Waste of hospital preparations, the example of ceftazidime ophthalmic solution at Angers University Hospital

5 October 2022

S. Maisonneuve, V. Lebreton, S. Vrignaud, F. Lagarce
Centre hospitalier universitaire d’Angers, France

In an age of diminishing resources and with hospital waste approaching 700,000 tons per year [1], it is becoming increasingly important to make efforts to reduce waste. While many efforts are already being made within hospital pharmacy units, there are still points for optimization. One of these points consists in reducing the destruction of pharmaceutical preparations due to expiration.

Last year, Angers University Hospital produced 129 units of ceftazidime ophthalmic solution with hospital preparation status. 35 units of this production were destroyed due to expiration, which is approximately 25% of the annual production. In addition to the waste generated (raw materials, bottles, packaging, paper, labelling), the waste of human resources is also to be deplored.

How can this proportion of waste generated by expiration be reduced?
One avenue currently being explored by the University Hospital is to increase the expiration dates of hospital preparations, which, for preparations with a short expiry date could be decisive.
In that objective, the University Hospital has launched a large stability study on all the hospital preparations.

Material and method
Every 30 days, a sample kept under standard storage conditions is controlled according to the internal control protocol. If the controls carried out make it possible to consider doubling the period of validity of the preparation, then controls making it possible to certify the conformity of the preparation with respect to the official references are carried out on 2 other samples.

Preliminary results
Since the launch of the study (January 2022), 5 specialties of various galenic forms (eye drops, oral suspension, cream) have been investigated.
To date, for the ceftazidime ophthalmic solution, a control point 12 months after the initial expiration date has been complied with 3 times in HPLC for chemical stability and 1 time in membrane filtration for microbiological stability (2 other microbiological manipulations on hold due to lack of time).

If this new expiration date is confirmed, a tripling of the current validity period could be envisaged, thus allowing us to reduce the number of production campaigns and expiries.

[1] Ministère des Affaires sociales et de la Santé - Pour une bonne gestion des déchets produits par les établissements de santé et médico-sociaux - 2016

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