Evaluation of the in-line filters for the intravenous infusion of amphotericin B fluid.

OBJECTIVE To evaluate the effects of four types of in-line filters on filtration rate, amphotericin B concentration and particulate matter. METHODS Filtration rates of amphotericin B fluid through in-line filters under maximum gravity flow were examined. The concentrations of amphotericin B and the particulate matter in the non-filtered and filtered amphotericin B fluid at the flow rate of 500 ml/24 h were measured. RESULTS Filtration through a 1.2 microm or 0.2 microm polyethersulphone (PES) filter under maximum gravity flow took less than 40 min. The 0.2 microm positively charged nylon 66 and 0.2 microm nylon 66 filters took 70 and 100 min, respectively, to filter 500 ml of amphotericin B fluid. The 0.2 microm positively charged nylon 66 filter and the 0.2 microm nylon 66 filter, but not the PES filter (1.2 and 0.2 microm), decreased the concentrations of amphotericin B in the filtered fluid by 100% within 1 h and by 66% within 24 h after the start of filtration, respectively. The particulate count in the non-filtered amphotericin B fluid was 27+/-5 particles/ml, exceeding the limit defined by USP XXIII. The 1.2 microm and 0.2 microm PES filters significantly decreased particulate matter by 83 and 97%, respectively, just after filtration. CONCLUSION The present results indicate that the 0.2 microm PES filter is optimal for intravenous infusion of amphotericin B fluid to minimize the introduction of particulate matter, microbial contaminants and endotoxin into patients.