Intravenous tigecycline with selected multichamber bag parenteral nutrition: A compatibility study

Background: Tigecycline is widely used to treat infections in intensive care units. Drugs often need to be delivered to critically ill patients feeding by parenteral nutrition (PN). Before two preparations are administered in the same infusion line, the safety of this combination should be established. The objective of this study was to determine the compatibility of tigecycline with selected multichamber bag PN (MCB-PN). Methods: Tigecycline was diluted in 0.9% sodium chloride solution and 5% glucose solution to obtain two 0.5 mg/ml solutions. Then the solutions were combined with selected MCB-PN in appropriate proportions. The samples were visually assessed, and pH, osmolality, turbidity, particle size, and zeta potential were measured. These measurements were made immediately after combining the solutions and after 4 h of storage at 23 degrees C +/- 1 degrees C. Results: It was determined that the pH values of the mixtures after combining with tigecycline changed by <= 0.1 unit. An increase in zeta potential was recorded, excluding one combination of tigecycline with the mixture. For all samples tested, the particle size distribution was within the acceptable range immediately after combination and after 4 h of storage. The difference in osmolality did not exceed +/- 3%, whereas the zeta potential decreased for only one combination. The turbidity of none of the samples exceeded a critical value. Conclusion: The physical compatibility of the tigecycline with five MCB-PN was proved. They can therefore be administered to patients in one infusion line using the Y-site.