# Compatibility Investigation of a Steroid and Two Antibiotics with Heparin for the Prevention of Catheter Occlusion in Neonatal Intensive Care Units

## TL;DR

This study checks if mixing a steroid and two antibiotics with heparin is safe for use in neonatal intensive care units.

## Contribution

The study provides new evidence on the compatibility of hydrocortisone sodium, ampicillin, and cefotaxime with heparin in NICU drug mixtures.

## Key findings

- No precipitation, turbidity, or color changes were observed in drug-heparin mixtures.
- UV absorbance and HPLC analysis showed minimal degradation of drugs after mixing with heparin.
- Slight pH changes were within acceptable limits, supporting safe co-administration.

## Abstract

Intravenous medications are frequently administered through shared catheter lines in neonatal intensive care units (NICUs) due to the limited venous access in preterm infants, raising concerns about drug incompatibilities that may cause serious complications. Hydrocortisone sodium (HDC), ampicillin (ABPC), and cefotaxime (CTX) are commonly used in NICUs and are often co-administered with unfractionated heparin (UFH), which is routinely infused to prevent catheter occlusion. This study evaluated the physicochemical compatibility of HDC, ABPC, and CTX when mixed with UFH. Each drug was combined with UFH at equal volumes, and the mixtures were assessed immediately and after 3 h of storage by visual inspection, pH measurement, UV absorbance, and HPLC-UV analysis. No precipitation, turbidity, or color changes were observed in any mixture, and UV absorbance showed no relevant deviations compared with controls. Slight pH variations were detected but remained within acceptable limits. In semi-quantitative HPLC analysis, relative peak area changes were all below 10%, indicating no major degradation of the drugs. These findings suggest that HDC, ABPC, and CTX maintain acceptable physicochemical compatibility when co-administered with UFH, supporting their safe concomitant use in NICU practice.