Longfield R, Longfield J, Smith L P, Hyams K C, Strohmer M E
Infect Control. 1984 Apr;5(4):165-9. doi: 10.1017/s0195941700059154.
Contaminated multiple-dose medication vials (MDV) have been implicated in transmission of bacterial infections. It has been suggested that MDV be discarded after 24 hours or even after a single use. At our hospital, we cultured 1,223 weekly samples from 863 MDV in-use over a three-month period. Medications included xylocaine, insulin, heparin, immunizations, and miscellaneous agents. None of the samples was culture-positive. The duration of use was 9.5d (median), 18d (mean), and 1-402d (range) with 13% of vials in-use for more than 30 days. The mean duration of use was significantly shorter for medicine wards, emergency room, and outpatient clinics than for surgery and ob-gyn wards (p less than 0.05). Heparin and insulin MDV were in-use for significantly less time than xylocaine and miscellaneous agents (p less than 0.05), and insulin MDV were more regularly dated (p = 0.001). The percentage of undated MDV declined significantly by month during the study (p = 0.003). These results lend support to our current guideline that MDV should be dated upon opening and that, unless visible or suspected contamination occurs, vials are discarded either when empty or at the manufacturer's expiration date.
受污染的多剂量药瓶（MDV）被认为与细菌感染的传播有关。有人建议多剂量药瓶在24小时后甚至单次使用后就应丢弃。在我们医院，我们在三个月的时间里对863个正在使用的多剂量药瓶每周采集1223份样本进行培养。药物包括利多卡因、胰岛素、肝素、疫苗以及其他各类药物。所有样本培养结果均为阴性。使用时长中位数为9.5天，平均为18天，范围是1 - 402天，其中13%的药瓶使用超过30天。内科病房、急诊室和门诊诊所药瓶的平均使用时长显著短于外科和妇产科病房（p < 0.05）。肝素和胰岛素多剂量药瓶的使用时间显著短于利多卡因和其他类药物（p < 0.05），且胰岛素多剂量药瓶标注日期更规范（p = 0.001）。在研究期间，未标注日期的多剂量药瓶百分比逐月显著下降（p = 0.003）。这些结果支持了我们目前的指导原则，即多剂量药瓶应在开启时标注日期，并且除非出现可见污染或疑似污染，药瓶应在清空时或达到制造商规定的有效期时丢弃。
