BackgroundThe accuracy, safety and feasibility of, the compounding robot APOTECAchemo were evaluated in the clinical practice of Japan.MethodsAccuracy and precision of robotic preparations by APOTECAchemo was evaluated in 20 preparations of fluorouracil (FU) and cyclophosphamide (CPA) infusions by four pharmacists. Environmental and product contaminations with FU and CPA were evaluated by wipe testing. Robotic performance was compared with manual preparation in a biological safety cabinet. The number of robotic products, total compounding time and total pre-reconstitution time of lyophilized drugs between January 1, 2014 to December 31, 2015 were investigated.ResultsRobotic preparation resulted more accurate and precise (mean absolute dose error and coefficient of variation were 0.83 and 1.04% for FU and 0.52 and 0.59% for CPA) than those of manual preparation (respective values were 1.20 and 1.46% for FU and 1.70 and 2.20% for CPA). Drug residue was not detected from any of the prepared infusion bags with the robotic preparation, whereas FU was detected in two of four analyzed infusion bags with manual preparation. Average total time to make single anticancer drug preparation (compounding plus reconstitution of lyophilized drugs) was 6.11 min in the second half of 2015. During the study period, the highest percentage of production covered by APOTECAchemo was 70.4% of the total inpatient pharmacy activity.ConclusionRobotic preparation using APOTECAchemo should give substantial advantages in drug compounding for accuracy and safety and was able to be successfully worked in Mie university hospital.
Stomatitis is one of the most common side effects caused by anticancer agents. Serious stomatitis leads to eating disorders and deteriorates quality of life significantly. However, no effective treatment has been established. Both sodium azulene sulfonate and tranexamic acid are generally used for stomatitis. Here, we aimed to assess the mouthwash containing these two drugs (A + T mouthwash) for the treatment of chemotherapy-induced stomatitis. In this study, we retrospectively investigated the grade of stomatitis (Common Terminology Criteria for Adverse Events version 4.0) and subjective symptom before and after the use of A + T mouthwash in cancer patients receiving chemotherapy, and assessed the ef cacy of A + T mouthwash against chemotherapy-induced stomatitis.Forty-four cancer patients (gastric, colon, cholecystitis, breast, ovarian and unknown primary cancer) were included in this study. The severity of stomatitis was signi cantly improved after using A + T mouthwash compared to before using it (P < 0.05). Of the 44 patients, the grade was improved in 25 patients (56.8 ) and the subjective symptom was improved in 36 patients (81.8 ). These results suggest that A + T mouthwash is effective for chemotherapy-induced stomatitis.
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