Compounding an extemporaneous sterile antibiotic solution for treating an infected wound

European Statement

Production and Compounding

Why was it done?

To solve a problem with a foot wound of a young man not responding on the standard secondary surgical healing intention wound treatments, that appeared at the General surgery department of our hospital.The wound was infected with 2 bacteria, S. aureus and Enterococcus species.The patient was quite long time treated with i.v. antibiotics without result.The wound infections are one of the biggest common nosocomial problems that demand special professional team engagement.

What was done?

Compounded an extemporaneous sterile vancomycine and gentamycine solution for secondary healing intention wound treatment.

How was it done?

A responsible pharmacist being alone on an afternoon duty, initiated a topical application of sterile antibiotic solution according to wound’s antibiogram.The surgeon demonstrate suspicion due to lack of that kind of experience/practice.So 100 ml solution was prepared under sterile conditions of the Department for infusion solutions production in our hospital, containing 50 mg/ml vancomycine and 1.2 mg/ml gentamycin in a 0.9% sodium chloride sterile and nonpyrogenic solution for i.v. administration.According to the SmPCs of the antibiotics manufacturers we determined 7 days expire after production, kept on room temperature.

What has been achieved?

A departmental surgeon has accepted the initiative and treated the wound twice daily at the surgery department.On the second day of applying, the wound edges held closely together and the wound has started epithelialisation.There were not any allergic reactions, significant tingling, itching and pain on the skin around the wound.On the third afternoon of introducing the solution use, the patient was discharged home and reassigned for an ambulatory treatment i.e. daily hospital, for once daily wound washing with the sterile solution.We prepared the second dose of the solution on the 7th treatment day and the wound was healed on the 13th day.

What next?

To incorporate this GPI into daily surgical standard procedures for bacterially infected wounds for a best patient issues.