title: Stability and compatibility of teicoplanin in parenteral nutrition solutions used in pediatrics.
abstract: OBJECTIVE
  To investigate teicoplanin added to pediatric parenteral nutrition solutions in terms of its stability, its compatibility with parenteral nutrition solution components, and its diffusion through an antibacterial filter material.
  
  
  METHODS
  Three binary solutions with and without teicoplanin were studied. Different solution compositions and teicoplanin concentrations were used: A (98.3 +/- 8.2 mg/l), B (116.3 +/- 12.4 mg/l), and C (162.7 +/- 16.2 mg/l). Concentrations of teicoplanin and of solution components, osmolality, and pH of each solution were measured at H0, after 24 h at room temperature, after 24 h at +4 degrees C followed by 24 h at room temperature, and after 144 h at +4 degrees C followed by 24 h at room temperature (H168). Teicoplanin concentrations were also measured before and after passage of each solution through a 0.22 micro filter.
  
  
  RESULTS
  Teicoplanin concentrations remained unchanged from H0 to H168 in solutions A (99.6 +/- 8.3 mg/l), B (116.9 +/- 12. 3 mg/l), and C (162.4+12.9 mg/l). During the H0-H168 interval, iron and methionine were the only components that showed significant decreases, which were similar in solutions without teicoplanin [iron, -6.1% (A), -6.8% (B), and -4.5% (C); methionine, -7.3% (A) and -8. 7% (B)] and in those with teicoplanin [iron, -6.2% (A), -7.1% (B), and -4.0% (C, nonsignificant); methionine, -10.5% (A) and -10.7% (B)], indicating that they were not dependent on the presence of teicoplanin. Teicoplanin levels after filtration were identical to prefiltration values in solutions A (86.4 +/- 5.0 vs 89.8 +/- 3.4 mg/l) and B (112.6 +/- 4.3 vs 115.3 +/- 9.0 mg/l) but were 10.0% lower in solution C (161.6 +/- 3.9 vs 145.4 +/- 4.0; P << 0.001).
  
  
  CONCLUSIONS
  Teicoplanin can be added to pediatric parenteral nutrition solutions to treat central venous catheter-related infections due to teicoplanin-susceptible organisms since its concentrations and those of solution components remain stable over time.
authors.affiliation: Pediatric Gastroenterology and Nutrition Department, Armand-Trousseau Hospital, Paris, 75012, France.
authors.forename: P
authors.initials: P
authors.lastname: Tounian
authors.forename: F
authors.initials: F
authors.lastname: Jehl
authors.forename: S
authors.initials: S
authors.lastname: Pauliat
authors.forename: G
authors.initials: G
authors.lastname: Morgant
authors.forename: L
authors.initials: L
authors.lastname: Ghirardi
authors.forename: M A
authors.initials: MA
authors.lastname: Selva
authors.forename: J L
authors.initials: JL
authors.lastname: Fontaine
authors.forename: P
authors.initials: P
authors.lastname: Aymard
authors.forename: J P
authors.initials: JP
authors.lastname: Girardet
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000737:chemistry*; D002648:Child; D004344:Drug Incompatibility; D004355:Drug Stability; D005374:Filtration; D005526:Food, Formulated / Q000032:analysis* / Q000592:standards; D006801:Humans; D007262:Infusions, Intravenous; D010288:Parenteral Nutrition; D010372:Pediatrics / Q000379:methods; D017334:Teicoplanin / Q000008:administration & dosage / Q000737:chemistry*; D013696:Temperature
chemical_list: D000900:Anti-Bacterial Agents; D017334:Teicoplanin