| Peer-Reviewed

Comparison of Vanco Ready® Vancomycin Injection Premix with Lyophilized Vancomycin Products in a Simulated Compounding & Clinical Setting

Received: 31 May 2023    Accepted: 19 June 2023    Published: 6 July 2023
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Abstract

This study aimed to compare Xellia Pharmaceuticals’ Vanco Ready® Vancomycin Injection, a premix, room-temperature stable vancomycin IV formulation, with compounded lyophilized vancomycin in a simulated sterile compounding setting, to assess dispensing time and dosing accuracy. Twelve simulations were performed to compare Vanco Ready® Vancomycin Injection premix, room-temperature formulation to single-dose, immediate-use compounded IV vancomycin and to multi-dose, batch compounded IV vancomycin. The first part of the study involved assessing the total dispensing time (i.e., time Rx order is received to when product is available for administration), which also included the compounding time required for the single-dose and batch-compounded, lyophilized products. The second component of the study involved measuring dosing accuracy, a composite of the diluent volumes needed for reconstitution and the residual drug volumes remaining in the vials, after the prescribed dose was removed. Vanco Ready® Vancomycin Injection premix was statistically better than single-dose, immediate-use compounded product and batch-compounded product for both dispensing time and dosing accuracy (p<0.05). The total dispensing time for Vanco Ready® Vancomycin Injection premix was an average of 1 minute/37 seconds compared to the total dispensing time for the single-dose, immediate-use compounded product, 20 minutes/28 seconds, and the batch-compounded product (8 bags) 28 minutes/7 seconds (average of 3 minutes/17 seconds per bag), which were inclusive of product verification and compounding times. Based on the total dispensing time, there was a statistical difference (p<0.05) between the total dispensing time for Vanco Ready® compared to single-dose, immediate-use compounded product, and compared to the batch compounded product average. The dose accuracy for Vanco Ready® Vancomycin Injection premix was assumed to be 100%, due to the rigorous, quality controls in place for commercially manufactured premix medications. The dosing accuracy of the single-dose, immediate-use compounded product was 91.20% and the dosing accuracy of batch-compounded product was 84.32%. Based on the dosing accuracy, there was a statistical difference (p<0.05) between the overall dose accuracy for Vanco Ready® compared to single-dose, immediate-use compounded product, and compared to the batch compounded product average. Vanco Ready® Vancomycin Injection premix showed a statistical improvement in the total dispensing time and dosing accuracy when compared to single-dose, immediate-use compounded product and batch compounded product. The results of this study indicate that commercially manufactured Vanco Ready® Vancomycin Injection may be a viable alternative over pharmacy compounded, lyophilized vancomycin, for healthcare institutions to consider for non-pregnant patients.

Published in Pharmaceutical Science and Technology (Volume 7, Issue 1)
DOI 10.11648/j.pst.20230701.13
Page(s) 13-19
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Clinical Simulation, Compounding, Dispensing Time, Dose Accuracy, Error Reduction, Vanco Ready® Vancomycin Injection, Premix, Ready-to-Use

References
[1] Burger M, Degnan D. Comparative Safety, Efficiency, and Nursing Preference Among 3 Methods for Intravenous Push Medication Preparation: A Randomized Crossover Simulation Study. J Patient Saf. 2019; 15 (3): 238-245. doi: 10.1097/PTS.0000000000000269.
[2] Hertig JB, Degnan DD, Scott CR, Lenz JR, Li X, Anderson CM. A Comparison of Error Rates Between Intravenous Push Methods: A Prospective, Multisite, Observational Study. J Patient Saf. 2018; 14 (1): 60-65. doi: 10.1097/PTS.0000000000000419.
[3] ASHP. American Society of Health-System Pharmacists: ASHP guidelines on preventing medication errors in hospitals. https://www.ashp.org/-/media/assets/policy-guidelines/docs/guidelines/preventingmedication- errors-hospitals.ashx.
[4] APSF. Anesthesia Patient Safety Foundation. Recommendations for improving medication safety. https://www.apsf.org/medication-safety-recommendations/.
[5] ISMP. Institute for Safe Medication Practices. Targeted medication safety best practices for hospitals. https://www.ismp.org/guidelines/best-practices-hospitals.
[6] Kumar A, Roberts D, Wood KE, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock*. Crit Care Med. 2006; 34 (6): 1589-1596. doi: 10.1097/01.CCM.0000217961.75225.E9.
[7] USP. <797> PHARMACEUTICAL COMPOUNDING — STERILE PREPARATIONS.
[8] Xellia Pharmaceuticals. Vanco Ready Pamphlet.
[9] James Sperry A, Cruikshank J, Winn A, et al. Comparison of EMERPHED (Ephedrine Sulfate) Injection with Current Concentrated Ephedrine Products in Simulated Clinical Settings. Pharmaceutical Science and Technology. 2021; 5 (1): 24. doi: 10.11648/j.pst.20210501.14.
[10] Food and Drug Administration. Vanco Ready Package Insert.
Cite This Article
  • APA Style

    Alexander James Sperry, James Cruikshank, Huong Hoang, Kato Nichols, George Edward MacKinnon III, et al. (2023). Comparison of Vanco Ready® Vancomycin Injection Premix with Lyophilized Vancomycin Products in a Simulated Compounding & Clinical Setting. Pharmaceutical Science and Technology, 7(1), 13-19. https://doi.org/10.11648/j.pst.20230701.13

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    ACS Style

    Alexander James Sperry; James Cruikshank; Huong Hoang; Kato Nichols; George Edward MacKinnon III, et al. Comparison of Vanco Ready® Vancomycin Injection Premix with Lyophilized Vancomycin Products in a Simulated Compounding & Clinical Setting. Pharm. Sci. Technol. 2023, 7(1), 13-19. doi: 10.11648/j.pst.20230701.13

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    AMA Style

    Alexander James Sperry, James Cruikshank, Huong Hoang, Kato Nichols, George Edward MacKinnon III, et al. Comparison of Vanco Ready® Vancomycin Injection Premix with Lyophilized Vancomycin Products in a Simulated Compounding & Clinical Setting. Pharm Sci Technol. 2023;7(1):13-19. doi: 10.11648/j.pst.20230701.13

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  • @article{10.11648/j.pst.20230701.13,
      author = {Alexander James Sperry and James Cruikshank and Huong Hoang and Kato Nichols and George Edward MacKinnon III and Nashaat Zakaria Gerges and Abhay Singh Chauhan},
      title = {Comparison of Vanco Ready® Vancomycin Injection Premix with Lyophilized Vancomycin Products in a Simulated Compounding & Clinical Setting},
      journal = {Pharmaceutical Science and Technology},
      volume = {7},
      number = {1},
      pages = {13-19},
      doi = {10.11648/j.pst.20230701.13},
      url = {https://doi.org/10.11648/j.pst.20230701.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.pst.20230701.13},
      abstract = {This study aimed to compare Xellia Pharmaceuticals’ Vanco Ready® Vancomycin Injection, a premix, room-temperature stable vancomycin IV formulation, with compounded lyophilized vancomycin in a simulated sterile compounding setting, to assess dispensing time and dosing accuracy. Twelve simulations were performed to compare Vanco Ready® Vancomycin Injection premix, room-temperature formulation to single-dose, immediate-use compounded IV vancomycin and to multi-dose, batch compounded IV vancomycin. The first part of the study involved assessing the total dispensing time (i.e., time Rx order is received to when product is available for administration), which also included the compounding time required for the single-dose and batch-compounded, lyophilized products. The second component of the study involved measuring dosing accuracy, a composite of the diluent volumes needed for reconstitution and the residual drug volumes remaining in the vials, after the prescribed dose was removed. Vanco Ready® Vancomycin Injection premix was statistically better than single-dose, immediate-use compounded product and batch-compounded product for both dispensing time and dosing accuracy (p<0.05). The total dispensing time for Vanco Ready® Vancomycin Injection premix was an average of 1 minute/37 seconds compared to the total dispensing time for the single-dose, immediate-use compounded product, 20 minutes/28 seconds, and the batch-compounded product (8 bags) 28 minutes/7 seconds (average of 3 minutes/17 seconds per bag), which were inclusive of product verification and compounding times. Based on the total dispensing time, there was a statistical difference (p<0.05) between the total dispensing time for Vanco Ready® compared to single-dose, immediate-use compounded product, and compared to the batch compounded product average. The dose accuracy for Vanco Ready® Vancomycin Injection premix was assumed to be 100%, due to the rigorous, quality controls in place for commercially manufactured premix medications. The dosing accuracy of the single-dose, immediate-use compounded product was 91.20% and the dosing accuracy of batch-compounded product was 84.32%. Based on the dosing accuracy, there was a statistical difference (p<0.05) between the overall dose accuracy for Vanco Ready® compared to single-dose, immediate-use compounded product, and compared to the batch compounded product average. Vanco Ready® Vancomycin Injection premix showed a statistical improvement in the total dispensing time and dosing accuracy when compared to single-dose, immediate-use compounded product and batch compounded product. The results of this study indicate that commercially manufactured Vanco Ready® Vancomycin Injection may be a viable alternative over pharmacy compounded, lyophilized vancomycin, for healthcare institutions to consider for non-pregnant patients.},
     year = {2023}
    }
    

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    AB  - This study aimed to compare Xellia Pharmaceuticals’ Vanco Ready® Vancomycin Injection, a premix, room-temperature stable vancomycin IV formulation, with compounded lyophilized vancomycin in a simulated sterile compounding setting, to assess dispensing time and dosing accuracy. Twelve simulations were performed to compare Vanco Ready® Vancomycin Injection premix, room-temperature formulation to single-dose, immediate-use compounded IV vancomycin and to multi-dose, batch compounded IV vancomycin. The first part of the study involved assessing the total dispensing time (i.e., time Rx order is received to when product is available for administration), which also included the compounding time required for the single-dose and batch-compounded, lyophilized products. The second component of the study involved measuring dosing accuracy, a composite of the diluent volumes needed for reconstitution and the residual drug volumes remaining in the vials, after the prescribed dose was removed. Vanco Ready® Vancomycin Injection premix was statistically better than single-dose, immediate-use compounded product and batch-compounded product for both dispensing time and dosing accuracy (p<0.05). The total dispensing time for Vanco Ready® Vancomycin Injection premix was an average of 1 minute/37 seconds compared to the total dispensing time for the single-dose, immediate-use compounded product, 20 minutes/28 seconds, and the batch-compounded product (8 bags) 28 minutes/7 seconds (average of 3 minutes/17 seconds per bag), which were inclusive of product verification and compounding times. Based on the total dispensing time, there was a statistical difference (p<0.05) between the total dispensing time for Vanco Ready® compared to single-dose, immediate-use compounded product, and compared to the batch compounded product average. The dose accuracy for Vanco Ready® Vancomycin Injection premix was assumed to be 100%, due to the rigorous, quality controls in place for commercially manufactured premix medications. The dosing accuracy of the single-dose, immediate-use compounded product was 91.20% and the dosing accuracy of batch-compounded product was 84.32%. Based on the dosing accuracy, there was a statistical difference (p<0.05) between the overall dose accuracy for Vanco Ready® compared to single-dose, immediate-use compounded product, and compared to the batch compounded product average. Vanco Ready® Vancomycin Injection premix showed a statistical improvement in the total dispensing time and dosing accuracy when compared to single-dose, immediate-use compounded product and batch compounded product. The results of this study indicate that commercially manufactured Vanco Ready® Vancomycin Injection may be a viable alternative over pharmacy compounded, lyophilized vancomycin, for healthcare institutions to consider for non-pregnant patients.
    VL  - 7
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Author Information
  • School of Pharmacy, Medical College of Wisconsin, Wauwatosa, The United States

  • School of Pharmacy, Medical College of Wisconsin, Wauwatosa, The United States; Department of Pharmacy, Froedtert Hospital, Milwaukee, The United States

  • School of Pharmacy, Medical College of Wisconsin, Wauwatosa, The United States

  • School of Pharmacy, Medical College of Wisconsin, Wauwatosa, The United States

  • School of Pharmacy, Medical College of Wisconsin, Wauwatosa, The United States

  • School of Pharmacy, Medical College of Wisconsin, Wauwatosa, The United States

  • School of Pharmacy, Medical College of Wisconsin, Wauwatosa, The United States

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