SESSION TYPE: Heart Failure Posters
PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM
PURPOSE: Prior studies have linked treprostinil (Remodulin®) with bloodstream infections (BSI). It is thought the acidic pH of normal saline (NS), used for mixing treprostinil, is more likely to promote bacterial growth than the basic pH of sterile diluent for Flolan® (SDF). The objective of this study was to identify and characterize the incidence of BSI in pulmonary hypertension (PH) patients receiving treprostinil mixed with NS or SDF.
METHODS: This was a single center retrospective cohort. Records were reviewed for patients >18 years of age with PH who received treprostinil between July 1, 2006 and June 30, 2011. The primary objective was incidence of BSI with treprostinil mixed with SDF as compared to NS. Secondary objectives included characterization of BSI’s by pathogen, duration of therapy, and immunosuppressive condition and medication.
RESULTS: Thirty patients were included in the study. BSI rate was 1.1 per 1000 treatment days for the SDF group and 0.9 for the NS group (p = 0.77). When evaluated by pathogen, there was no difference in gram negative BSI in the SDF group as compared to NS (0.2 vs. 0.76; p = 0.81). In addition, there was no difference in gram positive BSI in the SDF group compared to the NS group (0.9 vs. 0.13; p = 0.48). The multivariate analysis associated therapy >2 years with an increase in gram negative BSI (p = 0.0083). However, there was no correlation between SDF and gram negative BSI (p = 0.26).
CONCLUSIONS: There was no difference in total BSI rate, and gram negative and gram positive BSI rates when trepostinil is mixed with SDF or NS. However, therapy >2 years was associated with a statistically significant increase in gram negative BSI.
CLINICAL IMPLICATIONS: Further research is needed in a larger patient population to determine if mixing treprostinil with SDF instead of NS can prevent gram negative BSI.
DISCLOSURE: The following authors have nothing to disclose: Mirena Kovacheva, Micah Fisher, Stacey Folse
No Product/Research Disclosure InformationMercer University College of Pharmacy and Health Sciences, Atlanta, GA