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MATTHEW K. BRAMMER, PHARM.D., is Research Analyst; PAK CHAN is Research Analyst; KATHY HEATHERLY, M.S., is Research Analyst; CRAIG TRUSLEY, PHARM.D., is Research Analyst; and THOMAS C. KUPIEC, PH.D., is Director of Laboratories, Analytical Research Laboratories, Oklahoma City, OK. LAWRENCE A. TRISSEL, B.S., FASHP, is Research Consultant, TriPharma Research, Cashiers, NC. PETROS A. PSATHAS, PH.D., is Assistant Director, Drug Product Development; TIMOTHY GILMOR, PH.D., is Principal Scientist, Drug Product Development; and DANIEL SCHAUFELBERGER, PH.D., is Senior Director, ChemPharm Development, Johnson & Johnson PRD LLC, Raritan, NJ.

Address correspondence to Mr. Trissel at TriPharma Research, P.O. Box 265, Cashiers, NC 28717-0265 (tripharma{at}mail.com).

Purpose. The compatibility of doripenem diluted for infusion with 82 other drugs during simulated Y-site administration was studied. Methods. Five-milliliter samples of doripenem 5 mg/mL in 5% dextrose injection and separately in 0.9% sodium chloride injection were combined with 5 mL of 82 other drugs, undiluted or diluted in 5% dextrose injection or 0.9% sodium chloride injection. Visual examinations were performed with the unaided eye in fluorescent light and using a Tyndall beam to enhance visualization of small particles and low-level turbidity. The turbidity of each sample was measured, and particulate content was evaluated. Samples were inspected initially and one and four hours after preparation. Results. Of the drugs tested, doripenem 5 mg/mL in 5% dextrose injection and in 0.9% sodium chloride injection was incompatible with diazepam, potassium phosphates, and undiluted propofol. Doripenem 5 mg/mL in 0.9% sodium chloride injection but not in 5% dextrose injection was incompatible with amphotericin B-containing drugs due to the diluent. Doripenem was found to be compatible when combined with the other 75 drugs for at least four hours. Conclusion. Doripenem 5 mg/mL in 5% dextrose injection or in 0.9% sodium chloride injection was physically compatible for four hours at room temperature with 75 drugs during simulated Y-site administration. Three drugs combined with doripenem in 5% dextrose injection or 0.9% sodium chloride injection and 7 drugs combined with doripenem in 0.9% sodium chloride injection resulted in unacceptable precipitation or an increase in measured haze and should not be simultaneously administered with doripenem admixtures. Index terms: Antibiotics; Dextrose; Diluents; Doripenem; Incompatibilities; Injections; Sodium chloride; Stability; Storage; Turbidity