0.9 per cent is 9 mg of sodium chloride per millilitre — 0.9 g in 100 mL — which works out at about 154 mmol/L of each ion and is why it is called isotonic. What it does not contain is a preservative, and that is what the question turns on. A plain 0.9 per cent vial is labelled single-use precisely because nothing in those 9 mg/mL discourages growth; the salt is a tonicity agent, not an antimicrobial. Bacteriostatic water carries benzyl alcohol and is the one the twenty-eight-day convention was written for. So the honest answer is that the clock started at the first puncture and the diluent is not helping it.
If the supplier documentation specifies bacteriostatic water, there is a reason, and that reason is almost always "this is for multiple-withdrawal use."
The distinction worth internalising is that bacteriostatic water is for preservation during use, not for sterilisation of contaminated material.
The timeline after opening is: zero to 24 hours is almost risk-free, 24 hours to 7 days is low-risk if refrigerated, 7 to 28 days is acceptably low-risk if refrigerated and handled correctly, and over 28 days is guesswork.
One qualification: the 28-day date is not a hard expiry, it is a guideline based on convention and risk assessment.
Do not use bacteriostatic water as a substitute for aseptic technique.
4Confirming: I did the wrong thing here once and got exactly the predicted result. – w_okoye 5 months ago 5Two of us worked through this independently and arrived here, so at least it reproduces. – lyoph_cake 7 months ago add a comment