Background In 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.

Purpose The 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 methods An 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.

Results The 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.

Conclusion Within 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 Acknowledgements 1. 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.org

No conflict of interest