Iqbal, Muhammad Shahid
(2013)
Investigation Of Drug Nutrient Interactions And Physicochemical Compatibilities Of Ceftazidime, Cefotaxime And Cefepime In Neonatal Total Nutrient Admixtures Using HPLC.
PhD thesis, Universiti Sains Malaysia.
Abstract
Total nutrient admixtures (TNAs) is widely used therapeutic intervention in the management of
malnourished patients receiving parenteral nutrition since the approval of admixing intravenous
fat emulsions with various amino acids and dextrose solutions. The advantages of TNAs include
home nutrition therapy, less risk of infections, less need of nursing staff, no need of additional
fluids to dilute the drugs, decreased administration costs compared with the conventional
piggyback method and increased tolerance of intravenous fat emulsions in neonates. Addition of
antibiotics to the TNAs often raises question of stability of the antibiotics over longer periods
e.g. 24 hours. Unfortunately, very little data about TNAs stability in/with antibiotics is available.
This study was aimed to evaluate the stability and compatibility of antibiotics (ceftazidime,
cefepime and cefotaxime) in TNAs. The stability and compatibility were measured chemically,
by using a high-speed HPLC (Prominence UFLC model LC-20AD, Shimadzu, Columbia, USA)
based on newly developed and validated methods. Shelf life and percentage of remaining
antibiotics in all formulations were measured at different time intervals (H0, H4, H8, H16 and
H24) by using the above methods. The concentrations of TNAs’ components i.e. macronutrients
and micronutrients used in the study were according to the normal body weight of neonates i.e. 3
kg neonates. The study evaluated the effect of varied concentrations of macronutrients in/with
antibiotics. For each antibiotic, forty-eight TNAs formulations were prepared in different
combinations of macronutrients (dextrose, amino acids and fats) and micronutrients (vitamins,
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and trace elements).
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