TITLE: Intravenous Admixture for Antibiotics: Safety
DATE: 08 January 2009
RESEARCH QUESTION:
What is the evidence for the safety of using intravenous (IV) admixture to prepare intravenous
antibiotics?
METHODS:
A limited literature search was conducted on key health technology assessment resources,
including PubMed, the Cochrane Library (Issue 4, 2008), University of York Centre for Reviews
and Dissemination (CRD) databases, ECRI, EuroScan, international health technology
agencies, and a focused Internet search. Results include articles published between 2003 and
January 2009, and are limited to English language publications only. Filters were applied to limit
the retrieval to health technology assessments, systematic reviews, meta-analyses, guidelines,
randomized controlled trials, controlled clinical trials, and observational studies. Internet links
are provided, where available.
RESULTS:
HTIS reports are organized so that the higher quality evidence is presented first. Therefore,
health technology assessment reports, systematic reviews, and meta-analyses are presented
first. These are followed by randomized controlled trials, controlled clinical trials, observational
studies, and evidence-based guidelines.
The literature search did not identify any health technology assessments, systematic reviews,
meta-analyses, randomized controlled trials, or observational studies on the safety of using IV
admixture to prepare intravenous antibiotics. One controlled clinical trial and two guidelines
were identified, but these are not specific to intravenous antibiotics. Additional articles of
potential interest are included in the appendix.
Disclaimer: The Health Technology Inquiry Service (HTIS) is an information service for those involved in planning and providing
health care in Canada. HTIS responses are based on a limited literature search and are not comprehensive, systematic reviews.
The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts
within the time allowed. HTIS responses should be considered along with other types of information and health care considerations.
The information included in this response is not intended to replace professional medical advice, nor should it be construed as a
recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality
evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for
which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation
of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect.
CADTH is not liable for any loss or damages resulting from use of the information in the report.
Copyright: This report contains CADTH copyright material and may contain material in which a third party owns copyright. This
report may be used for the purposes of research or private study only. It may not be copied, posted on a web site,
redistributed by email or stored on an electronic system without the prior written permission of CADTH or applicable copyright
owner.
Links: This report may contain links to other information on available on the websites of third parties on the Internet. CADTH does
not have control over the content of such sites. Use of third party sites is governed by the owners’ own terms and conditions.
Health technology assessments
No literature identified.
Systematic reviews and meta-analyses
No literature identified.
Randomized controlled trials
No literature identified.
Controlled clinical trials
1.
Thomas M, Sanborn MD, Couldry R. I.V. admixture contamination rates: traditional
practice site versus a class 1000 cleanroom. Am J Health Syst Pharm
2005;62(22):2386-92. PubMed: PM16278330
Observational studies
No literature identified.
Guidelines and recommendations
2.
New Brunswick pharmaceutical society sterile compounding guidelines. Moncton (NB):
New Brunswick Pharmaceutical Society, 2004. Available:
http://www.nbpharmacists.ca/LinkClick.aspx?fileticket=xVMc54o3xnM%3D&tabid=261&
mid=695 (accessed 2009 Jan 5).
3.
Hospital standards of practice and guidelines on practice in hospital pharmacy. Winnipeg
(MB): Manitoba Pharmaceutical Association; 2004. Available:
http://www.napra.org/pdfs/provinces/mb/MPhA_Combined_SofP_July02_and_Guideline
s_on_Hospital_Pharmacy_04_v2.pdf (accessed 2009 Jan 5).
PREPARED BY:
Karen Cimon, Research Assistant
Jessie Cunningham, M.I.St., Information Specialist
Health Technology Inquiry Service
Email: [email protected]
Tel: 1-866-898-8439
IV Admixture for Antibiotics
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APPENDIX – FURTHER INFORMATION:
Observational studies
4.
Sunenshine RH, Tan ET, Terashita DM, Jensen BJ, Kacica MA, Sickbert-Bennett EE, et
al. A multistate outbreak of Serratia marcescens bloodstream infection associated with
contaminated intravenous magnesium sulfate from a compounding pharmacy. Clin Infect
Dis 2007;45(5):527-33. PubMed: PM17682984
5.
Yorioka K, Oie S, Oomaki M, Imamura A, Kamiya A. Particulate and microbial
contamination in in-use admixed intravenous infusions. Biol Pharm Bull
2006;29(11):2321-3. PubMed: PM17077539
Review articles
6.
Westwood M, Rodgers M, Sowden A. Patient safety: mapping the literature. Birmingham
(UK): University of Birmingham; 2008. Available:
http://www.pcpoh.bham.ac.uk/publichealth/psrp/documents/PS001_Final_Report_Westw
ood.pdf (accessed 2009 Jan 5). (see page 79)
Additional references
7.
Saginur M, Graham ID, Forster AJ, Boucher M, Wells GA. The uptake of technologies
designed to influence medication safety in Canadian hospitals. J Eval Clin Pract 2008
Feb;14(1):27-35. PubMed: PM18211640
8.
The King guide to parenteral admixtures. Napa (CA): King Guide Publications, Inc.;
2008. Available for purchase at: http://www.kingguide.com/ (accessed 2009 Jan 5).
9.
Lucas AJ. Improving medication safety in a neonatal intensive care unit. Am J Health
Syst Pharm 2004 Jan 1;61(1):33-7. PubMed: PM14725118
IV Admixture for Antibiotics
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