Hutchinson Hannah M, Sayre Brian E, Prettyman Terrence, King Erica
Hosp Pharm. 2017 Apr;52(4):286-293. doi: 10.1310/hpj5204-286.
Current guidelines for sterile compounding require that single dose vials of pharmaceuticals must be discarded after 6 hours when accessed in an ISO Class 5 environment. At this time, no studies have evaluated the sterility of single dose vials at any time after opening. The purpose of this study is to evaluate the sterility of single dose vials attached to an automated compounding device for up to 24 hours and accessed and maintained within a cleanroom environment. This is a prospective, observational study evaluating the sterility of 32 pooled samples of manufactured single dose injectable drugs attached to an automated compounding device for up to 24 hours and maintained within an ISO Class 5 environment in an ISO Class 7 buffer area. Each pooled sample was comprised of the remaining contents of 10 single dose vial additives that were used for total parenteral nutrition (TPN) and attached to the compounder within the previous 24 hours. Samples were evaluated using membrane filtration sterility testing and incubated for 14 days per USP <71> requirements. The results revealed zero failed sterility samples. Single dose vials remained attached to the compounder for an average of 23.8 hours (±0.1 hours). The average volume per sample was 879 mL (±105.1 mL). Manipulation of vials during the compounding process included an average of 20.4 manipulations (±1.4). Single dose injectable drugs attached to an automated compounding device within an ISO Class 5 cleanroom environment may remain sterile for up to 24 hours. Future studies are needed with a larger sample size and under continued dynamic working conditions to provide further evidence to extend the beyond use date within USP <797>.
当前的无菌配制指南要求,在ISO 5级环境中开启的单剂量药品小瓶在6小时后必须丢弃。目前,尚无研究评估单剂量小瓶在开启后任何时间的无菌性。本研究的目的是评估连接到自动配制设备上的单剂量小瓶在洁净室环境中长达24小时的无菌性,这些小瓶在该环境中被开启并保持。这是一项前瞻性观察研究,评估32个合并样本的无菌性,这些样本为连接到自动配制设备上长达24小时并保存在ISO 7级缓冲区的ISO 5级环境中的已生产单剂量注射用药物。每个合并样本由10个单剂量小瓶添加剂的剩余内容物组成,这些添加剂用于全胃肠外营养(TPN),并在之前24小时内连接到配制器上。使用膜过滤无菌测试对样本进行评估,并根据美国药典<71>要求培养14天。结果显示无菌样本无一失败。单剂量小瓶连接到配制器的平均时间为23.8小时(±0.1小时)。每个样本的平均体积为879 mL(±105.1 mL)。配制过程中对小瓶的操作平均为20.4次(±1.4次)。在ISO 5级洁净室环境中连接到自动配制设备上的单剂量注射用药物可能在长达24小时内保持无菌。需要进行更大样本量和在持续动态工作条件下的进一步研究,以提供更多证据来延长美国药典<797>中的超出使用日期。