Hemodialysis Catheters Requiring ALT (Antibiotic Lock Therapy) for peds

PLEASE NOTE:   Posts made to this forum should not be considered as the expressed opinions of, nor should be considered endorsed by, the Medication Safety Officer’s Society (MSOS) or the Institute for Safe Medication Practices (ISMP). 

Make sure your email is up-to-date
In order to continue to receive updates from MSOS, as well as forum posts and other valuable information as a member of MSOS, please be sure to update your email address with us, whenever it changes. If you need assistance doing so, please send an email to jgold@ismp.org

1 post / 0 new
Marina Rabin
Marina Rabin's picture
Offline
Last seen: 3 months 1 week ago
Joined: 12/10/2018 - 13:49
Hemodialysis Catheters Requiring ALT (Antibiotic Lock Therapy) for peds

Good Morning,
We are trying to implement the guidelines for ALT in pediatric patients on hemodialysis. But ran into an issue where stability of the final product lacks any supporting data.
Our list for ALT is:
1. Vancomycin 5mG/mL + heparin 1000 units/mL
2. Gentamicin 1 mG/mL + heparin 1000 units/mL
3. Cefazolin 5 mG/mL + heparin 1000 units/mL

Coming up with the guideline was easy, but operationalizing it a whole other issue. There is no stability data of these products at these concentrations published. So, the conversation is moving towards increasing the heparin concentration to 25,000 units/mL for each of the above listed ALTs. As, you may understand, there is a bit of reluctance with that for Pediatric population.
I was wondering how others are managing the issue. What does your process look like?
Thank you.