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Colistin methanesulfonate infusion solutions are stable over time and suitable for home administration
  1. Titiaan E Post1,2,
  2. Ingrid M C Kamerling2,
  3. Richard C J M van Rossen1,
  4. Jacobus Burggraaf2,
  5. Jasper Stevens1,
  6. Anneke C Dijkmans2,3,
  7. Harry G M Heijerman4,
  8. Daan J Touw5,
  9. Annelies J van Velzen1,
  10. Erik B Wilms1
  1. 1 The Hague Hospital Pharmacy, The Hague, The Netherlands
  2. 2 Centre for Human Drug Research, Leiden, The Netherlands
  3. 3 Department of Medical Microbiology, Haga Teaching Hospital, The Hague, The Netherlands
  4. 4 Department of Pulmonology and Cystic Fibrosis, Haga Teaching Hospital, The Hague, The Netherlands
  5. 5 Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  1. Correspondence to Titiaan E Post; titiaanpost{at}gmail.com

Abstract

The stability of colistin methanesulfonate (CMS) was determined in quadruplicate in elastomeric home infusion pumps containing 1, 2 or 3 MU CMS and in infusion bags with 2 MU CMS all in 100 mL normal saline. Infusions were stored at room temperature (20°C–24°C) with or without exposure to natural light or refrigerated (4°C–8°C) and protected from light up to 2 weeks. In the initial solution of 2 MU CMS in 100 mL saline sampled immediately after reconstitution and dilution, 1.5% of CMS was hydrolysed to colistin. When stored at room temperature and exposed to natural light, colistin concentration in elastomeric infusion pumps increased to 2.6% in 8 days and to 2.1% when stored at 4°C. CMS stability increases at lower temperatures and higher concentrations. Based on the current data, chemical stability of CMS infusion solution is sufficient for a shelf life of 7 days refrigerated plus 1 day at room temperature.

  • IV administration
  • Cystic Fibrosis
  • Colistin methanesulfonate (CMS)
  • Colistin
  • Home administration
  • Infusion bags
  • Elastomeric infusion pums

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