Ceftazidime stability in elastomeric pumps
Portable infusion pumps are an interesting solution to continue outpatient parenteral antimicrobial therapy (OPAT) at the patient’s home. However, the use of ceftazidime for such applications is challenging in view of its relatively poor stability in solution. In this study, elastomeric infusion pumps with 6 or 7 g of ceftazidime were deflated over 24 h in an oven at 33°C while ceftazidime and its degradation product, pyridine, were regularly monitored. Hereto, a fast and sensitive liquid chromatographic (LC) method has been developed using a Kinetex® C18 (150 mm x 3 mm, 2.6 μm) column with gradient elution. Ammonium formate 20 mM and acetonitrile (ACN) were mixed in a ratio of 98:2 (v/v) for mobile phase A and 85:15 (v/v) for mobile phase B. Both were adjusted to pH 4.5 with formic acid. The flow rate was set at 0.4 mL/min. The solution with a starting dose of 6 g of ceftazidime was found to be degraded for 10% after an average of 19h11min so that an administration of 6 g to the patient was not reached. For the solution with a starting dose of 7 g of ceftazidime, 10% degradation was observed after an average of 18h42min. However, by starting from a higher dose, an average of 6.56 g of ceftazidime could be administered over 24 h. In addition, 1.0% of pyridine versus ceftazidime pentahydrate with sodium carbonate ( = mixture for injection) was formed over 24 h.
Nguyen T, Menten L, Spriet I, Quintens C, Van Schepdael A, Adams E. Liquid chromatographic method to follow up ceftazidime and pyridine in portable elastomeric infusion pumps over 24 hours. Electrophoresis. 2021 Nov 15. doi: 10.1002/elps.202100275. Epub ahead of print. PMID: 34780670.