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Therefore, this evidence suggested that mixing of 40% v/v
ethanol with 4% sodium citrate in volumes higher than 40%
v/v should be used with caution.
Prior compatibility and stability studies by our group did
not assess the antibiotic susceptibility of the catheter lock
solutions.4,5 In this study, we evaluated antimicrobial activity
of each admixture under 4 different conditions at baseline
and at 72 hours. After 72 hours, antimicrobial activity ranged
from 95% to 106% of the baseline zones of inhibition. These
results support chemical stability testing that produced mean
vancomycin and gentamicin concentrations that ranged
between 95% and 105% of initial concentrations after 72
hours. Although we studied each admixture under different
conditions, a limitation of this study was that we were not
able to account for variables that may occur in a patient's
daily activity such as body movement and variations in body
temperature. Further evaluation of these admixtures in
patients may be necessary to account for these variables.

Hospital Pharmacy 52(10)

Conclusion
This study evaluated the in vitro physical stability, chemical
compatibility, and antimicrobial susceptibility for the combination of sodium citrate and vancomycin with either ethanol
or gentamicin. All solution containing sodium citrate 4%
combined with vancomycin 5 or 10 mg/mL with ethanol
(40% v/v) or gentamicin 1 mg/mL remained stable over 48
hours when stored in 25°C or 37°C with or without light. At
72 hours, vancomycin (5 mg/mL) and ethanol (40% v/v) in a
4% sodium citrate solution stored at 25°C with and without
light, and at 37°C with and without light, became slightly
turbid which we defined as incompatible for that time point.
All other solution combinations under each of the 4 conditions maintained their compatibility, stability, and efficacy
for 72 hours.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.

Funding
The author(s) disclosed receipt of the following financial support
for research, authorship, and/or publication of this article: The
authors are grateful for the support of this research provided by the
Department of Pharmacy Practice, University of Toledo College of
Pharmacy & Pharmaceutical Sciences.

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