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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. 1The Hague Hospital Pharmacy, The Hague, The Netherlands
  2. 2Centre for Human Drug Research, Leiden, The Netherlands
  3. 3Department of Medical Microbiology, Haga Teaching Hospital, The Hague, The Netherlands
  4. 4Department of Pulmonology and Cystic Fibrosis, Haga Teaching Hospital, The Hague, The Netherlands
  5. 5Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  1. Correspondence to Titiaan E Post, Centre for Human Drug Research, Leiden, The Netherlands; 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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