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Preservatives reduce bacterial growth during repeated vial access events

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-Bacteriostatic water for injection is distributed nationwide to over 5,000 U
The end result is gastric atrophy and depletion of intrinsic factor leading to poor absorption of food-bound, free, and biliary vitamin B 12 .2 Malabsorption is more complete and severe in PA compared to food-cobalamin malabsorption which is more partial in nature,2 and so the manifestations are more overt and severe in PA