Aseptic simulation test for cytotoxic drug production in isolators

• Published in: American journal of health-system pharmacy Vol. 71; no. 6; pp. 476 - 481
• Main Authors: SAVRY, AMANDINE, CORREARD, FLORIAN, BENNIS, YOUSSEF, ROUBAUD, SOPHIE, GAUTHIER-VILLANO, LAURENCE, PISANO, PASCALE, POURROY, BERTRAND
• Format: Journal Article
• Language: English
• Published: Bethesda, MD Copyright American Society of Health-System Pharmacists, Inc. All rights reserved 15.03.2014; American Society of Health Pharmacists; Oxford University Press; American Society of Health-System Pharmacists
• Subjects: Antineoplastic agents; Antineoplastic Agents - chemical synthesis; Antineoplastic Agents - standards; Biological and medical sciences; Cytotoxins - chemical synthesis; Cytotoxins - standards; Decontamination (from gases, chemicals, etc.); Drug compounding; Drug Compounding - methods; Drug Compounding - standards; Drug Contamination - prevention & control; General aspects; Humans; Life Sciences; Medical sciences; Medication; Methods; Occupational Exposure - prevention & control; Occupational Exposure - standards; Pharmaceutical sciences; Pharmacology. Drug treatments; Pharmacy Service, Hospital - methods; Pharmacy Service, Hospital - standards; Product testing; Quality management; France; Antineoplastic agent; Simulation; Preparation; Sterilized product; Isolation; Biosynthesis; Hospital; Good manufacturing practices
• ISSN: 1079-2082; 1535-2900
• DOI: 10.2146/ajhp130343

PURPOSEThe results of a media-fill test (MFT) study to validate processes for cytotoxic drug preparation inside and outside aseptic compounding isolators are presented. METHODSUsing an MFT protocol adapted to institution-specific production conditions, the pharmacy team at a hospital in France performed a series of tests to verify the efficacy of decontamination and sterile compounding procedures, as required by French compendial standards, while assessing the performance of its team of 12 isolator operators; all operators were tested on three occasions, producing 10 MFT samples per test for a total of 30 samples per operator. The team also tested alternative compounding systems (i.e., two closed-system transfer devices and a classic spike system) for use during power outages or other emergencies precluding drug preparation within isolators. MFTs were performed using a standard tryptone soy broth–based test kit under worst-case conditions. RESULTSThe hospitalʼs facilities for cytotoxic drug preparation were found to be in conformance with applicable sterility standards. Bacterial growth was not detected in any of the MFT samples produced by isolator operators during the study (total n = 360). In one instance, an MFT sample prepared using a closed-system transfer device was found to be contaminated due to improper cleaning of the medication vial, highlighting the importance of strict adherence to proper decontamination procedures. CONCLUSIONA hospitalʼs practices for preparation of sterile products according to applicable good manufacturing guidelines, as well as emergency procedures for cytotoxic drug preparation outside isolators, were validated by the results of an MFT study.