another Bacteriostatic Sterile Water thread

Augu5+1ne

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maybe I should add to prior bac water threads, but I noticed they veered off into other directions so I decided to start another. Firstly, where are the best places to buy bacteriostatic sterile water (bac water)? Amscomedical.com, peptidetest.com, or hcgsupplies.com, or private sellers? Currently the cheapest/safest seems to be amscomedical @$5/each if you buy box of 25.
Secondly, there seems to be a few who insist on the 28day rule for bac water which seems wise on first look, but as a consideration I wanted to inject the following thought.

Theoretical max shelf life safety for bacteriostatic water (0.9% benzyl alcohol in sterile water) is ~90 days per 2018 study in a busy hospital setting on multi-dose vials of sterile water, where there were NO GROWTH of microbials in the refrigerated samples even though uncontrolled and unlimited intrusions occurred from multiple RNs. Some might challenge the authors as to location and numbers, but the methods and testing seem reputable.

The 28 day rule is per USP and OSHA in busy hospital settings and perhaps shouldn't necessarily strictly apply to single users at home using rigorous sterile techniques, refrigerating the bac water, using very thin insulin needles only, minimizing puncture tears in the rubber stoppers of bac water vials, and wiping down the rubber of the vials before & after each use with 70% alcohol swabs. The 0.9% benzyl alcohol is stabilized in refrigerated temperatures and the growth of microbials are suppressed in refrigerated temperatures. Throwing away a 30ml vial of $5-$10 bac water is a waste of money for single home users knowledgeable about sterile technique. I would tentatively be comfortable with a "90 day rule for home users of USP bacteriostatic sterile water refrigerated promptly after each use."
 

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"Contamination of the infusate usually occurs extrinsically during manipulation of the fluid before the administration to the patient...Poor aseptic techniques employed during successive uses appear to be most likely route of contamination responsible for considerable morbidity and mortality."

"Research has shown that up to 25% of healthcare workers re-enter injection vials with needles just injected into the patients."

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here are a couple other studies to consider, first one is one showing that in 7200 consecutive samples accessed using sterile techniques, no microbial growth were found, which demonstrates the efficacy of sterile technique in reducing contamination, though the weakness is that it doesn't assess growth at beyond 3 days: https://pubmed.ncbi.nlm.nih.gov/25769293/

This study is older, but it deliberatedly innoculated vials with bacteria, yet despite this, of 928 samples, only 0.4% of samples demonstrated microbial growth seen, showing the efficacy of 0.9% benzyl alcohol: https://pubmed.ncbi.nlm.nih.gov/6800255/

This is a semi-decent study also supporting the 90days safety of bac water:
Wilson et al. (2000) (Infection Control and Hospital Epidemiology, 2000;21(5):345-348)

There are numerous studies showing that the benzyl alcohol's antimicrobial effects wane 4-6weeks out, but refrigerated benzyl alcohol's effects persist.

Again please note that probably 99+% of us users here ARE NOT in a busy hospital environment, and certainly not in 3rd world public hospitals where these practices are studied. We hopefully are in cleaner and more controlled environments and one could argue that even the 90 day rule is conservative, but it of course depends on the user and his/her OCD and sterile techniques.
 

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