JAC Advance Access published online on February 11, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg134
© 2003 by The British Society for Antimicrobial Chemotherapy
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Original article
1 Unité de Pharmacologie Cellulaire et Moléculaire,
Université Catholique de Louvain,
UCL 73.70 avenue E. Mounier 73, B-1200 Brussels, Belgium
* Corresponding author. E-mail: tulkens{at}facm.ucl.ac.be.
Received 25 July 2002
; revised 19 October 2002
; accepted 24 December 2002
Cefepime has been examined for stability, potential
liberation of degradation products and compatibility with other
drugs under conditions mimicking its potential use by continuous infusion
in cystic fibrosis and intensive care patients (5-12% w/v
solutions; temperatures from 20 to 37°C;
1 h contact at 25°C with other drugs
frequently co-administered by intravenous route to these types of
patients). Ceftazidime was used as a comparator based on a previous
normative study with this antibiotic for the same indications. Based
on a limit of max. 10% degradation, cefepime can be considered
stable for a maximum of 24 h at 25°C,
but for only
Keywords: stability, continuous infusion, degradation,
compatibility
Stability and compatibility study of cefepime in
comparison with ceftazidime for potential administration by continuous
infusion under conditions pertinent to ambulatory treatment of cystic
fibrosis patients and to administration in intensive care units
14 h at 30°C,
and for <10 h at 37°C. Cefepime
released so far unidentified degradation products if maintained
at >30°C for >12 h
as shown from a marked increase in pH and from the development of
a strong red-purple colour. Incompatibilities were observed
with erythromycin, propofol, midazolam, phenytoin, piritramide,
theophylline, nicardipine, N-acetylcysteine and
a concentrated solution of dobutamine. We conclude that: (i) cefepime
cannot be used safely by continuous infusion if containers are kept
for more than a few hours at 37°C (as
will be the case for cystic fibrosis patients if using portable
pumps carried under clothes); (ii) caution must be exercised in intensive
care patients if the temperature and co-administration of other
drugs is not kept under tight control. The nature and safety of
the cefepime degradation products need to be studied further.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. Hubert, E. Le Roux, T. Lavrut, B. Wallaert, P. Scheid, D. Manach, D. Grenet, I. Sermet-Gaudelus, S. Ramel, C. Cracowski, et al. Continuous versus Intermittent Infusions of Ceftazidime for Treating Exacerbation of Cystic Fibrosis Antimicrob. Agents Chemother., September 1, 2009; 53(9): 3650 - 3656. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Bertsche, Y. Mayer, R. Stahl, T. Hoppe-Tichy, J. Encke, and W. E. Haefeli Prevention of intravenous drug incompatibilities in an intensive care unit Am. J. Health Syst. Pharm., October 1, 2008; 65(19): 1834 - 1840. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. De Jongh, R. Hens, V. Basma, J. W. Mouton, P. M. Tulkens, and S. Carryn Continuous versus intermittent infusion of temocillin, a directed spectrum penicillin for intensive care patients with nosocomial pneumonia: stability, compatibility, population pharmacokinetic studies and breakpoint selection J. Antimicrob. Chemother., February 1, 2008; 61(2): 382 - 388. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Arlicot, G. Y. Rochefort, D. Schlecht, F. Lamoureux, S. Marchand, and D. Antier Stability of Antibiotics in Portable Pumps Used for Bronchial Superinfection: Guidelines for Prescribers Pediatrics, December 1, 2007; 120(6): 1255 - 1259. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Huang and M. J. Rybak Pharmacodynamics of Cefepime Alone and in Combination with Various Antimicrobials against Methicillin-Resistant Staphylococcus aureus in an In Vitro Pharmacodynamic Infection Model Antimicrob. Agents Chemother., January 1, 2005; 49(1): 302 - 308. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Navas, J. Caillon, C. Gras-Le Guen, C. Jacqueline, M.-F. Kergueris, D. Bugnon, and G. Potel Comparison of in vivo intrinsic activity of cefepime and imipenem in a Pseudomonas aeruginosa rabbit endocarditis model: effect of combination with tobramycin simulating human serum pharmacokinetics J. Antimicrob. Chemother., October 1, 2004; 54(4): 767 - 771. [Abstract] [Full Text] [PDF]
|
|