P08 Antibiotic residue higher in pre-filled compared with self-filled B Braun Easypump II devices

Sep 29, 2026

Uploaded by Eliana

Study comparing elastomeric antibiotic pump (EMP) residue between commercially pre-filled and nurse-while-filled preparations using B Braun Easypump II devices across two UK NHS Trusts. Background outlines three EMP filling routes and cost differences. A two-week Feb–Mar 2025 quality improvement audit collected administered piperacillin/tazobactam and flucloxacillin EMPs, drained or weighed pumps to quantify residue, and analyzed results in Excel with z-test and Mann–Whitney U-test. Findings show higher median residue in pre-filled vs nurse-filled EMPs (P=0.04) and higher residue for piperacillin/tazobactam vs flucloxacillin (P=0.008).

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Background

Objectives

Methods

Results

Conclusions

Posters Abstract citation ID: dlaf239.012 P08 Antibiotic residue higher in pre-ﬁlled compared with self-ﬁlled B Braun Easypump II devices Nicola Walker1, Daniel Hearsey2, Jade Lee-Milner1, Claire Painter3, Stuart E Bond1 1Mid Yorkshire Teaching NHS Trust, Wakeﬁeld, UK; 2Royal Cornwall Hospital NHS Trust, Cornwall, UK; 3Acute Care at Home, Truro Health Park, Inﬁrmary Hill, Truro, UK Background: The three options for elastomeric antibiotic pumps (EMP) used in patient’s homes are: pre-ﬁlled by a commercial manufacturer, pre-ﬁlled by an NHS pharmacy aseptic unit, and ﬁlled by nurses at the point of care. Mid Yorkshire Teaching NHS Trust (MYTT) uses commercially pre-ﬁlled Easypump® II EMPs for piperacillin/tazobactam and ﬂucloxacillin. Royal Cornwall Hospitals NHS Trust (RCHT) and Cornwall Partnership NHS Foundation Trust (CPFT) nurse-ﬁll Easypump® II EMPs in the patient’s home. Commercially ﬁlled devices are the most costly of the ﬁlling options. Representatives from the three NHS Trusts performed a joint audit of antibiotic EMP residue. Objectives: To compare EMP residue in MYTT pre-ﬁlled Easypump® II devices with CPFT nurse-ﬁlled Easypump® II devices. Methods: The quality improvement project did not require ethics approval. For two weeks in February and March 2025, MYTT community nurses collected all administered piperacillin/tazobactam and ﬂucloxacillin EMPs. The specialist pharmacy technician drained the EMPs and measured the residue. The CPFT OPAT nurses weighed each administered pump and used the weight of an empty pump to calculate the antibiotic residue. An Excel spreadsheet was used to document the drug, dose, type of vascular access, pre-ﬁlled/self-ﬁlled and antibiotic residue. Using Microsoft Excel®, a two-proportion z-test was used to determine statistical signiﬁcance anda Mann–Whitney U-test was used to compare the EMP residual volumes. Results: MYTTcollected 84 EMPs which included 9 piperacillin/tazobactam 13.5 g, 45 piperacillin/tazobactam 18 g, 28 ﬂucloxacillin 8 g and 2 ﬂucloxacillin 12 g. CPFT collected 55 EMPs which included 11 piperacillin/tazobactam 13.5 g, 24 piperacillin/ tazobactam 18 g and 20 ﬂucloxacillin 8 g. Twelve results were excluded (10 for MYTT, 2 for CPFT) due to known pump or vascular access issues. More pre-ﬁlled than nurse-ﬁlled EMPs contained residue (MYTT median residue 29 mL versus CPFT 17 mL, P=0.04) . More piperacillin/tazobactam than ﬂucloxacillin EMPs contained residue (median 30 mL versus 8 mL, P=0.008) . No difference in residue was found between strengths of piperacillin/tazobactam, between strengths of ﬂucloxacillin, or between vascular devices. Conclusions: Pre-ﬁlled Easypump® II EMPs were more likely to have residue than nurse-ﬁlled Easypump® II EMPs. A possible reason for this is crystallization in the pump due to longer expiry. Antibiotic residue was also more likely with piperacillin/tazobactam than ﬂucloxacillin. The method of measuring residue should be changed to be identical for both sites, such as weighing the EMP. Our ﬁndings will be used to inform future service improvement, and the design of a larger project is recommended across multiple Trusts to validate results.

FAQs

What comparison did the study conduct between Easypump II devices?

It compared antibiotic EMP residue in MYTT commercially pre-filled Easypump II devices with CPFT nurse-filled Easypump II devices.

How was antibiotic residue measured in each Trust?

MYTT’s pharmacy technician drained the EMPs and measured the residue, while CPFT OPAT nurses weighed each administered pump and used the empty pump weight to calculate residue.

What were the main results about residue differences?

Pre-filled EMPs contained residue more often than nurse-filled EMPs (median 29 mL vs 17 mL, P=0.04). Piperacillin/tazobactam also had higher residue than flucloxacillin (median 30 mL vs 8 mL, P=0.008).

What change does the study recommend for future measurement?

It recommends using an identical residue measurement method for both sites, such as weighing the EMP, and designing a larger multi-Trust project to validate findings.

Sep 29, 2026

Uploaded by Eliana