Stability Studies of Antipseudomonal Beta Lactam Agents for Outpatient Therapy
Outpatient parenteral antimicrobial therapy (OPAT) is a useful treatment strategy against <i>Pseudomonas aeruginosa</i> and other multidrug-resistant bacteria. However, it is hindered by the lack of stability data for the administration of antibiotics under OPAT conditions. Our objective...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Pharmaceutics |
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| Online Access: | https://www.mdpi.com/1999-4923/15/12/2705 |
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| author | Beatriz Fernández-Rubio Laura Herrera-Hidalgo Arístides de Alarcón Rafael Luque-Márquez Luis E. López-Cortés Sònia Luque José María Gutiérrez-Urbón Aurora Fernández-Polo Alicia Gutiérrez-Valencia María V. Gil-Navarro |
| author_facet | Beatriz Fernández-Rubio Laura Herrera-Hidalgo Arístides de Alarcón Rafael Luque-Márquez Luis E. López-Cortés Sònia Luque José María Gutiérrez-Urbón Aurora Fernández-Polo Alicia Gutiérrez-Valencia María V. Gil-Navarro |
| author_sort | Beatriz Fernández-Rubio |
| collection | DOAJ |
| description | Outpatient parenteral antimicrobial therapy (OPAT) is a useful treatment strategy against <i>Pseudomonas aeruginosa</i> and other multidrug-resistant bacteria. However, it is hindered by the lack of stability data for the administration of antibiotics under OPAT conditions. Our objective was to investigate the stability of nine antipseudomonal and broad-spectrum beta lactam antibiotics (aztreonam, cefepime, cefiderocol, ceftazidime, ceftazidime/avibactam, ceftolozane/tazobactam, meropenem, meropenem/vaborbactam, and piperacillin/tazobactam) to allow the spread of OPAT programs. All the antibiotics were diluted in 500 mL 0.9% sodium chloride and stored at 4, 25, 32, and 37 °C for 72 h in two different devices (infusion bags and elastomeric pumps). The solutions were considered stable if the color, clearness, and pH remained unchanged and if the percentage of intact drug was ≥90%. All the antimicrobials remained stable 72 h under refrigerated conditions and at least 30 h at 25 °C. At 32 °C, all the antibiotics except for meropenem and meropenem/vaborbactam remained stable for 24 h or more. At 37 °C, only aztreonam, piperacillin/tazobactam, cefepime, cefiderocol, and ceftolozane/tazobactam were stable for at least 24 h. The stability results were the same in the two devices tested. All the antibiotics studied are actual alternatives for the treatment of antipseudomonal or multidrug-resistant infections in OPAT programs, although the temperature of the devices is crucial to ensure antibiotic stability. |
| first_indexed | 2024-03-08T20:26:58Z |
| format | Article |
| id | doaj.art-680f851222f848f4a1d41c8aea0d9779 |
| institution | Directory Open Access Journal |
| issn | 1999-4923 |
| language | English |
| last_indexed | 2024-03-08T20:26:58Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pharmaceutics |
| spelling | doaj.art-680f851222f848f4a1d41c8aea0d97792023-12-22T14:32:04ZengMDPI AGPharmaceutics1999-49232023-11-011512270510.3390/pharmaceutics15122705Stability Studies of Antipseudomonal Beta Lactam Agents for Outpatient TherapyBeatriz Fernández-Rubio0Laura Herrera-Hidalgo1Arístides de Alarcón2Rafael Luque-Márquez3Luis E. López-Cortés4Sònia Luque5José María Gutiérrez-Urbón6Aurora Fernández-Polo7Alicia Gutiérrez-Valencia8María V. Gil-Navarro9Unidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, SpainUnidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, SpainUnidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Parasitologia, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, SpainUnidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Parasitologia, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, SpainCentro de Investigación en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, SpainCentro de Investigación en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, SpainUnidad de Gestión Clínica de Farmacia, Complexo Hospitalario Universitario de A Coruña, 15006 A Coruña, SpainUnidad de Gestión Clínica de Farmacia, Hospital Universitari Vall d’Hebron, Institut de Recerca Vall d’Hebron, 08035 Barcelona, SpainUnidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Parasitologia, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, SpainUnidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, SpainOutpatient parenteral antimicrobial therapy (OPAT) is a useful treatment strategy against <i>Pseudomonas aeruginosa</i> and other multidrug-resistant bacteria. However, it is hindered by the lack of stability data for the administration of antibiotics under OPAT conditions. Our objective was to investigate the stability of nine antipseudomonal and broad-spectrum beta lactam antibiotics (aztreonam, cefepime, cefiderocol, ceftazidime, ceftazidime/avibactam, ceftolozane/tazobactam, meropenem, meropenem/vaborbactam, and piperacillin/tazobactam) to allow the spread of OPAT programs. All the antibiotics were diluted in 500 mL 0.9% sodium chloride and stored at 4, 25, 32, and 37 °C for 72 h in two different devices (infusion bags and elastomeric pumps). The solutions were considered stable if the color, clearness, and pH remained unchanged and if the percentage of intact drug was ≥90%. All the antimicrobials remained stable 72 h under refrigerated conditions and at least 30 h at 25 °C. At 32 °C, all the antibiotics except for meropenem and meropenem/vaborbactam remained stable for 24 h or more. At 37 °C, only aztreonam, piperacillin/tazobactam, cefepime, cefiderocol, and ceftolozane/tazobactam were stable for at least 24 h. The stability results were the same in the two devices tested. All the antibiotics studied are actual alternatives for the treatment of antipseudomonal or multidrug-resistant infections in OPAT programs, although the temperature of the devices is crucial to ensure antibiotic stability.https://www.mdpi.com/1999-4923/15/12/2705<i>Pseudomonas aeruginosa</i>multidrug-resistant bacteriabeta lactamsstabilityoutpatient parenteral antimicrobial therapy |
| spellingShingle | Beatriz Fernández-Rubio Laura Herrera-Hidalgo Arístides de Alarcón Rafael Luque-Márquez Luis E. López-Cortés Sònia Luque José María Gutiérrez-Urbón Aurora Fernández-Polo Alicia Gutiérrez-Valencia María V. Gil-Navarro Stability Studies of Antipseudomonal Beta Lactam Agents for Outpatient Therapy Pharmaceutics <i>Pseudomonas aeruginosa</i> multidrug-resistant bacteria beta lactams stability outpatient parenteral antimicrobial therapy |
| title | Stability Studies of Antipseudomonal Beta Lactam Agents for Outpatient Therapy |
| title_full | Stability Studies of Antipseudomonal Beta Lactam Agents for Outpatient Therapy |
| title_fullStr | Stability Studies of Antipseudomonal Beta Lactam Agents for Outpatient Therapy |
| title_full_unstemmed | Stability Studies of Antipseudomonal Beta Lactam Agents for Outpatient Therapy |
| title_short | Stability Studies of Antipseudomonal Beta Lactam Agents for Outpatient Therapy |
| title_sort | stability studies of antipseudomonal beta lactam agents for outpatient therapy |
| topic | <i>Pseudomonas aeruginosa</i> multidrug-resistant bacteria beta lactams stability outpatient parenteral antimicrobial therapy |
| url | https://www.mdpi.com/1999-4923/15/12/2705 |
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