Stability of Trisodium Citrate and Gentamicin Solution for Catheter Locks after Storage in Plastic Syringes at Room Temperature

Abstract

Background: Catheter-related infections are a major problem for hemodialysis patients with central venous catheters for vascular access. Catheter lock solutions containing an anticoagulant are used to maintain the patency of the catheter between hemodialysis sessions. There is evidence that the use of lock solutions containing an antibiotic is associated with lower rates of infection but also that these solutions can kill microbes in colonized catheters and thus avoid the risks and costs associated with replacing the catheter.

Stability and compatibility of antimicrobial lock solutions

“…26 Gentamicin 2.5 mg/mL with TSC 40 mg/mL remains stable, with no change in gentamicin concentration, for at least 112 days at room temperature. 5,7,8 Solutions of gentamicin 3 mg/mL and daptomycin 1 mg/mL with or without TSC 28 mg/ mL maintained more than 90% of the original drug concentrations for 48 hours. 9 Gentamicin 5 mg/mL has also been studied with EDTA 30 mg/mL, and visual compatibility for at least 72 hours at 25 or 37 °C was demonstrated.…”

“…1 Heparin is the most commonly used anticoagulant additive in ALT, but other compounds, including trisodium citrate (TSC) and ethylenediaminetetraacetic acid (EDTA), which work synergistically with most antiinfectives, as well as thrombolytics, have been studied. [5][6][7][8][9][10][11] Because of the increase in ALT utilization in both inpatient and outpatient settings and the continuing emergence of novel lock solutions, it is imperative that concise and validated stability and compatibility data are available to practitioners. This review details the available stability and compatibility data from evaluations of antimicrobial lock solutions used in combination with anticoagulants or other additives and provides recommendations for clinical application.…”

pH-controlled delivery of gentamicin sulfate from orthopedic devices preventing nosocomial infections

“…GS was chosen because of its high stability in physiological medium (several months) and its broad spectrum against Gram negative rods and Staphylococci [43]. A cleavage reaction of the NPs-active molecule link, activated by the contact of material with the physiological medium or by a modification of the pH, induces a controlled release of the bioactive molecule in its native form.…”

Factors Associated with Infection of the Central Venous Catheter for Hemodialysis in Ouagadougou (Burkina Faso)

“…The fastest production of AVFs would contribute to a reduction of the prevalence of CVCs and the CRI. In our context of long-term use of non-tunneled CVC, the use of "locks" containing antibiotics like gentamicin associated with citrate [17] or 60% ethanol associated with heparin could also contribute to reducing the incidence of CRIs.…”