{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:53:39Z","timestamp":1791237219846,"version":"4.1.0"},"reference-count":41,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T00:00:00Z","timestamp":1724025600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Bacterial respiratory tract infections (e.g., in patients with cystic fibrosis) may be treated with the intravenous infusion of a piperacillin\/tazobactam (P\/T) solution through an elastomeric device. In the present work, we combined a 24-h drug stability study with an assessment of the drug solution flow rate during an in vitro simulated infusion. Experiments were performed in triplicate with two excipient-free generic P\/T solutions and an excipient-containing proprietary P\/T solution in saline (all 50\/6.25 mg\/mL) released from an elastomeric infusion device at 32 \u00b0C. The P\/T solutions\u2019 stability was assessed by an HPLC-UV assay, pH and osmolality measurements, a visual assessment, and particle counting. Before these analyses, a forced degradation study was performed. To assess the flow rate, a precision scale was used to weigh the solution collected at the infusion line outlet. The stability criteria were &lt;10% degradation and a flow rate within \u00b1 15% of the nominal value over the 24-h infusion period: all three P\/T solutions were found to be stable. The actual flow rate was lower than the expected flow rate; this difference was probably due to the drug solution\u2019s high viscosity and must be taken into account in clinical use.<\/jats:p>","DOI":"10.3390\/ph17081085","type":"journal-article","created":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T07:37:21Z","timestamp":1724053041000},"page":"1085","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Infusion of Piperacillin\/Tazobactam with an Elastomeric Device: A Combined 24-H Stability Study and Drug Solution Flow Rate Analysis"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9879-5347","authenticated-orcid":false,"given":"Laura","family":"N\u00e9grier","sequence":"first","affiliation":[{"name":"Univ. Lille, CHU Lille, ULR 7365\u2014GRITA\u2014Groupe de Recherche sur les formes Injectables et les Technologies Associ\u00e9es, F-59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0089-5284","authenticated-orcid":false,"given":"Anthony Martin","family":"Mena","sequence":"additional","affiliation":[{"name":"Univ. Lille, CHU Lille, ULR 7365\u2014GRITA\u2014Groupe de Recherche sur les formes Injectables et les Technologies Associ\u00e9es, F-59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Dupont","sequence":"additional","affiliation":[{"name":"H\u00f4pital Universitaire Cochin, Assistance Publique\u2014H\u00f4pitaux de Paris, 75014, France\u2014GIFAV\u2014Groupe Interdisciplinaire Francophone sur les Acc\u00e8s Vasculaires, 75014 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phil\u00e9mon","family":"Gamache","sequence":"additional","affiliation":[{"name":"Univ. Lille, CHU Lille, ULR 7365\u2014GRITA\u2014Groupe de Recherche sur les formes Injectables et les Technologies Associ\u00e9es, F-59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne-Olive","family":"Zimbril","sequence":"additional","affiliation":[{"name":"Univ. Lille, CHU Lille, ULR 7365\u2014GRITA\u2014Groupe de Recherche sur les formes Injectables et les Technologies Associ\u00e9es, F-59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmine","family":"Abdoune","sequence":"additional","affiliation":[{"name":"Univ. Lille, CHU Lille, ULR 7365\u2014GRITA\u2014Groupe de Recherche sur les formes Injectables et les Technologies Associ\u00e9es, F-59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9037-8490","authenticated-orcid":false,"given":"Youness","family":"Karrout","sequence":"additional","affiliation":[{"name":"Univ. Lille, INSERM, CHU Lille, U1008, F-59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Odou","sequence":"additional","affiliation":[{"name":"Univ. Lille, CHU Lille, ULR 7365\u2014GRITA\u2014Groupe de Recherche sur les formes Injectables et les Technologies Associ\u00e9es, F-59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3153-8538","authenticated-orcid":false,"given":"St\u00e9phanie","family":"Genay","sequence":"additional","affiliation":[{"name":"Univ. Lille, CHU Lille, ULR 7365\u2014GRITA\u2014Groupe de Recherche sur les formes Injectables et les Technologies Associ\u00e9es, F-59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8267-5594","authenticated-orcid":false,"given":"Bertrand","family":"D\u00e9caudin","sequence":"additional","affiliation":[{"name":"Univ. Lille, CHU Lille, ULR 7365\u2014GRITA\u2014Groupe de Recherche sur les formes Injectables et les Technologies Associ\u00e9es, F-59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1136\/ejhpharm-2020-002340","article-title":"Assessment of the Stability of Citrate-Buffered Piperacillin\/Tazobactam for Continuous Infusion When Stored in Two Commercially Available Elastomeric Devices for Outpatient Parenteral Antimicrobial Chemotherapy: A Study Compliant with the NHS Yellow Cover Document Requirements","volume":"29","author":"Jamieson","year":"2022","journal-title":"Eur. J. Hosp. Pharm."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Loeuille, G., D\u2019Huart, E., Vigneron, J., Nisse, Y.-E., Beiler, B., Polo, C., Ayari, G., Sacrez, M., Demor\u00e9, B., and Charmillon, A. (2022). Stability Studies of 16 Antibiotics for Continuous Infusion in Intensive Care Units and for Performing Outpatient Parenteral Antimicrobial Therapy. Antibiotics, 11.","DOI":"10.3390\/antibiotics11040458"},{"key":"ref_3","unstructured":"(2022, July 26). Base de donn\u00e9es publique des m\u00e9dicaments Summary of Product Characteristics- Pip\u00e9racilline\/Tazobactam VIATRIS 4 g\/0.5 g, Powder for Solution for Infusion. Available online: https:\/\/base-donnees-publique.medicaments.gouv.fr\/affichageDoc.php?specid=61008378&typedoc=R."},{"key":"ref_4","unstructured":"(2024, August 01). Monographie-Piperacillin Sodium\/Tazobactam-Stabilis 4.0. Available online: https:\/\/www.stabilis.org\/Monographie.php?IdMolecule=215."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"139","DOI":"10.2515\/therapie:2006031","article-title":"Traitement Des Surinfections Bronchiques: Stabilit\u00e9 Des Antibiotiques Dans Les Diffuseurs Portatifs","volume":"61","author":"Calbiac","year":"2006","journal-title":"Therapies"},{"key":"ref_6","unstructured":"(2024, May 22). Commission d\u2019\u00e9valuation des Produits et Prestations, Haute Autorit\u00e9 de Sant\u00e9 Avis de la Commission du 21 mai 2003: Diffuseurs Portables. Available online: https:\/\/www.has-sante.fr\/jcms\/c_398549\/fr\/diffuseurs-portables."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"71","DOI":"10.2147\/MDER.S18633","article-title":"Mechanical Performances of Elastomers Used in Diffusers","volume":"4","author":"Guiffant","year":"2011","journal-title":"Med. Devices"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez-Rubio, B., Del Valle-Moreno, P., Herrera-Hidalgo, L., Guti\u00e9rrez-Valencia, A., Luque-M\u00e1rquez, R., L\u00f3pez-Cort\u00e9s, L.E., Guti\u00e9rrez-Urb\u00f3n, J.M., Luque-Pardos, S., Fern\u00e1ndez-Polo, A., and Gil-Navarro, M.V. (2021). Stability of Antimicrobials in Elastomeric Pumps: A Systematic Review. Antibiotics, 11.","DOI":"10.3390\/antibiotics11010045"},{"key":"ref_9","unstructured":"Baxter (2024). Baxter Elastomeric Pumps: Technical Guide 2019, Baxter."},{"key":"ref_10","unstructured":"Vygon (2018). Elastomeric Brochure of Accufuser, Vygon."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Song, W., Zhong, F., Calautit, J.K., and Li, J. (2024). Exploring the Role of Skin Temperature in Thermal Sensation and Thermal Comfort: A Comprehensive Review. Energy Built Environ.","DOI":"10.1016\/j.enbenv.2024.03.002"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40780-020-00185-5","article-title":"Impact of Air Temperature and Drug Concentration on Liquid Emission from Elastomeric Pumps","volume":"7","author":"Abe","year":"2021","journal-title":"J. Pharm. Health Care Sci."},{"key":"ref_13","first-page":"A70","article-title":"4CPS-049 Underdosing with High Dose Piperacillin\/Tazobactam Administered via Continuous Infusion in Outpatient Parenteral Antimicrobial Therapy: A Stability or Viscosity Problem?","volume":"27","author":"Quintens","year":"2020","journal-title":"Eur. J. Hosp. Pharm."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.ijid.2020.11.176","article-title":"Stability of Antimicrobial Agents in an Elastomeric Infusion Pump Used for Outpatient Parenteral Antimicrobial Therapy","volume":"103","author":"Akahane","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2849","DOI":"10.1128\/AAC.02637-13","article-title":"How To Minimize Toxic Exposure to Pyridine during Continuous Infusion of Ceftazidime in Patients with Cystic Fibrosis?","volume":"58","author":"Bourget","year":"2014","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1136\/ejhpharm-2021-002729","article-title":"Systematic Review of the Stability of Antimicrobial Agents in Elastomeric Devices for Outpatient Parenteral Antimicrobial Therapy Services Based on NHS Yellow Cover Document Standards","volume":"29","author":"Jenkins","year":"2022","journal-title":"Eur. J. Hosp. Pharm."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.medmal.2020.10.019","article-title":"Home Intravenous Antibiotherapy and the Proper Use of Elastomeric Pumps: Systematic Review of the Literature and Proposals for Improved Use","volume":"51","author":"Diamantis","year":"2021","journal-title":"Infect. Dis. Now"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2327","DOI":"10.1128\/AAC.46.8.2327-2332.2002","article-title":"Comparative Stability Studies of Antipseudomonal Beta-Lactams for Potential Administration through Portable Elastomeric Pumps (Home Therapy for Cystic Fibrosis Patients) and Motor-Operated Syringes (Intensive Care Units)","volume":"46","author":"Viaene","year":"2002","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1093\/jac\/dkw582","article-title":"Antibiotic Stability Related to Temperature Variations in Elastomeric Pumps Used for Outpatient Parenteral Antimicrobial Therapy (OPAT)","volume":"72","author":"Voumard","year":"2017","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1136\/ejhpharm-2019-001875","article-title":"Systematic Review of Stability Data Pertaining to Selected Antibiotics Used for Extended Infusions in Outpatient Parenteral Antimicrobial Therapy (OPAT) at Standard Room Temperature and in Warmer Climates","volume":"27","author":"Perks","year":"2020","journal-title":"Eur. J. Hosp. Pharm."},{"key":"ref_21","unstructured":"Loeuille, G. (2021). R\u00e9alisation d\u2019\u00e9tudes de Stabilit\u00e9 d\u2019antibiotiques, Ceftolozane\/Tazobactam, M\u00e9rop\u00e9nem, T\u00e9mocilline, C\u00e9fid\u00e9rocol, Ceftazidime, Ceftazidime\/Avibactam et Pip\u00e9racilline\/Tazobactam En Seringue et En Diffuseur Portable Dans Le Cadre de l\u2019optimisation de Ces Mol\u00e9cules En Administration Continue En R\u00e9animation et En Ambulatoire. [PhD Thesis, Universit\u00e9 de Lorraine]."},{"key":"ref_22","first-page":"e32","article-title":"Stability Testing of Piperacilline\/Tazobactam in Elastomeric Infusion Pumps","volume":"52","author":"Meier","year":"2017","journal-title":"Pharm. Hosp. Clin."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez-Rubio, B., Herrera-Hidalgo, L., de Alarc\u00f3n, A., Luque-M\u00e1rquez, R., L\u00f3pez-Cort\u00e9s, L.E., Luque, S., Guti\u00e9rrez-Urb\u00f3n, J.M., Fern\u00e1ndez-Polo, A., Guti\u00e9rrez-Valencia, A., and Gil-Navarro, M.V. (2023). Stability Studies of Antipseudomonal Beta Lactam Agents for Outpatient Therapy. Pharmaceutics, 15.","DOI":"10.3390\/pharmaceutics15122705"},{"key":"ref_24","unstructured":"NHS Pharmaceutical Quality Assurance Committee (PQAC) A Standard Protocol for Deriving and Assessment of Stability (2024, August 01). Part 1-Aseptic Preparations (Small Molecules). Available online: https:\/\/pasg.nhs.uk\/downloads.php?did=288."},{"key":"ref_25","unstructured":"NHS Pharmaceutical Quality Assurance Committee (PQAC) A Standard Protocol for Deriving and Assessment of Stability (2024, August 01). Part 1-Aseptic Preparations (Small Molecules). Available online: https:\/\/www.sps.nhs.uk\/articles\/a-standard-protocol-for-deriving-and-assessment-of-stability-part-1-aseptic-preparation\/."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2153","DOI":"10.1080\/03007995.2017.1374936","article-title":"Evaluation of the Performance of Elastomeric Pumps in Practice: Are We under-Delivering on Chemotherapy Treatments?","volume":"33","author":"Salman","year":"2017","journal-title":"Curr. Med. Res. Opin."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1002\/jppr.1523","article-title":"Total Intended Antibiotic Delivery Related to Drug Concentration Affecting the Flow Rate of Elastomeric Devices Used in Outpatient Parenteral Antimicrobial Therapy (OPAT)","volume":"49","author":"Perks","year":"2019","journal-title":"J. Pharm. Pract. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1002\/jppr.1291","article-title":"Safety of Continuous Antibiotic Infusions Administered through an Australian Hospital in the Home Service: A Pilot Study","volume":"47","author":"Pandya","year":"2017","journal-title":"J. Pharm. Pract. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"755","DOI":"10.3109\/10837450.2011.583926","article-title":"Effect of Coefficient of Viscosity and Ambient Temperature on the Flow Rate of Drug Solutions in Infusion Pumps","volume":"17","author":"Kawabata","year":"2012","journal-title":"Pharm. Dev. Technol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1007\/BF00640667","article-title":"Measurement of Torso Skin Temperature under Clothing","volume":"57","author":"Livingstone","year":"1988","journal-title":"Europ. J. Appl. Physiol."},{"key":"ref_31","unstructured":"Pinewood Laboratories, Ireland Patient Information Leaflet for Piperacillin\/Tazocillin Powder for Solution for Infusion 2022."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"101560","DOI":"10.1016\/j.bjid.2021.101560","article-title":"Antimicrobial Stewardship in the Outpatient Parenteral Antimicrobial Therapy (OPAT) Setting: The Impact of Prescription Assessment by an Infectious Diseases Specialist","volume":"25","author":"Cassettari","year":"2021","journal-title":"Braz. J. Infect. Dis."},{"key":"ref_33","unstructured":"(2024, June 03). Base de donn\u00e9es publique des m\u00e9dicaments Summary of Product Characteristics-Tazocilline 4 g\/0.5 g, Powder for Solution for Infusion-Base de Donn\u00e9es Publique Des M\u00e9dicaments. Available online: https:\/\/base-donnees-publique.medicaments.gouv.fr\/affichageDoc.php?specid=60445784&typedoc=R."},{"key":"ref_34","unstructured":"European Medicines Agency (2024, August 01). Summary of Product Characteristics of Tazocin, Powder for Solution for Infusion, Labelling and Package Leaflet, Annex III. Available online: https:\/\/www.ema.europa.eu\/en\/documents\/referral\/tazocin-article-30-referral-annex-iii_en.pdf."},{"key":"ref_35","unstructured":"(2024, August 01). SFPC (French Society of Clinical Pharmacy); GERPAC (Evaluation and Research Group on Protection in Controlled Atmosphere) Methodological Guidelines for Stability Studies of Hospital Pharmaceuticals Preparations, Part 1: Liquid Preparations 2013. Available online: https:\/\/www.gerpac.eu\/IMG\/pdf\/guide_stabilite_anglais.pdf."},{"key":"ref_36","first-page":"169","article-title":"M\u00e9thodes Chromatographiques de Dosage Dans Les Milieux Biologiques: Strat\u00e9gie de Validation-Rapport d\u2019une Commission SFSTP","volume":"7","author":"Chapuzet","year":"1997","journal-title":"S.T.P. Pharma Prat."},{"key":"ref_37","unstructured":"European Pharmacopoeia 11.5 2.2.3 (2024, May 24). Potentiometric Determination of pH. Available online: https:\/\/pheur-edqm-eu.ressources-electroniques.univ-lille.fr\/app\/11-5\/content\/default\/20203E.htm."},{"key":"ref_38","unstructured":"European Pharmacopoeia 11.5 2.2.35 (2024, May 24). Osmolality. Available online: https:\/\/pheur-edqm-eu.ressources-electroniques.univ-lille.fr\/app\/11-5\/content\/11-5\/20235E.htm?highlight=on&terms=2.2.35."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1097\/NHH.0000000000000481","article-title":"The 2016 Infusion Therapy Standards of Practice","volume":"35","author":"Gorski","year":"2017","journal-title":"Home Healthc Now"},{"key":"ref_40","unstructured":"European Pharmacopoeia 11.5 2.9.20 (2024, May 24). Particulate Contamination: Visible Particles. Available online: https:\/\/pheur-edqm-eu.ressources-electroniques.univ-lille.fr\/app\/11-5\/content\/11-5\/20920E.htm?highlight=on&terms=visual&terms=visual."},{"key":"ref_41","unstructured":"European Pharmacopoeia Commission 2.9.19 (2024, August 01). Particulate Contamination: Sub-Visible Particles. In European Pharmacopoeia 10.8. Available online: https:\/\/pheur.edqm.eu."}],"container-title":["Pharmaceuticals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8247\/17\/8\/1085\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:39:01Z","timestamp":1760110741000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8247\/17\/8\/1085"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,19]]},"references-count":41,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8]]}},"alternative-id":["ph17081085"],"URL":"https:\/\/doi.org\/10.3390\/ph17081085","relation":{},"ISSN":["1424-8247"],"issn-type":[{"value":"1424-8247","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,19]]}}}