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Year : 2021  |  Volume : 33  |  Issue : 3  |  Page : 274-277

Multidose bevacizumab (Avastin) vial microbial safety: A real-life scenario

1 Department of Ophthalmology, Santhiram Medical College and General Hospital, Nandyal, Kurnool, Andhra Pradesh, India
2 Department of Ophthalmology, Consultant of Santhiram Superspeciality Hospital, Nandyal, Kurnool, Andhra Pradesh, India

Correspondence Address:
Dr. Sheshadri Vishnu Mahajan
Department of Ophthalmology, Santhiram Medical College and General Hospital, Nandyal, Kurnool, Andhra Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/kjo.kjo_189_20

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Purpose: The purpose of the study is to evaluate the microbiological safety profile of multidoses of bevacizumab (Avastin) from a single-use vial in a real-life scenario. Methods: In a prospective interventional study, a total of 12 sequential vials of bevacizumab (Avastin) were used for this study. After using each vial for multipuncture, multidoses of intravitreal injections for 1 month, leftover bevacizumab in the vial was again stored in the refrigerator at 4°C. All the vials were sent for microbiological evaluation using Gram staining, potassium hydroxide mount, blood agar, MacConkey agar, and brain–heart infusion broth cultures; both at the opening of each vial and after utilization of 12th vial. Patients receiving intravitreal injections from these vials for various ophthalmic indications were followed up at least 3 months postprocedure for clinical evidence of infection. The Microbiology Laboratory is standardized, especially for ophthalmology specimens, and the media, blood agar and MacConkey, agar were prepared in-house, whereas brain–heart infusion broth is commercial media (HiMedia). Results: All the 12 used vials' microbiological evaluation when evaluated at the opening of vials and 13th month of the study period showed no bacterial or fungal elements. None of the patients who received intravitreal injections from these vials developed clinically detectable ocular infection or inflammation. Conclusion: This study suggests that the contents of multiple-dose bevacizumab (Avastin) vials remain sterile over a period of 1 year without any microbial contamination if proper refrigeration and aseptic precautions are maintained. Multipuncture, multidose Avastin vial utilization with due aseptic precautions and storage shows reliable microbiological safety both in vitro and in vivo over 1 year period.

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