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Multidose Medication Vial Sterility: An In-Use Study and a Review of the Literature

Published online by Cambridge University Press:  02 January 2015

Robert Longfield ,
Jenice Longfield ,
L. Patrick Smith ,
K. Craig Hyams  and
M. Elena Strohmer
Robert Longfield*
Affiliation:
Hospital Infection Control, Infections Diseases Division, Department of Internal Medicine, Naval Hospital, and the Division of Epidemiology, Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
Jenice Longfield
Affiliation:
Hospital Infection Control, Infections Diseases Division, Department of Internal Medicine, Naval Hospital, and the Division of Epidemiology, Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
L. Patrick Smith
Affiliation:
Hospital Infection Control, Infections Diseases Division, Department of Internal Medicine, Naval Hospital, and the Division of Epidemiology, Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
K. Craig Hyams
Affiliation:
Hospital Infection Control, Infections Diseases Division, Department of Internal Medicine, Naval Hospital, and the Division of Epidemiology, Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
M. Elena Strohmer
Affiliation:
Hospital Infection Control, Infections Diseases Division, Department of Internal Medicine, Naval Hospital, and the Division of Epidemiology, Department of Preventive Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
*
Hospital Epidemiologist, Naval Hospital, Bethesda, MD 20814
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Abstract

Contaminated multiple-dose medication vials (MDV) have been implicated in transmission of bacterial infections. It has been suggested that MDV be discarded after 24 hours or even after a single use. At our hospital, we cultured 1,223 weekly samples from 864 MDV in-use over a three-month period. Medications included xylocaine, insulin, heparin, immunizations, and miscellaneous agents. None of the samples was culture-positive. The duration of use was 9.5d (median), 18d (mean), and 1-402d (range) with 13% of vials in-use for more than 30 days. The mean duration of use was significantly shorter for medicine wards, emergency room, and outpatient clinics than for surgery and obgyn wards (p<0.05). Heparin and insulin MDV were in-use for significantly less time than xylocaine and miscellaneous agents (p<0.05), and insulin MDV were more regularly dated (p=0.001). The percentage of undated MDV declined significantly by month during die study (p=0.003). These results lend support to our current guideline that MDV should be dated upon opening and that, unless visible or suspected contamination occurs, vials are discarded either when empty or at the manufacturer's expiration date.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 5 , Issue 4 , April 1984 , pp. 165 - 169
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1984

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