From the Guidelines
Reusing single-dose vials for the same patient, even under sterile conditions, is not recommended due to significant risks of contamination and complications. The practice of reusing single-dose vials poses a risk of contamination, as the exterior surfaces of most injection vials are not intended to be sterile 1. Even with proper cleaning and sterile technique, the risk of contamination remains, particularly with medications like propofol that can support bacterial and fungal growth 1.
Key considerations for the reuse of single-dose vials include:
- The lack of preservatives in single-dose vials to prevent microbial growth, creating an environment where bacteria and fungi can multiply rapidly 1
- The increased risk of contamination with storage time after the initial use, as microorganisms have more opportunity to proliferate
- The potential decrease in medication stability and potency after the vial is opened, potentially reducing therapeutic effectiveness
Instead of reusing single-dose vials, healthcare facilities should follow manufacturer guidelines by using single-dose vials only once and immediately discarding any unused portion 1. If multiple doses are needed for the same patient, multi-dose vials (which contain preservatives) or single-use prefilled syringes are safer alternatives. The potential harm to patients and subsequent treatment costs for complications far outweigh any initial savings from reusing single-dose vials. Healthcare providers should prioritize patient safety and adhere to guidelines that minimize the risk of contamination and complications.
From the Research
Risk of Complications with Reuse of Single-Dose Vial of Medication
The risk of complications when reusing a single-dose vial of medication for the same patient under sterile conditions is a topic of interest.
- The study 2 found that reusing single-use vials of botulinum toxin for intralaryngeal injection in the same patient did not result in infection-related complications.
- However, the study 3 highlights the potential risks associated with reusing single-use medical devices, including infection, staff and environmental risks, and legal, ethical, and financial issues.
- Another study 4 found that reusing needles for subcutaneous insulin injection was not associated with an increased risk of infection, but was associated with an increased risk of lipohypertrophy and perceived pain.
Safety and Efficacy of Reuse
- The study 2 demonstrated the safety and efficacy of reusing single-use vials of botulinum toxin for intralaryngeal injection in the same patient, with a low rate of adverse events and a high self-reported efficacy rate.
- The study 5 found that there is a lack of awareness among patients and physicians about the practice of reusing single-use medical devices, and that education may be able to alleviate patient concerns.
- The study 6 found that reusing single-use endotracheal suctioning catheters may increase the risk of respiratory infection, but also found that flushing suction circuits with chlorhexidine while reusing single-use catheters might reduce the risk of respiratory infections.
Considerations for Reuse
- The study 3 emphasizes the importance of considering the risks and benefits of reusing single-use medical devices, including the potential for cost savings and reduced medical waste.
- The study 4 highlights the need for further research on the safety and efficacy of reusing single-use medical devices, particularly in the context of subcutaneous insulin injection.
- The study 6 suggests that nurses in resource-limited countries can follow their hospital policy regarding the changing frequency of endotracheal suction catheters due to a lack of robust evidence.