Background The ESCRS study (a study of prophylaxis of endophthalmitis after cataract surgery) demonstrated the effectiveness of cefuroxime (1 mg/0.1 mL) administered in the anterior chamber at the end of cataract surgery for the prevention of the appearance of endophthalmitis. The marketed presentation (Prokram) contains 50 mg per vial in a final volume of 10 ml. The manufacturer recommends the use of one vial per patient (even if it involves discarding 98% of the contents of the vial).
Purpose To describe the optimisation in the use of Prokram (cefuroxime) vials through its redosification in order to obtain prefilled syringes with a concentration of 1 mg/0.1 mL.
Material and methods A bibliographic search was carried out, both for the indications for which the preparation was requested, as well as of its galenic properties, collecting the stability, the conservation and the necessary microbiological controls.
After agreement with the ophthalmology service, it was agreed to prepare pre-filled syringes containing cefuroxime 2 mg/0.2 ml in order to administer 1 mg of cefuroxime. The syringes are made in batches of 20 units and are frozen at −18°C. The units that are ordered according to the daily surgical part are sent to the operating room.
For the elaboration of the cost analysis, the cost of the vial of cefuroxime 50 mg, the insulin syringe of 0.3 ml, the sterile cap, the double bag for the packaging and the cost of the personnel elaborating them, has been quantified.
Results In 2017, 1239 syringes (associated cost of €847) were prepared. The cost for the hospital of each vial of Prokam is €7.80, so if they had not been redosed in the pharmacy service the cost would have amounted to €9664.
No postoperative endophthalmitis has been described.
Conclusion The preparation of pre-filled syringes of cefuroxime 0.2 mg/0.2 ml has produced a cost optimisation of 91%.
Reference and/or acknowledgements Barry P, Seal DV, Gettinby G, et al. ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery: preliminary report of principal results from a European multicenter study. J Cataract Refract Surg 2006;32:407–10.
No conflict of interest.
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