2. Academic Validation
  3. Stability Studies of Antipseudomonal Beta Lactam Agents for Outpatient Therapy

Stability Studies of Antipseudomonal Beta Lactam Agents for Outpatient Therapy

  • Pharmaceutics. 2023 Nov 30;15(12):2705. doi: 10.3390/pharmaceutics15122705.
Beatriz Fernández-Rubio 1,  Laura Herrera-Hidalgo 1 2 3,  Arístides de Alarcón 2 3,  Rafael Luque-Márquez 2 3,  Luis E López-Cortés 3 4,  Sònia Luque 3 5 6,  José María Gutiérrez-Urbón 7,  Aurora Fernández-Polo 8,  Alicia Gutiérrez-Valencia 2,  María V Gil-Navarro 1 2 3
Affiliations

Affiliations

  • 1 Unidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, Spain.
  • 2 Unidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Parasitologia, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, Spain.
  • 3 Centro de Investigación en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, 28029 Madrid, Spain.
  • 4 Infectious Diseases and Microbiology Clinical Unit, University Hospital Virgen Macarena/Department of Medicine, School of Medicine, University of Sevilla/Biomedicine Institute of Sevilla (IBiS)/CSIC, 41009 Seville, Spain.
  • 5 Pharmacy Department, Hospital del Mar, Parc de Salut Mar, 08003 Barcelona, Spain.
  • 6 Infectious Pathology and Antimicrobials Research Group (IPAR), Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain.
  • 7 Unidad de Gestión Clínica de Farmacia, Complexo Hospitalario Universitario de A Coruña, 15006 A Coruña, Spain.
  • 8 Unidad de Gestión Clínica de Farmacia, Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, 08035 Barcelona, Spain.
PMID: 38140046 DOI: 10.3390/pharmaceutics15122705
Abstract

Outpatient parenteral antimicrobial therapy (OPAT) is a useful treatment strategy against Pseudomonas aeruginosa 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.

Keywords

Pseudomonas aeruginosa; beta lactams; multidrug-resistant bacteria; outpatient parenteral antimicrobial therapy; stability.

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