Stability of penicillin G sodium diluted with 0.9% sodium chloride injection or 5% dextrose injection and stored in polyvinyl chloride bag containers and elastomeric pump containers

Hossain, Mirza Akram; Friciu, Mihaela; Aubin, Sébastien; Leclair, Grégoire

doi:10.2146/ajhp130440

Cited by 11 publications

(5 citation statements)

References 13 publications

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“…The principal characteristics of each antimicrobial group, such as drug, reference [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ], main conditions (composition of the elastomeric device chosen, concentration, diluent, temperature, and duration of storage), chemical and physical stability obtained, and the most relevant comments for the systematic review, are summarized in Table 1 , Table 2 , Table 3 , Table 4 , Table 5 , Table 6 , Table 7 and Table 8 .…”

Section: Resultsmentioning

confidence: 99%

Stability of Antimicrobials in Elastomeric Pumps: A Systematic Review

et al. 2021

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Outpatient parenteral antimicrobial therapy (OPAThttp) programs have become an important healthcare tool around the world. Portable elastomeric infusion pumps are functional devices for ambulatory delivery of antimicrobial drugs, and their stability is an essential point to guarantee an appropriate infusion administration. We conducted a systematic review to provide a synthesis and a critical evaluation of the current evidence regarding antimicrobial stability in elastomeric pumps. Data sources were PubMed, EMBASE, and Web of Sciences. The review protocol was registered on the Center for Open Science, and it was carried out following the PRISMA guidelines. Studies were eligible if the aim was the evaluation of the physicochemical stability of an antimicrobial agent stored in an elastomeric device. Of the 613 papers identified, 33 met the inclusion criteria. The most studied group of antimicrobials was penicillins, followed by cephalosporins and carbapenems. In general, the stability results of the antimicrobials that have been studied in more than one article agree with each other, with the exception of ampicillin, flucloxacillin, and ceftazidime. The antibiotics that displayed a longer stability were glycopeptides and clindamycin. Regarding the stability of antifungals and antivirals, only caspofungin, voriconazole, and ganciclovir have been investigated. The information provided in this article should be considered in patient treatments within the OPAT setting. Further stability studies are needed to confirm the appropriate use of the antimicrobials included in this program to ensure optimal patient outcomes.

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Section: Resultsmentioning

confidence: 99%

Stability of Antimicrobials in Elastomeric Pumps: A Systematic Review

et al. 2021

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“…Penicillins are relatively unstable in the environment, e.g. piperacillin can remain stable with 5% tazobactam sodium for 2 days at 25°C (38), amoxicillin remains stable with clavulanic acid for 26 hours at 25°C (39) and penicillin G could be stable for 24 hours at 25°C (40). Although there is little evidence about the stability of penicillin metabolites in laboratory or environmental conditions, the penillic acid, penicilloic acid and penicillenic acid can be highly unstable metabolites with an unstable beta-lactam ring (25), so the evidence for the uncertain stability of the metabolite is required.…”

Section: Discussionmentioning

confidence: 99%

“…It is made available under a preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in The copyright holder for this this version posted September 6, 2022. ; https://doi.org/10.1101/2022.09.06.506739 doi: bioRxiv preprint Penicillins are relatively unstable in the environment, e.g. piperacillin can remain stable with 5% tazobactam sodium for 2 days at 25°C (38), amoxicillin remains stable with clavulanic acid for 26 hours at 25°C (39) and penicillin G could be stable for 24 hours at 25°C (40). Although there is little evidence about the stability of penicillin metabolites in laboratory or environmental conditions, the penillic acid, penicilloic acid and penicillenic acid can be highly unstable metabolites with an unstable betalactam ring (25), so the evidence for the uncertain stability of the metabolite is required.…”

Section: Figurementioning

confidence: 99%

Predicting bioactivity of antibiotic metabolites by molecular docking and dynamics

Chio

Guest

Hobman

et al. 2022

Preprint

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Antibiotics enter the environment through waste streams, where they can exert selective pressure for antimicrobial resistance in bacteria. However, many antibiotics are excreted as partly metabolized forms, or can be subject to partial breakdown in wastewater treatment, soil, or through natural processes in the environment. If a metabolite is bioactive, even at sub-lethal levels, and also stable in the environment, then it could provide selection pressure for resistance. (5S)-penicilloic acid of piperacillin has previously been found complexed to the binding pocket of penicillin binding protein 3 (PBP3) of Pseudomonas aeruginosa. Here, we predicted the affinities of all potentially relevant antibiotic metabolites of ten different penicillins to that target protein, using molecular docking and molecular dynamics simulations. Docking predicts that, in addition to penicilloic acid, pseudopenicillin derivatives of these penicillins, as well as 6-aminopenicillanic acid (6APA), could also bind to this target. Molecular dynamics simulations further confirmed that (5R)-pseudopenicillin and 6APA bind the target protein, in addition to (5S)-penicilloic acid. Thus, it is possible that these metabolites are bioactive, and, if stable in the environment, could be contaminants selective for antibiotic resistance. This could have considerable significance for environmental surveillance for antibiotics as a means to reduce antimicrobial resistance, because targeted mass spectrometry could be required for relevant metabolites as well as the native antibiotics.

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“…may vary by patient. In medical pharmacies or clinics, skilled technicians or nurses may dilute a stock solution of medication according to the prescribed dosages. − On the topic of “Bridging Chemistry and Medicine (Part 1)”, following virtual experimentation (dilution and monitoring pH) and pH calculations, students were instructed to submit a lab report, which would include the following discussion topic: What are some possible advantages for utilizing “serial dilution” in healthcare? Are there any scenarios, in which using “serial dilution” in healthcare, would be a disadvantage?…”

Section: Changing Lanes From “In-person Wet Labs” To “In-person 2d La...mentioning

confidence: 99%

Moving Forward: Resilience of a Chemistry for Health Professions 2D Virtual Lab Program During COVID

Mahaffey

2022

J. Chem. Educ.

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Chemical education laboratory practices have not been exempted from the present healthcare crisis. Learning environments have shifted from face-to-face exercises to virtual and video conferencing platforms. Here, we discuss a chemistry for health sciences course which (i) adapted the previous face-to-face laboratory exercises to 100% online using online platforms two years preceding COVID only to shift to completely remote learning and back again and (ii) highlight correlations between chemistry concepts (e.g., pH, solubility, and serial dilutions) and medical practices. Additionally, course pass/fail trends pre-COVID and during COVID are identified and discussed by the author. Regarding example laboratory teaching and learning, this article further examines the responses for two groups of students and their perspectives on 2D virtual chemistry lab experiences and parallel discussions in healthcare: (1) For group 1, students (n = 135) completed an anonymous and voluntary Likert-type questionnaire for a pH and serial dilution online lab experience with over 92% recommending the lab experience for future enrollees, and (2) for group 2, student (n = 107) results indicated 93% of the survey participants were providing the same recommendation.

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Stability of penicillin G sodium diluted with 0.9% sodium chloride injection or 5% dextrose injection and stored in polyvinyl chloride bag containers and elastomeric pump containers

Abstract: Penicillin G for injection (2,500 and 50,000 units/mL) diluted in 0.9% sodium chloride injection or 5% dextrose injection and stored at 5°C in PVC containers or elastomeric pump containers was physically and chemically stable for a period of at least 21 days.

Cited by 11 publications

References 13 publications

Stability of Antimicrobials in Elastomeric Pumps: A Systematic Review

Stability of Antimicrobials in Elastomeric Pumps: A Systematic Review

Predicting bioactivity of antibiotic metabolites by molecular docking and dynamics

Moving Forward: Resilience of a Chemistry for Health Professions 2D Virtual Lab Program During COVID

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