No abstract

This study aimed to determine the physical stability of norepinephrine bitartrate (Levophed®) with various antibiotics such as ampicillin-sulbactam, ceftolozane/ tazobactam (Zerbaxa®), levofloxacin, azithromycin, cefepime and isavuconazonium sulfate (Cresemba®) when infused simultaneously with Levophed® during simulated intravenous Y-site administration. Simulation of Y-compatibility of intravenous fluids beaches has been experimentally demonstrated by mixing equal volumes of two drugs of interest. Therefore, we prepared a 1:1 mixture of Levophed® by mixing 32 µg/mL or 64 µg/mL of Levophed® individually with clinically relevant concentrations of ampicillinsulbactam, Zerbaxa®, azithromycin, cefepime, levofloxacin, and Cresemba® when infused simultaneously with Levophed®. Physical compatibility of the mixtures was determined by visual and turbidimetric assessments performed immediately after mixing and at both 2 and 4 hours. The visual assessment and turbidity measurements showed that Levophed® is compatible with ampicillin-sulbactam, Zerbaxa®, azithromycin, cefepime, levofloxacin, and Cresemba®.