title: Compatibility of ceftobiprole medocaril with selected drugs during simulated Y-site administration.
abstract: OBJECTIVE
  The physical compatibility of the new cephalosporin ceftobiprole medocaril with 70 other drugs during simulated Y-site injection was studied.
  
  
  METHODS
  Ceftobiprole was reconstituted with sterile water for injection. Dilutions of ceftobiprole 2 mg/mL (as ceftobiprole medocaril 2.67 mg/mL) were prepared in 5% dextrose injection, 0.9% sodium chloride injection, and lactated Ringer's injection. For testing compatibility with the other drugs, a 5-mL sample of the ceftobiprole 2-mg/mL admixtures was combined with a 5-mL sample of the other drug either undiluted or diluted with one of the three vehicles. Each combination was prepared in duplicate, switching the order of drug addition, and kept at room temperature. At intervals up to four hours after preparation, samples were examined visually and with the aid of a Tyndall beam and measured with a turbidimeter and a particle sizer and counter. Compatibility with propofol was evaluated by checking for emulsion separation and particles after centrifugation.
  
  
  RESULTS
  In all three vehicles, ceftobiprole was compatible with 31 other drugs and incompatible with 32. With 7 drugs, compatibility was dependent on the vehicle used. Signs of incompatibility included the presence of visible and subvisible particles, haze, and turbidity. No incompatibilities were related to the order of mixing.
  
  
  CONCLUSIONS
  Of the 70 drugs evaluated for compatibility with ceftobiprole 2 mg/ mL (as medocaril) in 5% dextrose injection, 0.9% sodium chloride injection, and lactated Ringer's injection, 31 were found to be compatible and 32 were found to be incompatible in all three of the infusion solutions. For 7 of the drugs, compatibility was dependent on which infusion solution was used. Ceftobiprole medocaril should not be simultaneously administered via a Y site with drugs with which it was shown to be incompatible.
authors.affiliation: Analytical Research Laboratories, Oklahoma City, OK, USA.
authors.forename: Pak
authors.initials: P
authors.lastname: Chan
authors.forename: Amanda
authors.initials: A
authors.lastname: Bishop
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Kupiec
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Trissel
authors.forename: Dilip
authors.initials: D
authors.lastname: Gole
authors.forename: Ilias M
authors.initials: IM
authors.lastname: Jimidar
authors.forename: Hans
authors.initials: H
authors.lastname: Vermeersch
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000737:chemistry*; D002511:Cephalosporins / Q000008:administration & dosage / Q000737:chemistry*; D004344:Drug Incompatibility; D005947:Glucose / Q000737:chemistry; D006801:Humans; D007262:Infusions, Intravenous; D007552:Isotonic Solutions / Q000737:chemistry; D010316:Particle Size; D014677:Pharmaceutical Vehicles / Q000737:chemistry; D000077331:Ringer's Solution; D012965:Sodium Chloride / Q000737:chemistry; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D007552:Isotonic Solutions; D014677:Pharmaceutical Vehicles; D012965:Sodium Chloride; C443755:ceftobiprole; D000077331:Ringer's Solution; D005947:Glucose