Stability of aztreonam in a portable pump reservoir used for home intravenous antibiotic treatment (HIVAT)

Abstract

The stability of the monocyclic β-lactam antibiotic aztreonam in portable pump reservoirs was studied during storage at temperatures of-20°C and +5°C and during drug delivery at 37°C. Three 100-ml drug reservoirs and three glass containers containing 60 mg/ml aztreonam were stored at-20°C and 2-ml samples were analysed in the freshly prepared solution and after thawing at days 7, 21, 28, 70 and after 6 months of storage. A separate triplicate batch of 100-ml prefilled drug reservoirs and glass containers containing a similar aztreonam concentration (60 mg/ml) were refrigerated and tested immediately after preparation and daily for 8 days and after 70 days. Solutions of aztreonam in duplicate freshly prepared reservoirs were tested for stability when the solution was pumped at 37°C over a 24-h period. All solutions were inspected for visual changes and tested for pH. Drug concentration was analysed by high-performance liquid chromatography. No colour changes or pH differences were observed in any of the solutions in the reservoirs or containers. No statistically significant decrease in aztreonam concentration could be detected after 6 months of storage at-20°C. Aztreonam was stable at 5°C for at least 8 days. A 24-h pumping period at 37°C showed a 3.6% decrease in aztreonam concentration. Aztreonam at a concentration of 60 mg/ml in a pump reservoir is sufficiently stable to be used in home intravenous antibiotic treatment programmes.