title: Using a medium-fill simulation to evaluate the microbial contamination rate for USP medium-risk-level compounding.
abstract: OBJECTIVE
  The estimated microbial contamination rate for complex, multiple-step, medium-risk-level compounding was studied.
  
  
  METHODS
  The results of evaluations of the aseptic technique of pharmacists and technicians in compounding complex USP medium-risk-level sterile preparations were compiled to estimate the microbial contamination rate. The testing took place in 2002 and 2003 at a single institution and involved reconstitution of sterile dry growth medium and a series of complicated transfers of the medium from vials and ampuls to intravenous bags. The bags were incubated at 25-35 degrees C for 14 days and observed for microbial growth.
  
  
  RESULTS
  Of 539 evaluations, 28 (5.2%) resulted in preparations that yielded microbial growth. Pharmacists' compounding resulted in a slightly lower contamination rate (4.4%) than that of technicians (6.2%). Inadvertent touch contamination may have been the principal source of the contamination.
  
  
  CONCLUSIONS
  . A two-year series of 539 evaluations of the aseptic technique of pharmacists and technicians conducted with sterile growth medium and designed to simulate the compounding of USP medium-risk-level sterile preparations yielded an overall contamination rate of 5.2%.
authors.affiliation: Division of Pharmacy, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Trissel
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Gentempo
authors.forename: Roger W
authors.initials: RW
authors.lastname: Anderson
authors.forename: Joel D
authors.initials: JD
authors.lastname: Lajeunesse
mesh_terms: D004339:Drug Compounding / Q000379:methods*; D004340:Drug Contamination / Q000517:prevention & control* / Q000706:statistics & numerical data; D005069:Evaluation Studies as Topic; D006801:Humans; D010604:Pharmacy