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Evaluation of the stability of aciclovir in elastomeric infusion devices used for outpatient parenteral antimicrobial therapy.
Sime, Fekade Bruck; Wallis, Steven; Jamieson, Conor; Hills, Tim; Gilchrist, Mark; Santillo, Mark; Seaton, R Andrew; Drummond, Felicity; Roberts, Jason.
Afiliación
  • Sime FB; University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia f.sime@uq.edu.au.
  • Wallis S; University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia.
  • Jamieson C; NHS England, Birmingham, UK.
  • Hills T; Pharmacy Department, Nottingham University Hospitals, Nottingham, UK.
  • Gilchrist M; Department of Pharmacy/Infection, Imperial College Healthcare NHS Trust, London, UK.
  • Santillo M; University Hospitals Plymouth NHS Trust, Plymouth, UK.
  • Seaton RA; University Hospitals Bristol and Weston NHS Trust, Bristol, UK.
  • Drummond F; Department of Infectious Diseases, Queen Elizabeth University Hospital, Glasgow, UK.
  • Roberts J; British Society for Antimicrobial Chemotherapy, Birmingham, UK.
Eur J Hosp Pharm ; 2024 Feb 06.
Article en En | MEDLINE | ID: mdl-38071555
OBJECTIVES: To investigate the stability of aciclovir solutions in elastomeric devices used for outpatient parenteral antimicrobial therapy (OPAT). METHODS: Triplicates of two elastomeric devices, Accufuser and Easypump II, were filled with a solution of 200 mg, 2400 mg, and 4500 mg aciclovir in 240 mL 0.9% w/v saline. Devices were stored at room temperature for 14 days, followed by 24 hours storage at 32°C. Assessment using a stability indicating assay, pH and subvisible particle analysis was undertaken at 11 time points throughout the study. RESULTS: Aciclovir solution at 200 mg and 2400 mg in 240 mL was stable for 14 days at room temperature (<20°C) and 24 hours of 32°C 'in-use' temperature exposure, remaining above the 95% limit for NHS stability protocols. The high dose was also stable for 14 days at room temperature, but when stored at 32°C there was precipitation of aciclovir within 4 hours in both devices. The precipitate was confirmed as aciclovir and precipitation was not a sign of chemical degradation. CONCLUSIONS: Aciclovir concentrations above 2400 mg/240 mL are liable to precipitation and cannot be recommended for OPAT services because of heightened risks of nephrotoxicity. Aciclovir solution can be given as a continuous 24-hour infusion for OPAT services at a concentration range of 200-2400 mg in 240 mL in Accufuser and Easypump II elastomeric devices following 14 days storage at room temperature, protected from light.

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur J Hosp Pharm Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur J Hosp Pharm Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido