The combination of vancomycin (V) and the b-lactam/ b -lactamase inhibitor pair piperacillin/tazobactam (PT) has shown enhanced activity against both methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-intermediate S. aureus (VISA) as compared to either drug independently. This makes co-delivery of the drugs a desirable option. While dosing protocols involving prolonged infusions of vancomycin and the piperacillin/tazobactam via separate intravenous lines have been implemented at some institutions, recent work by this group has suggested the combination may not be suitable for co-administration through a single port over certain concentrations ranges. In these ranges, the vancomycin and piperacillin/tazobactam pairing results in precipitation when co-solubilized. However, the cause of the solid formation is not well understood. The present work explores this incompatibility by examining changes in the local environments of the drugs upon co-solubilization using Raman spectrometry and pH measurements. Results inside the precipitation range are compared with those immediately outside it.

Probing local environments in co-solubilized solutions of vancomycin and piperacillin/tazobactam

251st National Meeting (2016)

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