Clark Bernadette A, Sessink Paul J M
Oncology, Cleveland Clinic Cancer Center, Fairview Hospital, OH 44111, USA.
J Oncol Pharm Pract. 2013 Jun;19(2):99-104. doi: 10.1177/1078155212468367. Epub 2013 Jan 4.
To evaluate the effectiveness of a closed system drug-transfer device, EquaShield®, at reducing surface contamination with antineoplastic agents throughout an ambulatory cancer chemotherapy infusion center.
Surfaces throughout the cancer center were sampled three times. The first samples were obtained in June 2010 without prior cleaning to measure baseline levels of contamination of the current technique (Chemo Dispensing Pin, B. Braun Medical Inc.). The second samples were obtained in August 2010 after the implementation of the closed system drug-transfer device and cleaning to evaluate if the contamination was removed. The third samples were obtained in August 2011. Wipe samples were taken from five positions in the pharmacy and from five positions in the infusion suite. Wipe samples were also collected from two positions in office areas. Samples were analyzed for cyclophosphamide and 5-fluorouracil.
The results from the first two sets of samples showed contamination with cyclophosphamide on about half of the positions at all locations during both collection periods. However, levels of contamination were very low and mostly just above the detection limit of the analytical method. The highest level of contamination was found on the door and handle in the pharmacy. Contamination with 5-fluorouracil was only observed on the dispensing counter in the pharmacy during the second collection period. The results from the third and final collection period showed no contamination with cyclophosphamide or 5-fluorouracil in the pharmacy, the infusion suite or in offices of the cancer center.
Implementation of the closed system drug-transfer device for preparing and administering chemotherapy eliminated surface contamination with cytotoxic agents at the ambulatory cancer chemotherapy infusion center.
评估一种封闭系统药物转移装置EquaShield®在整个门诊癌症化疗输液中心减少抗肿瘤药物表面污染的有效性。
对癌症中心的表面进行了三次采样。第一批样本于2010年6月采集,未事先清洁,以测量当前技术(贝朗医疗公司的化疗配药针)的基线污染水平。第二批样本于2010年8月在实施封闭系统药物转移装置并清洁后采集,以评估污染是否被清除。第三批样本于2011年8月采集。擦拭样本取自药房的五个位置和输液室的五个位置。还从办公区域的两个位置采集了擦拭样本。对样本进行环磷酰胺和5-氟尿嘧啶分析。
前两组样本的结果显示,在两个采集期内,所有位置约一半的采样点均检测到环磷酰胺污染。然而,污染水平非常低,大多仅略高于分析方法的检测限。污染最严重的是药房的门和把手。仅在第二次采集期内在药房的配药台上检测到5-氟尿嘧啶污染。第三批也是最后一批采集期的结果显示,药房、输液室或癌症中心办公室未检测到环磷酰胺或5-氟尿嘧啶污染。
在门诊癌症化疗输液中心,使用封闭系统药物转移装置制备和给药化疗药物可消除细胞毒性药物的表面污染。