Significance of osmoticity in antibiotic small-volume parenterals

The most common cause of intravenous therapy morbidity is postinfusion phlebitis. It affects 25-70 percent of all hospitalized patients and can result in a prolonged stay. One potential contributing factor to postinfusion phlebitis is that most current intravenous antibiotic products and delivery systems do not consider osmolality. One important contribution hospital pharmacists can make to decreasing postinfusion phlebitis is to control final admixture osmoticity, thus ensuring that antibiotic small-volume parenterals are not causative factors. The purpose here is to discuss how changes in osmolality affect the development of postinfusion phlebitis and to provide hospital pharmacists with ideas for action to provide iso-osmotic formulations.