| Autor: |
Vincentelli, J., Braguer, D., Guillet, P., Delorme, J., Carles, G., Perez, R., Duffaud, F., Nicoara, A., Drancourt, M., Favre, R., Crevat, A. |
| Zdroj: |
Journal of Oncology Pharmacy Practice; March 1997, Vol. 3 Issue: 1 p18-23, 6p |
| Abstrakt: |
Introduction:Because of the increased use of im plantable access systems, the incidence of blood stream and catheter infections associated with these systems has concomitantly increased. Classically, he parin-lock flush solutions were used to prevent thrombosis; more recently, vancomycin was added to the solution to prevent infections caused by Gram- positive bacteria, particularly coagulase-negative Staphylococci. Disorders due to Gram-negative organ isms have now appeared in oncologic patients. We therefore tested the addition of colistin to heparin- vancomycin solutions. Colistin was chosen for its good activity against Gram-negative bacteria (98% susceptibility in our hospital), its good tolerance due to low systemic passage, and its low cost.Methods:We developed formulations contain ing heparin (100 IU/mL) and various concentrations of vancomycin (10-500 μg/mL) and colistin (10-100 μg/mL) in 0.9% NaCl. Each sterile solution was tested for physical and chemical compatibility (spectropho tometry, nuclear magnetic resonance, and pH mea surements) and its antibacterial activity (against ox acillin-resistant Staphylococcusaureus, Enterococcus faecium,Klebsiella pneumoniaeexhibiting broad- spectrum betalactamase (BSBL), imipenem-resistant Pseudomonas aeruginosa)for 2 months at 4°C and at room temperature.Results:The most suitable combination of drugs is heparin (100 IU/mL), vancomycin (100 μg/mL), and colistin (100 μg/mL). This flush solution main tains activity when stored at 4°C for up to 1 month.Conclusions:We feel that the combination of heparin, vancomycin, and colistin can be used as a flush solution for indwelling catheters. |
| Databáze: |
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