Masking of an intravenous preparation of ceftriaxone for use in clinical trials: A technical report

Crit Care Resusc. 2023 Nov 23;25(4):172-174. doi: 10.1016/j.ccrj.2023.10.002. eCollection 2023 Dec.

Abstract

Background: Intravenous antibiotics are often evaluated in clinical trials in hospitalised patients but for blinded trials masking of antibiotics is required.

Objective: To evaluate the effectiveness of masking of ceftriaxone and amoxicillin / clavulanic acid for use in blinded clinical trials.

Design setting and participants: Amoxicillin / clavulanic acid (1.2g) and ceftriaxone (1g and 2g) were diluted in 100mL of sodium chloride. Clinicians from a single centre were asked to attempt to distinguish solutions containing antibiotics from solutions without added antibiotics at time points up to 12 hours following dilution.

Results: 1g of ceftriaxone diluted in 100 mL of 0.9 sodium chloride stored in a light-protected bag and refrigerated at 3-4 °C for up to 10 h could not readily be distinguished from 100 mL of 0.9 % sodium chloride. However, solutions containing either amoxicillin / clavulanic acid (1.2g) or ceftriaxone (2g) were readily identifiable.

Conclusions: 1 g of ceftriaxone can be effectively masked by dilution in 100mL of sodium chloride.

Keywords: Antibiotic; Blinding; Clinical trials; Masking; Performance bias.