Is it safe to reuse a single-use vial (single dose container) more than once?

From the Guidelines

No, it is not safe to reuse a single-use vial more than once. Single-use vials are designed and tested for one-time use only and should be discarded after the initial use, even if there appears to be medication remaining in the vial. Using a single-use vial multiple times significantly increases the risk of contamination with bacteria, fungi, or other pathogens that can cause serious infections, as noted in guidelines from reputable sources such as the CDC and FDA 1.

Key Considerations

• Single-use vials lack preservatives that would inhibit microbial growth between uses.
• Repeatedly inserting needles into the vial compromises the sterility of the contents.
• Even if a new sterile needle is used each time, microorganisms from the environment can be introduced.
• Healthcare facilities and regulatory agencies strongly advise against this practice due to documented outbreaks of infections resulting from reusing single-use vials 1.

Recommendations

• If medication conservation is a concern, multi-dose vials containing appropriate preservatives are specifically designed for multiple entries and should be used instead when appropriate.
• Medications should be used, stored, and handled as per product-specific recommendations, and discarded if beyond use-by dates or with visible contamination or breaches of sterile integrity 1.
• The exterior surfaces of most injection vials are not intended to be sterile and should be cleaned with an isopropanol 70% v/v (with or without chlorhexidine) wipe and allowed to dry before insertion of a drawing-up needle 1.

Conclusion is not needed, the answer is based on the most recent and highest quality study

The most recent study 1 from 2019 provides the strongest evidence against reusing single-use vials, emphasizing the importance of handling medications as per product-specific recommendations to prevent contamination and ensure patient safety.

From the Research

Safety of Reusing Single-Use Vials

The question of whether it is safe to reuse a single-use vial more than once has been addressed in several studies.

• The risk of bacterial contamination is a primary concern when reusing single-use vials 2, 3.
• A study found that the prevalence of vial contamination was high, with 5.5% of multiple-dose vials and no single-dose vials contaminated with aerobic bacteria 2.
• Another study demonstrated that gadolinium-based contrast media did not support the growth of microbial pathogens, suggesting that these solutions could be used for more than one procedure 4.
• However, the study also found that some organisms persisted for at least 48 hours after inoculation, highlighting the potential risk of contamination 4.

Factors Affecting Contamination Risk

Several factors can affect the risk of contamination when reusing single-use vials, including:

• Handling and storage conditions: improper handling and storage can increase the risk of contamination 2, 3.
• Environment: the environment where medication is handled can also impact contamination risk 2.
• Syringe and needle reuse: reusing syringes and needles can increase the risk of contamination 2.
• Sterile technique: using basic sterile technique can help maintain sterility when transferring contents from single-use vials to disposable syringes 5.

Sterility Studies

Several studies have investigated the sterility of single-use vials after reuse:

• One study found no evidence of microbial growth in samples withdrawn from single-use vials over three days 5.
• Another study found that the contamination rate of preservative-free single-dose unit dexamethasone 0.1% eye drops did not increase after multiple use within 24 hours 6.
• However, the study also found that contamination from fingertip flora was more likely than from ocular surface flora, highlighting the importance of proper handling and hygiene 6.