Stability and compatibility of Teicoplanin in parenteral nutrition solutions used in pediatrics

• Published in: Clinical nutrition (Edinburgh, Scotland) Scotland), 1999-06, Vol.18 (3), p.159-165
• Main Authors: Tounian, P., Jehl, F., Morgant, G., Ghirardi, L., Selva, M.A., Fontaine, J.L., Aymard, P., Girardet, J.P.
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - chemistry; antiobiotics; Biological and medical sciences; central venous catheter; Child; Drug Incompatibility; Drug Stability; Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition; Filtration; Food, Formulated - analysis; Food, Formulated - standards; Humans; Infusions, Intravenous; Intensive care medicine; Medical sciences; Parenteral Nutrition; Pediatrics - methods; sepsis; stability; teicoplania; Teicoplanin - administration & dosage; Teicoplanin - chemistry; Temperature
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1016/S0261-5614(99)80006-5

To investigate toicoplanin added to pediatric parenteral nutrition solutions in terms of its stability, its compatibility with parenteral nutrition solution components, and its diffusion through an antibacterial filter material. Three binary solutions with and without teicoplanin were studied. Different solution compositions and teicoplanin concentrations were used: A (98.3 ± 8.2 mg/l), B (118.3 ± 12.4 mg/l), and C (162.7 ± 16.2 mg/l). Concentrations of teicoplanin and of solution components, osmolality, and pH of each solution were measured at H0, after 24h at room temperature, after 24 h at +4°C followed by 24 h at room temperature, and after 144 h at +4°C followed by 24 h at room temperature (H168). Teicoplanin concentrations were also measured before and after passage of each solution through a 0.22 μ filter. Teicoplanin concentrations remained unchanged from H0 to H168 in solutionsA (99.6 ± 8.3 mg/l), B (116.9 ± 12.3 mg/l), and C (162.4 + 12.9 mg/l). During the H0-H1G8 interval, iron and methionine were the only components that showed significant decreases, which were similar in solutions without teicoplanin [iron, −6.1% (A), −6.8% (B), and −4.5% (C); methionine, −7.3% (A) and −8.7% (13)] and in those with teicoplanin [iron, −6.2% (A), −7.1% (B), and −4.0% (C, nonsignificant); methionine −10.5% (A) −10.7% (B)], indicating that they were not dependent on the presence of teicoplanin. Teicoplanin levels after filtration were identical to prefiltration values in solutions A (86.4 ± 5.0 vs 89.8 ± 5.0 vs 89.8 ± 3.4 mg/l) and B (112.6 ± 4.3 vs 115.3 ± 9.0 mg/l) but were l0.0% lower in solution C (161.6 ± 3.9 vs 145.4 ± 4.0; P < 0.001). Teicoplanin can be added to pediatric parenteral nutrition solutions to treat central venouscatheter-related infections due to teicoplanin-susceptible organisms since its concentrations and those of solution components remain stable over time.