Are Multiple-Dose Vials as Safe as Single-Dose Vials If Drawn With Aseptic Technique: Q&A With Dr. Clifford Gevirtz

The following reader question came in response to the column “Critical Guidance for Complying With Anesthesia Infection Control Rules,” which features insight from Clifford Gevirtz, MD, an anesthesiologist with Somnia Anesthesia Services who practices throughout New York and Long Island, N.Y.

Q: The difference between a single dose and multiple dose vial is that the single dose vial does not have preservatives (no preservatives = less chance for contraindications with injection). This only gives single dose bacteria static properties for up to 4-6 hours after opening. How are multiple dose vials any safer than single dose vials if aseptic technique is utilized and both are injected within 1-4 hours of being drawn up? Both would be susceptible to bloodborne contamination and both would be susceptible to detritus from multiple injections … neither if used within 1-4 hours would allow time for the foreign detritus to grow bacteria prior to use. Isn’t it true that if used as recommended by the manufacturer that both are safe if drawn up with aseptic technique?

Dr. Clifford Gevirtz: There are two key points of that are not evidence-based.

1. The one-hour rule is not based on bacteriology results; it is a consensus approach by the committee that made . Please note that there were no anesthesiologists on that committee.

2. The observation that multiple entries versus single entry is irrelevant in the presence of bacteriostatic medication is a clinical truism. However, the FDA begs to differ. They state that if the label says “single patient use only,” then the container may be entered only once for a single patient. Their focus is on the labeling and not on clinical experience. The staff at CMS, similarly, have their own focus and anesthesia providers are now clearly in the crosshairs. However, the danger of non-compliance seems to far outweigh what is clinically reasonable.

Learn more about Somnia Anesthesia Services.

At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.

Next Up in Patient Safety & Outcomes

Are Multiple-Dose Vials as Safe as Single-Dose Vials If Drawn With Aseptic Technique: Q&A With Dr. Clifford Gevirtz

The 2 KPIs that drive readmissions — and how hospitals act on them in real time

Next Up in Patient Safety & Outcomes

2 dead in Michigan's cyclosporiasis outbreak

What leaders are overlooking in midcareer nurse burnout

The $36 vs. $95 problem: How RVU negotiations are skewing physician pay

The 2 KPIs that drive readmissions — and how hospitals act on them in real time

Next Up in Patient Safety & Outcomes

Join the 500,000+ healthcare executives who start their day with Becker’s