Extemporaneous Compounding Practice for Dermatologic Preparations in Ethiopian Public Hospitals: Regulatory Requirements and Quality Concerns

Prevalence, Risk, and Challenges of Extemporaneous Preparation for Pediatric Patients in Developing Nations: A Review

Extemporaneous preparations are still widely prescribed for pediatric patients with special treatments of certain doses and/or combinations of drugs. Several problems related to extemporaneous preparations have been linked to the incidence of adverse events or a lack of therapeutic effectiveness. Developing nations are facing the challenges of compounding practices. The prevalence of compounded medication in developing nations must be explored to determine the urgency of compounding practices. Furthermore, the risks and challenges are described and explained through investigation and collection of numerous scientific articles from reputable databases, including Web of Science, Scopus, and PubMed. Pediatric patients need compounded medication related to the appropriate dosage form and dosage adjustment. Notably, it is important to observe extemporaneous preparations in order to provide patient-oriented medication.

Compounding in Ukraine: Assessment of the Risks for the Ointment’s Quality by the FMECA Method

The level of compounded medicines (CM) quality has always been questioned in different countries. This problem has been resolved by the introduction of quality assurance system (QAS) standards. One of its main areas of significance is the risks assessment process, which is especially important for the compounding pharmacy according to the requirements of different international documents. Since ointments constitute a large part of CM, quantity assessment of risks for their quality by the FMECA method has been completed. During the first step of the research, 42 potential deviations of compounded ointments (CO) quality were identified. Via the questioning of compounding pharmacies specialists in different regions of Ukraine by a pre-developed ten-point scale, the severity of deviations consequence, their occurrence probability, and detecting possibility were determined followed by the calculation of the priority risk number (PRN) value. The Pareto analysis showed that nine possible CO quality defects represented 21% of their total number. Defects related to the composition or technology of ointments (29%) and their compliance with microbiological purity requirements (23%) had the largest percentage contribution to the total PRN value. It was also found that the deviations consequence had the most serious impact on the CO quality, due to their direct influence on patient health.

Prescribing Pattern of Dermatological Compounding in Ethiopia: The Case of ALERT Hospital

BACKGROUND

Skin diseases are among the major contributors of disease burden in Ethiopia affecting individuals of all age. Extemporaneous compounding of topical medications serves as a necessary option to treat skin diseases when manufactured medications could not meet specific patient needs. Different classes of drugs are commonly used for the treatment of dermatologic diseases. Failure to periodically assess the prescribing pattern and patient needs may lead to inappropriate planning and implementation that ultimately compromise the service. Periodic prescription analysis for compounded medications helps to monitor the prescription pattern with respect to medication selection, disease condition, dosage form types and other relevant parameters. The current study was conducted to analyze the pattern of compounding prescriptions for dermatologicals in ALERT hospital.

METHODS

A cross-sectional design was conducted by retrospectively evaluating compounding prescription records of January and July, 2021. A total of 460 prescriptions in the hospital community pharmacy were systematically selected. Data related to disease pattern, product selection and dosage form type were extracted and analyzed. Data analysis was done using software for the statistical package for social science version 25.0.

RESULTS

A total of 441 prescriptions containing dermatological products for compounding were analyzed. Most patients were female (62.8%) and aged 30-64 years (44.0%). Psoriasis (36.2%), acne vulgaris (15.3%), and rosacea (13.4%) were the top 3 skin diseases for which the compounding preparations were prescribed. Salicylic acid (38.0%) was the most frequently prescribed drug followed by betamethasone (20.2%); while white petrolatum (47.2%) was the most common diluting agent used for compounding.

CONCLUSION

Psoriasis was the major dermatologic disease for compounding prescriptions and salicylic acid was the most frequent product used in compounding for treatment of the prescribed skin diseases.