Disturbance of Vancomycin Infusion Flow during Multidrug Infusion: Influence on Endothelial Cell Toxicity.

Autor: Drouet M; CHU Lille, ULR 7365-GRITA-Groupe de Recherche sur les Formes Injectables et les Technologies Associées, University Lille, F-59000 Lille, France., Cuvelier E; CHU Lille, ULR 7365-GRITA-Groupe de Recherche sur les Formes Injectables et les Technologies Associées, University Lille, F-59000 Lille, France.; CHU Lille, Institut de Pharmacie, F-59000 Lille, France., Chai F; Institut National de la Santé et de la Recherche Médicale (INSERM) U1008, University of Lille, UFR3S, 1 Place de Verdun, F-59000 Lille, France., Genay S; CHU Lille, ULR 7365-GRITA-Groupe de Recherche sur les Formes Injectables et les Technologies Associées, University Lille, F-59000 Lille, France.; CHU Lille, Institut de Pharmacie, F-59000 Lille, France., Odou P; CHU Lille, ULR 7365-GRITA-Groupe de Recherche sur les Formes Injectables et les Technologies Associées, University Lille, F-59000 Lille, France.; CHU Lille, Institut de Pharmacie, F-59000 Lille, France., Décaudin B; CHU Lille, ULR 7365-GRITA-Groupe de Recherche sur les Formes Injectables et les Technologies Associées, University Lille, F-59000 Lille, France.; CHU Lille, Institut de Pharmacie, F-59000 Lille, France.
Jazyk: angličtina
Zdroj: Antibiotics (Basel, Switzerland) [Antibiotics (Basel)] 2021 Dec 24; Vol. 11 (1). Date of Electronic Publication: 2021 Dec 24.
DOI: 10.3390/antibiotics11010016
Abstrakt: Background: Phlebitis is a common side effect of vancomycin peripheral intravenous (PIV) infusion. As only one PIV catheter is frequently used to deliver several drugs to hospitalized patients through the same Y-site, perturbation of the infusion flow by hydration or other IV medication may influence vancomycin exposure to endothelial cells and modulate toxicity.
Methods: We assessed the toxicity of variations in vancomycin concentration induced by drug mass flow variations in human umbilical vein endothelial cells (HUVECs), simulating a 24 h multi-infusion therapy on the same line. Results were expressed as the percentage of viable cells compared with a 100% control, and the Kruskal-Wallis test was used to assess the toxicity of vancomycin.
Results: Our results showed that variations in vancomycin concentration did not significantly influence local toxicity compared to a fixed concentration of vancomycin. Nevertheless, the loss of cell viability induced by mechanical trauma mimicking multidrug infusion could increase the risk of phlebitis.
Conclusion: To ensure that vancomycin-induced phlebitis must have other causes than variation in drug mass flow, further in vitro experiments should be performed to limit mechanical stress to frequent culture medium change.
Databáze: MEDLINE