AI Article Synopsis
- Limited information exists about the stability of penicillin-based antibiotics for skin testing, prompting a study on 16 parenteral antibiotics to evaluate their physicochemical stability and provide guidelines for clinicians.
- Most antibiotics showed good stability for 2 to 7 days, with amoxicillin/clavulanic acid being a notable exception, dropping below acceptable levels by day 2.
- The research included specific tests for chemical and physical stability, revealing that while many antibiotics maintained acceptable performance, some experienced significant color changes and pH drops over time.
Article Abstract
Background: Limited information is available regarding the physicochemical stability of penicillin-based preparations for skin testing purposes, and no information is currently available for other classes of antibiotics.
Objective: To perform chemical and physical stability studies on 16 parenteral antibiotics for skin testing purposes, with an overall aim to provide practical recommendations to clinicians on suitable components, storage, and optimal shelf-life of such preparations.
Methods: Chemical stability was assessed via validated stability-indicating high performance liquid chromatography with ultraviolet detection assays, while absence of precipitations or haziness, significant pH shift, and color change were used to determine physical stability.
Results: Other than amoxicillin/clavulanic acid, all of the parenteral antibiotics were found to have adequate physicochemical stability between 2 and 7 days. Amoxicillin in water for injection BP retained more than 90% stability, whereas amoxicillin/clavulanic acid dropped to less than 80%. Ampicillin remained more than 90% stable for 2 days, and benzylpenicillin, flucloxacillin, and piperacillin/tazobactam were stable for 2 days or more at approximately 95%. Cephalosporins were stable for 2 days, except ceftazidime, which increased to more than 110%. Aztreonam, ciprofloxacin, and vancomycin retained more than 95% stability for 7 days, whereas meropenem was stable for 2 days. Sulfamethoxazole/trimethoprim in plastic syringe lost 15% but stabilized at approximately 85% for 7 days. No precipitation occurred, but amoxicillin/clavulanic acid changed color by day 2. pH decreases of 1.0 unit or less were observed in penicillins, whereas cefepime dropped below acceptable pH limits by day 7. Absorbance shifts of more than 100 units were seen in several antibiotics by day 7.
Conclusions: This study has generated practical stability information for clinicians, allowing 15 parenteral antibiotics from 7 different classes to be aseptically prepared in advance for use in the testing of drug allergy reactions.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jaip.2024.10.040 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Long-Term Self-Administered Outpatient Parenteral Antimicrobial Therapy in the Treatment of Tuberculosis.
Drugs
December 2024
Division of Clinical Infectious Diseases, Research Center Borstel, Leibniz Lung Center, Borstel, Germany.
Objectives: To investigate the safety profiles and clinical outcomes in a continuous cohort of tuberculosis (TB) patients from a clinical referral centre in Germany receiving self-administered outpatient parenteral antimicrobial therapy (sOPAT).
Methods: We conducted a retrospective observational cohort study of patients receiving sOPAT after discharge from the Research Center Borstel in Germany between January 2015 and December 2020. Data were extracted from medical records.
A Three-year Longitudinal Assessment of Pseudomonas aeruginosa Antibiotic Susceptibility in Children With Cystic Fibrosis in the Era of Cystic Fibrosis Transmembrane Conductance Regulator Modulator Therapy.
Pediatr Infect Dis J
October 2024
From the Division of Infectious Diseases, Rady Childrens Hospital San Diego, San Diego.
fibrosis is a genetic disease characterized by chronic lung infection, often with Pseudomonas aeruginosa, requiring repeated antibiotic treatment for pulmonary exacerbations. In the era of cystic fibrosis transmembrane conductance regulator modulator therapy, we assessed susceptibility to antipseudomonal antibiotics in modulator-eligible and modulator-ineligible children over 3 years and found that P. aeruginosa isolates largely remained susceptible to standard parenteral but not oral antimicrobial agents.
View Article and Find Full Text PDFImpact of a nurse practitioner-led dedicated outpatient parenteral antibiotic therapy clinic on patient outcomes and administrative workload: a retrospective cohort study.
Ther Adv Infect Dis
December 2024
Division of Infectious Diseases, University of Toledo College of Medicine and Life Sciences, 3000 Arlington Avenue, Mail Stop 1186, Toledo, OH 43614, USA.
Background: Outpatient parenteral antibiotic therapy (OPAT) enhances patient safety, improves outcomes, and reduces healthcare costs by decreasing 30-day readmissions and adverse events. However, the optimal structure and follow-up protocols for OPAT programs remain undefined. Identifying high-risk patients for readmission and managing adverse drug events (ADEs) are critical components of OPAT care.
View Article and Find Full Text PDFStenotrophomonas maltophilia Associated Factors and Outcomes in a Neonatal Intensive Care Unit: A Retrospective Matched Case-control Study.
Pediatr Infect Dis J
January 2025
Division of Pediatric Infectious Diseases, Department of Pediatrics, State University of New York Downstate Health Sciences University, Brooklyn, New York.
Background: Stenotrophomonas maltophilia is a multi-drug-resistant, hospital-acquired Gram-negative bacillus associated with significant morbidity and mortality. The objective of this study is to identify risk factors and outcomes associated with S. maltophilia isolation in a high-risk neonatal population.
View Article and Find Full Text PDFEarly Antiviral Use and Supplemental Oxygen Decrease the Risk of Secondary Bacterial Infections: A Multicentre Nested Case-Control Study.
J Hosp Infect
December 2024
Department of Pulmonary and Critical Care Medicine at The Seventh Medical Center, College of Pulmonary and Critical Care Medicine of The Eighth Medical Center, Chinese PLA General Hospital, Beijing, 100853, China; Department of Pulmonary and Critical Care Medicine at The First Medical Center, College of Pulmonary and Critical Care Medicine of The Eighth Medical Center, Chinese PLA General Hospital, Beijing, 100853, China; Department of Pulmonary and Critical Care Medicine at The Third Medical Center, College of Pulmonary and Critical Care Medicine of The Eighth Medical Center, Chinese PLA General Hospital, Beijing, 100853, China; State Key Laboratory of Kidney Disease, Beijing, 100853, China. Electronic address:
Objective: To evaluate the treatment strategies that dictate the host susceptibility to secondary bacterial infections during coronavirus disease 2019 (COVID-19).
Design: Setting and Participants: This nested case-control study was conducted in three general hospitals in China between December 1, 2022, to March 1, 2023. A total of 456 confirmed COVID-19 patients matched 1:2 (152 cases and 304 controls) based on age, sex, disease severity and age-adjusted Charlson Comorbidity Index (aCCI) using Propensity-Score Matching (PSM) were included.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!