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On April 10, 2015, the Provincial Infectious Diseases Advisory Committee on Infection Prevention and Control (PIDAC-IPC) updated the guidance on the use of multidose vials in Infection Prevention and Control for Clinical Office Practice. This guidance was revised as a result of inquiries from health care providers from outpatient and inpatient settings to clarify when opened multidose vials should be discarded.

The use of multidose vials for injectable medications and vaccines increases the risk of transmission of blood-borne pathogens and bacterial contamination of the vial and should be avoided. Patient safety should be prioritized over cost when choosing between multidose and single-use medication vials. 

• All needles are SINGLE PATIENT USE ONLY.
• All syringes are SINGLE PATIENT USE ONLY.
• NEVER re-enter a vial with a used needle OR used syringe.

If multidose vials are selected for use, the following recommendations must be followed each time the multidose vial is used: 

• Once medication is drawn up, the needle should be IMMEDIATELY withdrawn from the vial. A needle should NEVER be left in a vial to be attached to a new syringe.
• Use multidose vial for a single patient whenever possible and mark the vial with the patient’s name.
• Mark the multidose vial with the date it was first used and ensure that it is discarded at the appropriate time.
• Adhere to aseptic technique when accessing multidose vials. Multidose vials should be accessed on a surface that is clean and where no dirty, used or potentially contaminated equipment is placed or stored. Scrub the access diaphragm of vials using friction and 70% alcohol. Allow to dry before inserting a new needle and new syringe into the vial.
• Discard the multidose vial immediately if sterility is questioned or compromised or if the vial is not marked with the patient’s name and original entry date.
• Review the product leaflet for recommended duration of use after entry of the multidose vial. Discard opened multidose vials according to the manufacturer’s instructions or within 28 days, whichever is shorter*

 

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* EXCEPTIONS can be considered for multidose vials used for a single patient (e.g., allergy shots) if the manufacturer’s instructions state that the vial can be used for longer than 28 days. All of the above steps must be followed and the vial must only be used for a single patient