3PC-039 Centralised non-hazardous intravenous compounding: improvement of clinical practice

Abstract

BackgroundIn April 2016 the Central IntraVenous Additive Service (CIVAS) began to compound non-toxic injectable therapies with a robotic system.1 The production started with antiemetic therapies, followed by antibiotic therapies ready to infuse, as cefazoline 1 g in syringes and piperacillin-tazobactam 4.5 g in bags.PurposeThe purpose of this study is to present the new drugs involved that led to production increasing and to describe how CIVAS guarantees the non-hazardous preparations’ supply to hospital departments.Material and methodsAn analysis concerning the actual hospital antibiotic treatment needs has been carried out through the electronic medical record (EMR). Drugs in ready-to-use injectable form were immediately excluded as well as those with a daily consumption under 20 units. Among the remaining amount of medications, only those with a sufficient physical and chemical stability,2 that allow batch production and at least 7 days of storage, were considered. For every new molecule, a testing production with five batchs of 10 preparations each were compounded through a robotic system, in order to evaluate the dosage accuracy.ResultsThe new validated drugs included in the automated production result were: oxacillin 1 g, cefotaxime 2 g, azithromycin 500 mg, vancomycin 500 mg and ceftriaxone 1 g, all in 100 ml NaCl bags. The average dosage accuracy ranges from 93.43% of azithromycin to 99.64% of cefotaxime, always compliant with the 10% error limit set by the Official Pharmacopoeia. The annual workload, including piperacillin-tazobactam 4.5 g and cefazoline 1 g already compounded inside the automated system, is estimated as 80 000 bags.ConclusionWithin 2017, the robotic system will cover the dispensing of antibiotic treatments of 50% of hospital departments, reaching 100% by the end of 2018.References and/or Acknowledgements1. Bufarini C, et al. Centralised non-hazardous intravenous compounding: from theory to clinical practice. Eur J Hosp Pharm2017;24(1):A1–A288 PP-041.2. ‘Stabilis 4.0’. www.stabilis.orgNo conflict of interest