The Comparison of the Accuracy in Preparing Small Vancomycin Dosage : Single vs. Double Dilution Method

소용량 Vancomycin 주사액 조제방법의 차이에 의한 정확성 비교: 단일희석방법과 이중희석방법

This study was to find a more accurate method fur measuring small vancomycin dosages which are commonly used in neonates by comparing single and double dilution method. For single dilution method, 500 mg of vancomycin powder was accurately measured and reconstituted with 5 ml of distilled water to make a concentration of 100 mg/ml. Volumes of 0.05, 0.1, 0.15, 0.2, 0.3, 0.4, and 0.5 ml, which equal the target dosages of 5, 10, 15, 20, 30, 40, and 50 mg, were measured using syringes made by Shina and each sample was further diluted with 2 ml of $5\%$ dextrose. The solution of 100 mg/ml concentration was further diluted with $5\%$ dextrose to make a concentration of 20 mg/ml. Volumes of 0.25, 0.5, 0.75, 1.0, 1.5, 2.0, and 2.5 ml, which correspond to 5, 10, 15, 20, 30, 40, and 50 mg, were sampled by the same Shina's syringe as in single dilution method and then each sample was further diluted to make a total volume of 10 ml. Each sample was analyzed by HPLC. The measured dosages of each sample in both single and double dilution methods were lower than the target dosages; however, e values in double dilution method were higher than those in single dilution method for seven target dosages. Percent target dosages in single dilution method were 65 to $90\%$, while in double dilution method 91 to $94\%$. Statistically significant difference between two groups was shown in 5, 10, 15, 20, and 40 mg dosages (p<0.05). In conclusion, when preparing small vancomycin dosages lower an 20 mg $(volume{\leq}0.2\;ml)$, using Shina's syringes, the double dilution method has a closer value to the target dosage than single dilution method.