Sterility of Anesthetic Multiple-dose Vials after Opening

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Abstract
Despite the widespread use of multiple dose vials (MDV) for anesthetic medications, there is a paucity of data concerning the sterility of in-use MDV. The frequency of bacterial contamination of MDV used in current anesthesia practice was analyzed. Weekly samples were collected from 351 in-use MDV for 7 consecutive weeks and cultured using appropriate bacterial growth media. The vials contained drugs including neuromuscular blockers, anticholinergics, and an induction agent. They were sampled from locations designated for elective as well as emergency surgery. Six vial subgroups were studied with multiple samplings for 6-48 days. One-half of all opened vials remained in use after 4-9 days, while < 5% remained after 6 wk. No vial yielded bacteria. The incidence of MDV contamination with live bacteria is low for the anesthetic medications studied. This appeared to be true even for vials with increasing duration of use and for vials from locations where emergency surgery commonly was performed.