ceftazidime for potential administration by continuous infusion under conditions pertinent to ambulatory treatment of cystic fibrosis patients and to administration in intensive care units.

نویسندگان

  • Nariné Baririan
  • Hugues Chanteux
  • Eric Viaene
  • Hélène Servais
  • Paul M Tulkens
چکیده

Cefepime has been examined for stability, potential liberation of degradation products and compatibility with other drugs under conditions mimicking its potential use by continuous infusion in cystic fibrosis and intensive care patients (5-12% w/v solutions; temperatures from 20 to 37 degrees C; 1 h contact at 25 degrees C with other drugs frequently co-administered by intravenous route to these types of patients). Ceftazidime was used as a comparator based on a previous normative study with this antibiotic for the same indications. Based on a limit of max. 10% degradation, cefepime can be considered stable for a maximum of 24 h at 25 degrees C, but for only approximately 14 h at 30 degrees C, and for <10 h at 37 degrees C. Cefepime released so far unidentified degradation products if maintained at >30 degrees C for >12 h as shown from a marked increase in pH and from the development of a strong red-purple colour. Incompatibilities were observed with erythromycin, propofol, midazolam, phenytoin, piritramide, theophylline, nicardipine, N-acetylcysteine and a concentrated solution of dobutamine. We conclude that: (i) cefepime cannot be used safely by continuous infusion if containers are kept for more than a few hours at 37 degrees C (as will be the case for cystic fibrosis patients if using portable pumps carried under clothes); (ii) caution must be exercised in intensive care patients if the temperature and co-administration of other drugs is not kept under tight control. The nature and safety of the cefepime degradation products need to be studied further.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Comparative Stability Studies of Antipseudomonal -Lactams for Potential Administration through Portable Elastomeric Pumps (Home Therapy for Cystic Fibrosis Patients) and Motor-Operated Syringes (Intensive Care Units)

The stability of antipseudomonal -lactams in concentrated solutions was examined in view of their potential administration by continuous infusion with external pumps (for intensive care patients) or with portable pumps carried under clothing (for cystic fibrosis patients). Aztreonam (100 g/liter), piperacillin (128 g/liter, with tazobactam), and azlocillin (128 g/liter) remained 90% stable for ...

متن کامل

Continuous-infusion antipseudomonal Beta-lactam therapy in patients with cystic fibrosis.

OBJECTIVE We sought to evaluate the pharmacokinetics, efficacy, safety, stability, pharmacoeconomics, and quality-of-life effects of continuous-infusion antipseudomonal beta-lactam therapy in patients with cystic fibrosis (CF). DATA SOURCES Literature retrieval was accessed through Medline (from 1950 to December 2010) using the following terms: cystic fibrosis; beta-lactams or piperacillin or...

متن کامل

An Observational Study of Errors Related to the Preparation and Administration of Medications Given by Infusion Devices in a Teaching Hospital

Since there is no detailed hospital based incident reporting system, this study was designed to evaluate the medication errors associated with infusion pumps in intensive care unit (ICU). The investigation was conducted in a Teaching hospital in the form of a prospective, observational study. A sample size of 43 doses administered to ICU patients was chosen to enable reliable estimate of error ...

متن کامل

Determining Frequency of Prescription, Administration and Transcription Errors in Internal Intensive Care Unit of Shahid Faghihi Hospital in Shiraz with Direct Observation Approach

     Medication errors (MEs) are the most common error in ICUs. In fact, 78% of all serious errors in ICUs are due to MEs. Therefore, detecting MEs has vital significance. The goal of this study was to investigate the frequency, type and consequences of different types of errors including prescribing, transcribing and administration errors in an ICU of a large teaching hospital. Disguised direc...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • The Journal of antimicrobial chemotherapy

دوره 51 3  شماره 

صفحات  -

تاریخ انتشار 2003