Stability and compatibility of admixtures of intravenous ciprofloxacin and selected drugs

Elmore, Richard L.; Contois, Mary Ellen; Kelly, Jacqueline; Noe, Anson; Poirier, Albert

doi:10.1016/s0149-2918(96)80005-1

Cited by 15 publications

(12 citation statements)

References 5 publications

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“…1). This dry powder system is advantageous as compared to a nebulizer for codelivery of the two antibiotics, as the two tend to precipitate when they co-exist in solution (13).…”

Section: Discussionmentioning

confidence: 99%

“…This procedure was modified for co-encapsulating ceftazidime and ciprofloxacin into the DAL particles (CTZ and CIP), since the two antibiotics were incompatible in aqueous solution (13). The solutions containing DAL and each antibiotic were prepared separately as above and dispensed into two respective 60-ml syringes.…”

Section: Preparation Of Microparticlesmentioning

confidence: 99%

“…Hence, nebulized drugs must be highly potent; otherwise, the long administration time may impair patient compliance (11,12). Co-nebulizing several antibiotics is difficult because some combinations of antibiotic solutions can form precipitates (13). Finally, nebulization disperses antibiotics into the ambient air and generates antibiotic resistance among ubiquitous bacteria (14).…”

Section: Introductionmentioning

confidence: 99%

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Microparticles for Inhalational Delivery of Antipseudomonal Antibiotics

Tsifansky

Yeo

Evgenov

et al. 2008

AAPS J

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Abstract. Chronic pseudomonal bronchopulmonary infections in cystic fibrosis patients are frequently controlled with inhaled antibiotics. Dry-powder inhalable antibiotics are an attractive alternative to nebulized medications. We produced and evaluated microparticles composed of dipalmitoylphosphatidylcholine, albumin, and lactose as a model system for intrapulmonary delivery of ceftazidime, ciprofloxacin, and several combinations of the two, none of which is presently available for inhalation. Microparticles containing one or both antibiotics were prepared by spray-drying. Their Anderson cascade impactor deposition profiles showed 10-30% fine particle fractions of the nominal dose. Microparticles containing varying amounts of each antibiotic showed statistically different deposition profiles. Aerodynamics and deposition of microparticles co-encapsulating both antibiotics were similar to those of single-drug microparticles with the same proportion of ciprofloxacin alone. The antipseudomonal activities of microparticles co-encapsulating half of the 50% effective concentration (EC 50 ) of both ceftazidime and ciprofloxacin (5 mg of particles containing 5% ceftazidime and 10% ciprofloxacin) were at least additive compared to particles containing the EC 50 of each antibiotic separately (5 mg of particles containing 10% ceftazidime or 5 mg of particles containing 20% ciprofloxacin). Co-encapsulation of the antibiotics in microparticles ensures co-deposition at desired ratios, improves the particles' aerodynamics and fine particle fraction, as compared to microparticles with equivalent amounts of ceftazidime alone, and achieves additive antipseudomonal activity.

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“…1). This dry powder system is advantageous as compared to a nebulizer for codelivery of the two antibiotics, as the two tend to precipitate when they co-exist in solution (13).…”

Section: Discussionmentioning

confidence: 99%

Section: Preparation Of Microparticlesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Microparticles for Inhalational Delivery of Antipseudomonal Antibiotics

Tsifansky

Yeo

Evgenov

et al. 2008

AAPS J

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“…Despite the lure of inhaled combination therapy, it is important to note that not all antibiotics are compatible and stable in the presence of an admixture (121). Antimicrobial agents without reported data confirming their stability and compatibility should not be mixed in a nebulizer solution for use as combination therapy.…”

Section: Inhaled Antibiotic Admixturesmentioning

confidence: 99%

Inhaled Antibiotics for Gram-Negative Respiratory Infections

et al. 2016

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SUMMARYGram-negative organisms comprise a large portion of the pathogens responsible for lower respiratory tract infections, especially those that are nosocomially acquired, and the rate of antibiotic resistance among these organisms continues to rise. Systemically administered antibiotics used to treat these infections often have poor penetration into the lung parenchyma and narrow therapeutic windows between efficacy and toxicity. The use of inhaled antibiotics allows for maximization of target site concentrations and optimization of pharmacokinetic/pharmacodynamic indices while minimizing systemic exposure and toxicity. This review is a comprehensive discussion of formulation and drug delivery aspects,in vitroand microbiological considerations, pharmacokinetics, and clinical outcomes with inhaled antibiotics as they apply to disease states other than cystic fibrosis. In reviewing the literature surrounding the use of inhaled antibiotics, we also highlight the complexities related to this route of administration and the shortcomings in the available evidence. The lack of novel anti-Gram-negative antibiotics in the developmental pipeline will encourage the innovative use of our existing agents, and the inhaled route is one that deserves to be further studied and adopted in the clinical arena.

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“…Jedoch können erhöhte Temperatur, pH-Wert (maximale Stabilität zwischen 4,5-6,5) oder Art des Infusionsbehälters zu einer Beschleunigung des Abbaus von Ceftazidim führen [15][16][17][18]. Chemische und physikalische Inkompatibilitäten wurden auch in Kombination mit anderen Arzneistoffen, wie Aminophyllin, Ciprofloxacin, Vancomycin, Nicardipin und Midazolam beobachtet [19][20][21]. Ebenso erwies sich Flucloxacillin für den Einsatz in der kontinuierliche Infusion als ausreichend stabil, jedoch zeigten sich auch hier Unverträglichkeiten mit anderen Wirkstoffen wie mit Heparin oder Ofloxacin [22][23][24] Ebenfalls führt eine erhöhte Lagerungstemperatur zu einer beschleunigten Hydrolyse des Betalaktamringes [25].…”

Section: Introductionunclassified

Examination of stability and compatibility of flucloxacillin (Floxapen®) and ceftazidime (Fortum®) in two infusion media: relevance for the clinical praxis

Thalhammer

Maier‐Salamon

Jäger

2005

Wien Med Wochenschr

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Flucloxacillin (Floxapen) and ceftazidime (Ceftazidim) are both highly active antibiotics against Gram-positive and Gram-negative organisms, respectively. Because of their complementary spectra of activity, simultaneous administration of both drugs via continuous infusion is highly favored by clinicians. Therefore, the aim of the present study was to examine the stability and compatibility of both drugs in Aqua ad injections and in physiological solution of sodium chloride in the presence and absence of furosemide (Lasix). Physical and chemical stability were examined using different concentrations of flucloxacillin (2-12 g/50 ml) and ceftazidime (2-9 g/50 ml). On the basis of a limit of max. 10% degradation, flucloxacillin and ceftazidime can be considered stable at 4 degrees C and room temperature for up to 24 hours. Neither concentration nor infusion medium had significant influence on the degradation of both compounds. Addition of furosemide (250 mg/50 ml) does not cause any incompatibilities or significant decrease of the antimicrobial drug concentrations.

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Stability and compatibility of admixtures of intravenous ciprofloxacin and selected drugs

Cited by 15 publications

References 5 publications

Microparticles for Inhalational Delivery of Antipseudomonal Antibiotics

Microparticles for Inhalational Delivery of Antipseudomonal Antibiotics

Inhaled Antibiotics for Gram-Negative Respiratory Infections

Examination of stability and compatibility of flucloxacillin (Floxapen®) and ceftazidime (Fortum®) in two infusion media: relevance for the clinical praxis

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