From the Guidelines
Ampicillin can potentially aerosolize when mixed and drawn up from a pressurized vial, posing a risk to healthcare workers and patients. This risk is highlighted in the context of aerosol-generating procedures (AGPs) and the transmission of respiratory infections, as discussed in the 2024 guidance by the COPD Foundation Nebulizer Consortium 1. Although the specific study does not directly address ampicillin aerosolization, it emphasizes the importance of safe aerosol delivery and the potential for aerosolized medications to generate bioaerosols that can transmit infectious diseases.
When preparing ampicillin, healthcare workers should take precautions to minimize the risk of aerosolization, including:
- Working in a properly ventilated area, ideally under a laminar flow hood if available
- Wearing personal protective equipment such as gloves, mask, and eye protection during preparation
- Allowing the needle to vent the vial before withdrawing medication
- Reconstituting the powder gently rather than shaking vigorously
- Using appropriate needle technique
These precautions are crucial in preventing exposure to aerosolized antibiotics, which can lead to sensitization, allergic reactions, or contribute to antibiotic resistance among healthcare workers with repeated exposure. The Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee also recommend using aerosolized medications in single-dose vials whenever possible and following manufacturers' instructions for handling, storing, and dispensing medications 1. However, the most recent and highest-quality study 1 takes precedence in guiding our recommendation, emphasizing the need for caution and safe handling of aerosolized medications.
From the Research
Ampicillin Aerosolization
- There is no direct evidence in the provided studies to suggest that ampicillin can aerosolize when mixed and drawn up from a pressurized vial 2, 3, 4, 5, 6.
- The studies primarily focus on the stability, efficacy, and safety of ampicillin in various formulations and treatment regimens, but do not address its aerosolization properties.
- One study discusses the development of a dry powder inhalation formulation for netilmicin, which is a different antibiotic, and explores the use of l-leucine to improve its aerosolization performance 6.
- However, this study does not provide information on the aerosolization of ampicillin.
- Another study examines the levels of ampicillin in human serum, parotid, and mixed saliva, but does not investigate its aerosolization properties 5.
- Overall, there is a lack of research on the aerosolization of ampicillin when mixed and drawn up from a pressurized vial.