Stability of Antimicrobials in Elastomeric Pumps: A Systematic Review
Beatriz Fernández-Rubio,
Paula del Valle-Moreno,
Laura Herrera-Hidalgo,
Alicia Gutiérrez-Valencia,
Rafael Luque-Márquez,
Luis E. López-Cortés,
José María Gutiérrez-Urbón,
Sonia Luque-Pardos,
Aurora Fernández-Polo,
María V. Gil-Navarro
Affiliations
Beatriz Fernández-Rubio
Unidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío, 41013 Seville, Spain
Paula del Valle-Moreno
Unidad de Gestión Clínica de Farmacia, Hospital Universitario Virgen del Rocío, 41013 Seville, Spain
Laura Herrera-Hidalgo
Unidad de Gestión Clínica de Farmacia, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, 41013 Seville, Spain
Alicia Gutiérrez-Valencia
Infección por el VIH y Farmacocinética de Antivirals, Instituto de Biomedicina de Sevilla (IBiS), 41013 Seville, Spain
Rafael Luque-Márquez
Unidad de Gestión Clinica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, 41013 Seville, Spain
Luis E. López-Cortés
Unidad de Gestión Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen Macarena/CSIC/, 41013 Seville, Spain
José María Gutiérrez-Urbón
Unidad de Gestión Clínica de Farmacia, Complexo Hospitalario Universitario de A Coruña, 15006 A Coruna, Spain
Sonia Luque-Pardos
Unidad de Gestión Clínica de Farmacia, Hospital del Mar, 08003 Barcelona, Spain
Aurora Fernández-Polo
Servicio de Farmacia, Proa-NEN, Hospital Infantil, Vall d’Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
María V. Gil-Navarro
Unidad de Gestión Clínica de Farmacia, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, 41013 Seville, Spain
Outpatient parenteral antimicrobial therapy (OPAThttp) programs have become an important healthcare tool around the world. Portable elastomeric infusion pumps are functional devices for ambulatory delivery of antimicrobial drugs, and their stability is an essential point to guarantee an appropriate infusion administration. We conducted a systematic review to provide a synthesis and a critical evaluation of the current evidence regarding antimicrobial stability in elastomeric pumps. Data sources were PubMed, EMBASE, and Web of Sciences. The review protocol was registered on the Center for Open Science, and it was carried out following the PRISMA guidelines. Studies were eligible if the aim was the evaluation of the physicochemical stability of an antimicrobial agent stored in an elastomeric device. Of the 613 papers identified, 33 met the inclusion criteria. The most studied group of antimicrobials was penicillins, followed by cephalosporins and carbapenems. In general, the stability results of the antimicrobials that have been studied in more than one article agree with each other, with the exception of ampicillin, flucloxacillin, and ceftazidime. The antibiotics that displayed a longer stability were glycopeptides and clindamycin. Regarding the stability of antifungals and antivirals, only caspofungin, voriconazole, and ganciclovir have been investigated. The information provided in this article should be considered in patient treatments within the OPAT setting. Further stability studies are needed to confirm the appropriate use of the antimicrobials included in this program to ensure optimal patient outcomes.
