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Stability and Sterility of Extemporaneously Prepared Nonpreserved Cefazolin, Ceftazidime, Vancomycin, Amphotericin B, and Methylprednisolone Eye Drops.
Cornea. 2019 Aug; 38(8):1017-1022.C

Abstract

PURPOSE

To determine in-use stability and sterility of fortified cefazolin, ceftazidime, vancomycin, amphotericin B, and methylprednisolone eye drops in a simulated inpatient setting with and without a mobile refrigerated container (MR).

METHODS

Each drug was prepared and divided into 4 groups: 1) simulated patient use with the MR group: stored at 4°C and kept in the MR during drug administration, 2) simulated patient use without the MR (NoMR) group: stored at 4°C and no MR, 3) refrigerated control group: stored at 4°C, and 4) room temperature control group: stored at room temperature. Stability and sterility data were evaluated at days 0, 4, 7, 14, 21, and 28. Linear mixed-effects model and survival analysis were performed.

RESULTS

Median time to 10% loss of concentration for in-use medications (MR/NoMR groups) was >28/27.9, 22.2/22.2, 19.4/19.4, 10.18/<4, and >28/>28 days for cefazolin, ceftazidime, vancomycin, amphotericin B, and methylprednisolone, respectively. There was no significant difference in the predicted concentration loss per day among all groups for vancomycin and methylprednisolone (all P > 0.05). For the other study medications, all room temperature control groups, the cefazolin NoMR group, and the ceftazidime NoMR group had significantly greater predicted concentration loss per day compared with the refrigerated control groups (all P ≤ 0.02). Culture results were negative for all drugs throughout the study.

CONCLUSIONS

The NoMR group showed that the drug significantly degraded rapidly for cefazolin, ceftazidime, and amphotericin B. Implementation of MR could decrease the predicted loss of concentration per day for cefazolin and ceftazidime. In vitro antimicrobial activity and sterility were retained for 28 days.

Authors+Show Affiliations

Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.Department of Pharmacology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.Department of Nursing, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.Department of Nursing, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.Glaucoma Research Unit, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

31090593

Citation

Ratprasatporn, Nitee, et al. "Stability and Sterility of Extemporaneously Prepared Nonpreserved Cefazolin, Ceftazidime, Vancomycin, Amphotericin B, and Methylprednisolone Eye Drops." Cornea, vol. 38, no. 8, 2019, pp. 1017-1022.
Ratprasatporn N, Wittayalertpanya S, Khemsri W, et al. Stability and Sterility of Extemporaneously Prepared Nonpreserved Cefazolin, Ceftazidime, Vancomycin, Amphotericin B, and Methylprednisolone Eye Drops. Cornea. 2019;38(8):1017-1022.
Ratprasatporn, N., Wittayalertpanya, S., Khemsri, W., Chatsuwan, T., Chongpison, Y., Chamsai, T., Wattanakijkarn, M., & Chansangpetch, S. (2019). Stability and Sterility of Extemporaneously Prepared Nonpreserved Cefazolin, Ceftazidime, Vancomycin, Amphotericin B, and Methylprednisolone Eye Drops. Cornea, 38(8), 1017-1022. https://doi.org/10.1097/ICO.0000000000001992
Ratprasatporn N, et al. Stability and Sterility of Extemporaneously Prepared Nonpreserved Cefazolin, Ceftazidime, Vancomycin, Amphotericin B, and Methylprednisolone Eye Drops. Cornea. 2019;38(8):1017-1022. PubMed PMID: 31090593.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Stability and Sterility of Extemporaneously Prepared Nonpreserved Cefazolin, Ceftazidime, Vancomycin, Amphotericin B, and Methylprednisolone Eye Drops. AU - Ratprasatporn,Nitee, AU - Wittayalertpanya,Supeecha, AU - Khemsri,Wondee, AU - Chatsuwan,Tanittha, AU - Chongpison,Yuda, AU - Chamsai,Tasanee, AU - Wattanakijkarn,Mayura, AU - Chansangpetch,Sunee, PY - 2019/5/16/pubmed PY - 2019/8/24/medline PY - 2019/5/16/entrez SP - 1017 EP - 1022 JF - Cornea JO - Cornea VL - 38 IS - 8 N2 - PURPOSE: To determine in-use stability and sterility of fortified cefazolin, ceftazidime, vancomycin, amphotericin B, and methylprednisolone eye drops in a simulated inpatient setting with and without a mobile refrigerated container (MR). METHODS: Each drug was prepared and divided into 4 groups: 1) simulated patient use with the MR group: stored at 4°C and kept in the MR during drug administration, 2) simulated patient use without the MR (NoMR) group: stored at 4°C and no MR, 3) refrigerated control group: stored at 4°C, and 4) room temperature control group: stored at room temperature. Stability and sterility data were evaluated at days 0, 4, 7, 14, 21, and 28. Linear mixed-effects model and survival analysis were performed. RESULTS: Median time to 10% loss of concentration for in-use medications (MR/NoMR groups) was >28/27.9, 22.2/22.2, 19.4/19.4, 10.18/<4, and >28/>28 days for cefazolin, ceftazidime, vancomycin, amphotericin B, and methylprednisolone, respectively. There was no significant difference in the predicted concentration loss per day among all groups for vancomycin and methylprednisolone (all P > 0.05). For the other study medications, all room temperature control groups, the cefazolin NoMR group, and the ceftazidime NoMR group had significantly greater predicted concentration loss per day compared with the refrigerated control groups (all P ≤ 0.02). Culture results were negative for all drugs throughout the study. CONCLUSIONS: The NoMR group showed that the drug significantly degraded rapidly for cefazolin, ceftazidime, and amphotericin B. Implementation of MR could decrease the predicted loss of concentration per day for cefazolin and ceftazidime. In vitro antimicrobial activity and sterility were retained for 28 days. SN - 1536-4798 UR - https://www.unboundmedicine.com/medline/citation/31090593/Stability_and_Sterility_of_Extemporaneously_Prepared_Nonpreserved_Cefazolin_Ceftazidime_Vancomycin_Amphotericin_B_and_Methylprednisolone_Eye_Drops_ L2 - http://dx.doi.org/10.1097/ICO.0000000000001992 DB - PRIME DP - Unbound Medicine ER -