Abstract
Background:
Piperacillin/tazobactam, an intravenous broad-spectrum antibiotic commonly used in the hospital setting, has recently been reformulated with edetate disodium dehydrate (EDTA) and sodium citrate due to new guidelines on particulate standards. This reformulation is now compatible with lactated Ringer's solution and certain aminoglycosides.
Objective:
To determine the time required for pharmacy technicians to reconstitute the reformulated piperacillin/tazobactam solution compared with the original and European (Vial X) formulations.
Methods:
This study was conducted in an intravenous preparation room using a time–motion design. Each of 5 pharmacy technicians, who were blinded to the formulation, repeated the reconstitution process 6 times for a total of 30 observations of each strength within each formulation. Each piperacillin/tazobactam vial was reconstituted individually. Labor costs were calculated using the 2005 US hourly wage for pharmacy technicians.
Results:
Reconstitution times did not differ between formulations for the 3.375 g vial (mean ± SE, 4.15 ± 0.26 min for original vs 4.92 ± 0.58 min for EDTA formulations; p = 0.112). However, formulations containing EDTA went into solution more rapidly at the 4.5 g strength (4.41 ± 0.33 min vs 6.79 ± 0.61 min; p < 0.001) and did not differ from the Vial X formulation (4.12 ± 0.23 min; p = 0.781). The large 40.5 g pharmacy bulk vial was tested only with the EDTA formulation, which required 5.58 ± 0.41 minutes to reconstitute.
Conclusions:
Based on these timings, the labor costs associated with reconstituting a single vial of each strength is approximately $1 per vial, regardless of which formulation is used. Reformulated piperacillin/tazobactam containing EDTA and sodium citrate will go into solution at least as quickly as the original formulation.
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