title: Compatibility of ceftaroline fosamil for injection with selected drugs during simulated Y-site administration.
abstract: OBJECTIVE
  The physical compatibility of ceftaroline fosamil with commonly used medications and diluents (a total of 73 drugs in 219 admixtures) during simulated Y-site administration was evaluated.
  
  
  METHODS
  Duplicate 5-mL samples of ceftaroline fosamil (2.22 mg/mL) in 5% dextrose injection, 0.9% sodium chloride injection, and lactated Ringer's injection were combined at a 1:1 ratio with samples of 73 drugs (diluted or undiluted). Visual examinations were performed with the unaided eye in fluorescent light and with the aid of a Tyndall beam; the turbidity and particulate content of each sample were also measured. The compatibility of ceftaroline fosamil with propofol was evaluated by visually inspecting for emulsion separation and particle formation after centrifugation. All evaluations were performed within 15 minutes of sample preparation and at one and four hours after preparation.
  
  
  RESULTS
  Ceftaroline fosamil was physically compatible with 64 drugs in a combination of 196 admixtures for at least four hours, exhibiting color, clarity, turbidity, and microparticle content similar to those of control solutions. Signs of physical incompatibility, including visible precipitation, increased turbidity, and microparticle formation, were observed with 9 drugs in 23 admixtures during the four-hour observation period.
  
  
  CONCLUSIONS
  Of the 73 drugs evaluated, 64 were compatible and 7 were incompatible with ceftaroline fosamil 2.22 mg/mL in 3 standard infusion solutions. Nine drugs in 23 admixtures were observed to exhibit signs of incompatibility with ceftaroline fosamil within four hours of mixing; those drugs should not be simultaneously administered via a Y-site with ceftaroline preparations.
authors: Forest Research Institute, 49 Mall Drive, Commack, NY 11725, USA. brahma.singh@frx.com
authors: Brahma N
authors: BN
authors: Singh
authors: Mahendra G
authors: MG
authors: Dedhiya
authors: James
authors: J
authors: DiNunzio
authors: Pak
authors: P
authors: Chan
authors: Thomas C
authors: TC
authors: Kupiec
authors: Lawrence A
authors: LA
authors: Trissel
authors: Joseph B
authors: JB
authors: Laudano
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000737:chemistry; D002511:Cephalosporins / Q000008:administration & dosage* / Q000737:chemistry; D003198:Computer Simulation; D004344:Drug Incompatibility; D005950:Glucose Solution, Hypertonic; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D007552:Isotonic Solutions; D000077331:Ringer's Solution; D012462:Saline Solution, Hypertonic; D000097583:Ceftaroline
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D005950:Glucose Solution, Hypertonic; D007552:Isotonic Solutions; D000077331:Ringer's Solution; D012462:Saline Solution, Hypertonic; D000097583:Ceftaroline