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首页> 美国卫生研究院文献>Hospital Pharmacy >Y-site Incompatibility Between Premix Concentrations of Vancomycin and Piperacillin-Tazobactam: Do Current Compatibility Testing Methodologies Tell the Whole Story?
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Y-site Incompatibility Between Premix Concentrations of Vancomycin and Piperacillin-Tazobactam: Do Current Compatibility Testing Methodologies Tell the Whole Story?

机译：万古霉素和哌拉西林-他唑巴坦的预混物浓度之间的Y位不相容性：当前的相容性测试方法是否能说明整个问题？

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>Background: Published literature has demonstrated commercially available premix vancomycin (5 mg/mL) and piperacillin-tazobactam (67.5 mg/mL) as physically compatible via simulated Y-site methodology. Compatibility via actual Y-site infusion has yet to be established.>Objective: To assess and compare the compatibility of commercially available premix concentrations of vancomycin and piperacillin-tazobactam via simulated and actual Y-site evaluation.>Methods: Vancomycin and piperacillin-tazobactam were tested using simulated and actual Y-site infusion methodologies. Simulated Y-site compatibility was performed using previously published methods via visual inspection, turbidity evaluation, and pH evaluation. Evaluation occurred immediately, 60 minutes, 120 minutes, and 240 minutes following mixing for each mixture and control. Mixtures were considered physically incompatible if there was visual evidence of precipitation or haze, an absorbance value was greater than 0.01 A, or an absolute change of 1.0 pH unit occurred. Actual Y-site infusion was simulated to mirror antibiotic infusion in the clinical setting by nursing personnel using smart pumps and intravenous tubing.>Results: No evidence of physical incompatibility was observed during simulated Y-site testing via visual inspection, turbidity assessment, and pH evaluation. Conversely, physical incompatibility was observed to the unaided eye within 2 minutes during actual Y-site infusion.>Conclusions: Despite observed compatibility between vancomycin and piperacillin-tazobactam via simulated Y-site testing, visual evidence of physical incompatibility was observed during actual Y-site infusion. This poses a potential compromise to patient safety if these antibiotics are administered simultaneously in the clinical setting. Actual Y-site testing should be performed prior to clinical adoption of compatibility studies that are based solely on simulated methodologies.
机译：>背景：已发表的文献证明，通过模拟Y位点方法物理相容的市售预混万古霉素（5 mg / mL）和哌拉西林-他唑巴坦（67.5 mg / mL）具有物理相容性。 >目标：通过模拟和实际Y位置评估来评估和比较市售预混浓度的万古霉素和哌拉西林-他唑巴坦的兼容性。> >方法：使用模拟和实际Y位置输注方法对万古霉素和哌拉西林-他唑巴坦进行了测试。使用先前公布的方法，通过目视检查，浊度评估和pH评估，模拟了Y位点的相容性。每种混合物和对照混合后立即，60分钟，120分钟和240分钟进行评估。如果有肉眼观察到沉淀或混浊，吸光度值大于0.01 A或发生1.0 pH单位的绝对变化，则认为混合物在物理上不相容。护理人员使用智能泵和静脉输液管模拟了实际的Y部位输注，以反映临床情况下的抗生素输注。>结果：在通过肉眼检查进行的模拟Y部位测试中，未观察到物理不相容的证据，浊度评估和pH评估。相反，在实际的Y部位输注过程中，在2分钟内肉眼观察到身体不相容。>结论：尽管通过模拟的Y部位测试观察到万古霉素和哌拉西林-他唑巴坦具有相容性，但视觉证据表明身体不相容在实际的Y部位输注过程中观察到。如果在临床环境中同时使用这些抗生素，可能会对患者的安全造成危害。实际的Y现场测试应在临床采用兼容性研究之前进行，该研究仅基于模拟方法。

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