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Am J Health Syst Pharm

Receipt of supratherapeutic dalbavancin.

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Receipt of supratherapeutic dalbavancin.
Am J Health Syst Pharm. 2020 Jan 17;:
Authors: Mahoney MV, Padival S
PMID: 31950151 [PubMed – as supplied by publisher]

Comparison of linezolid and vancomycin lock solutions with and without heparin against biofilm-producing bacteria.

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Comparison of linezolid and vancomycin lock solutions with and without heparin against biofilm-producing bacteria.

Am J Health Syst Pharm. 2017 May 01;74(9):e193-e201

Authors: Luther MK, Mermel LA, LaPlante KL

Abstract
PURPOSE: The activity of linezolid and vancomycin lock solutions against biofilm-producing strains of Staphylococcus aureus, S. epidermidis, and Enterococcus faecalis was studied.
METHODS: Two strains each of methicillin-susceptible S. aureus (MSSA), methicillin-resistant S. aureus (MRSA), and S. epidermidis, and 1 strain of vancomycin-susceptible E. faecalis and vancomycin-resistant E. faecalis were tested against vancomycin and linezolid to assess prevention of biofilm formation and eradication of these pathogens within a formed biofilm. Activity was also tested in a 72-hour in vitro central venous catheter (CVC) model. After 24 hours of biofilm growth in a CVC, a lock solution containing vancomycin (2 or 5 mg/mL) or linezolid (1 or 2 mg/mL) alone or in combination with heparin sodium (5,000 units/mL with benzyl alcohol 0.45%) was instilled and incubated at 35 °C for 72 hr. Heparin and 0.9% sodium chloride injection were also tested.
RESULTS: Linezolid and vancomycin prevented biofilm formation below the minimum inhibitory concentration for 88% and 25% of isolates tested, respectively. The addition of preservative-containing heparin decreased the activity of vancomycin and linezolid lock solutions against all strains. Vancomycin 2- and 5-mg/mL lock solutions had the most activity against MSSA and E. faecalis strains (p < 0.01). Linezolid 2 mg/mL was the most active lock solution against the MRSA strains tested (p < 0.01). There were no significant differences in vancomycin or linezolid lock solution activity against S. epidermidis.
CONCLUSION: Heparin reduced activity of vancomycin and linezolid lock solutions against S. aureus, S. epidermidis, and E. faecalis biofilms. While linezolid or vancomycin lock solution reduced overall biofilm burden, it did not completely eradicate the bacteria at tested concentrations.

PMID: 28438824 [PubMed – in process]

Physical compatibility of ceftolozane-tazobactam with selected i.v. drugs during simulated Y-site administration.

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Physical compatibility of ceftolozane-tazobactam with selected i.v. drugs during simulated Y-site administration.

Am J Health Syst Pharm. 2017 Jan 01;74(1):e47-e54

Authors: Thabit AK, Hamada Y, Nicolau DP

Abstract
PURPOSE: Results of a study to examine the physical compatibility of ceftolozane-tazobactam with common i.v. medications during simulated Y-site administration are presented.
METHODS: Ceftolozane-tazobactam was reconstituted according to manufacturer recommendations and diluted with 0.9% sodium chloride or 5% dextrose to solutions containing 15 mg (10 mg of ceftolozane and 5 mg of tazobactam)/mL. All other i.v. drugs were prepared according to manufacturer recommendations and diluted with 0.9% sodium chloride or 5% dextrose to standard concentrations used clinically. Y-site administration was simulated by mixing ceftolozane-tazobactam solution with each tested drug solution at a 1:1 ratio. Solutions were inspected for visual, turbidity, and pH changes immediately and 15, 60, and 120 minutes after mixing. Incompatibility was defined as precipitation, color change, a positive Tyndall test, a change in turbidity of ≥0.5 nephelometric turbidity unit, or a change in pH of ≥1 unit during the 120-minute observation period.
RESULTS: Of the 95 i.v. drugs tested, ceftolozane-tazobactam was compatible with 86 drugs in both diluents; notably, it was compatible with metronidazole in both solutions. No substantial pH changes were observed in any tested combination. Ceftolozane-tazobactam was incompatible with albumin, amphotericin B, caspofungin, cyclosporine, nicardipine, and phenytoin sodium due to turbidity changes and with propofol due to formation of an oily layer.
CONCLUSION: Ceftolozane-tazobactam 15 mg (10 mg of ceftolozane and 5 mg of tazobactam)/mL was physically compatible with 86 of 95 study drugs tested in both 0.9% sodium chloride injection and 5% dextrose injection during simulated Y-site administration.

PMID: 28007721 [PubMed – in process]