Compatibility of Y-Site Injection of Meropenem Trihydrate With 101 Other Injectable Drugs

Lessard, Jean-Justin; Caron, Elsa; Scherer, H; Forest, Jean‐Marc; Leclair, Grégoire

doi:10.1177/0018578719844168

Cited by 3 publications

(3 citation statements)

References 2 publications

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“…Studies reported that pH changes of intravenous drug solution within the range of 0.2 to 1.0, the solution was stable and compatible [19][20][21][22]. Dotson et al defined physical incompatibility as a pH value of no more than 10% change from baseline (0 hour) after 48 hours [15].…”

Section: Plos Onementioning

confidence: 99%

Physical compatibility of Xuebijing injection with 53 intravenous drugs during simulated Y-site administration

Tong,

Li,

Ding

et al. 2024

PLoS ONE

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Objective Xuebijing injection (XBJ) is a commonly used herbal medicine injection in China. However, the physical compatibility of XBJ with other intravenous drugs remains unclear. The purpose of this research is to evaluate physical compatibility of Xuebijing injection (XBJ) with 53 intravenous drugs (including 31 Chinese medicine injections and 22 chemicals) during simulated Y-site administration. Methods Y-site administration was simulated in vitro by admixing 0.33 ml/ml XBJ with an equal volume of other diluted 53 intravenous drugs, respectively. Physical compatibility including visual inspection, Tyndall beam, particle limits, turbidity, pH, chromacity value, spectroscopic absorption of 550 nm and 420 nm (A550 nm and A420 nm) were observed and assessed at 0, 1, 2, and 4 h. Physical compatibility was defined as all solutions with no color changes, no gas evolution, particulate formation and no Tyndall beam within 4 hours, turbidity changes <0.5 nephelometric turbidity unit (NTU) compared to 0 h, particle limits allowed by the Chinese Pharmacopoeia (Ch.P) 2020 edition, pH changes <10% compared to 0, chromacity value changes <200 compared to 0 h, or photometrical changes of A420 nm <0.0400 or A550 nm <0.0100 compared to 0 h. Results XBJ was physically incompatible with 27 of the 53 intravenous drugs tested, 26 were compatible with XBJ for 4 h. Conclusions XBJ should not be simultaneously co-administered with 27 of the 53 intravenous drugs during simulated Y-site. If coadministration was inevitable, flushing tube with NS or D5W before and after infusion of XBJ was needed. Assessment included visual inspection, Tyndall beam, turbidity measurement, particle counts, pH measurement, chromacity value measurement and absorption of A550 nm were proved to be valid and robust for the quality control of infusion and compatibility of Chinese herbal injection.

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Section: Plos Onementioning

confidence: 99%

Physical compatibility of Xuebijing injection with 53 intravenous drugs during simulated Y-site administration

Tong,

Li,

Ding

et al. 2024

PLoS ONE

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“…Ten percent of the gaps in our review are related to meropenem, much more than the rest of other antimicrobials studied. Latest published data show incompatibility with key drugs, such as dobutamine and vancomycin 45,46 …”

Section: Resultsmentioning

confidence: 99%

“…Latest published data show incompatibility with key drugs, such as dobutamine and vancomycin. 45,46 In addition, the compatibility of ceftolozane-tazobactam with different i.v. drugs during Y-site administration was also analysed.…”

Section: Beta-lactam Antibioticsmentioning

confidence: 99%

Compatibility of prolonged infusion antibiotics during Y‐site administration

Núñez-Núñez

Murillo-Izquierdo

Moya-Martin

et al. 2022

Nursing in Critical Care

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Background: Antimicrobial resistance is a threat to global public health. The use of prolonged infusions in the hospital setting for certain antimicrobials is widely increasing in order to improve their efficacy and safety, including resistance development.Due to limited vascular access, it is important to clarify whether they can be infused through the same line with other drugs during Y-site administration.Aim: The aim of this review is to update and summarize the evidence on Y-site compatibility of antibacterial agents administered as prolonged infusions in intensive care units (ICUs).Study Design: A literature review of PubMed, EMBASE and Trissel's Handbook on Injectable Drugs databases was conducted on the compatibility of selected antimicrobials administered simultaneously at a Y-site connection with parenteral nutrition and other widely used drugs in ICUs. All articles published up to October 30, 2021, in English or Spanish were included, regardless of the type of publication (original articles, case reports, letters, etc.). Eligible antimicrobials were those that can be administered as prolonged infusions: ceftazidime, cefepime, piperacillin/tazobactam, meropenem, ceftolozane/tazobactam, ceftaroline, cloxacillin, ceftobiprole, vancomycin and fosfomycin.Results: A total of 1302 drug-to-drug potential combinations were explored, 196 (15.05%) were found to be incompatible, and in 541 (41.55%), data were not available. The results were presented in a simple 2-dimensional consultation chart as a quick reference for health care professionals.Conclusions: This review provides useful and reliable information on the compatibility of antimicrobials administered as Y-site infusion with other drugs commonly used in the critical setting. This review contributes to patient safety in nursing practice.Relevance to Clinical Practice: To our knowledge, this is the first review on Y-site compatibility of antimicrobials used as prolonged infusions with other commonly used drugs, including anti-emetics, analgesics and anti-epileptic and parenteral nutrition. The results of the current review need to be addressed to promote the knowledge sharing between health professionals and improve the quality and safety of

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Physicochemical compatibility of caffeine citrate and caffeine base injections with parenteral medications used in neonatal intensive care settings

De Silva,

Petrovski,

Strunk

et al. 2024

Eur J Clin Pharmacol

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Purpose To investigate the physicochemical compatibility of caffeine citrate and caffeine base injections with 43 secondary intravenous (IV) drugs used in Neonatal Intensive Care Unit (NICU) settings. Methods Caffeine citrate (20 mg/mL or 10 mg/mL) or caffeine base injection (10 mg/mL) were mixed in a volume ratio of 1:1 with the secondary drug solution to simulate Y-site co-administration procedures in NICUs. Physical compatibility was evaluated based on visual observation for 2 h, against a black and white background and under polarised light, for changes in colour, precipitation, haze and evolution of gas. Chemical compatibility was determined from caffeine concentration measurements, using a validated high-performance liquid chromatography assay. Results Six of the 43 secondary drugs tested (aciclovir, amphotericin (liposomal), furosemide, hydrocortisone, ibuprofen and ibuprofen lysine) were physically incompatible with caffeine citrate undiluted injection (20 mg/mL), at their high-end, clinically relevant concentrations for NICU settings. However, when tested at lower concentrations, hydrocortisone (1 mg/mL) was physicochemically compatible, whereas furosemide (0.2 mg/mL) was physically incompatible with caffeine citrate. The six drugs which showed physical incompatibility with caffeine citrate 20 mg/mL injection were also physically incompatible with caffeine citrate 10 mg/mL solution. All 43 secondary drugs tested were physicochemically compatible with caffeine base injection. Conclusions Most secondary test drugs, except aciclovir, amphotericin (liposomal), furosemide, hydrocortisone, ibuprofen and ibuprofen lysine, were physicochemically compatible with caffeine citrate injection. Caffeine base injection was physicochemically compatible with all 43 test drugs tested.

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Compatibility of Y-Site Injection of Meropenem Trihydrate With 101 Other Injectable Drugs

Cited by 3 publications

References 2 publications

Physical compatibility of Xuebijing injection with 53 intravenous drugs during simulated Y-site administration

Physical compatibility of Xuebijing injection with 53 intravenous drugs during simulated Y-site administration

Compatibility of prolonged infusion antibiotics during Y‐site administration

Physicochemical compatibility of caffeine citrate and caffeine base injections with parenteral medications used in neonatal intensive care settings

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