Oseltamivir compounding in the hospital pharmacy during the (H1N1) influenza pandemic

AIMS: Pandemics impose large demands on the health care system. The supply of appropriate chemotherapeutic agents, namely oseltamivir solution, presented a serious challenge in the recent influenza pandemic. This study reports on the rational series of pharmacotechnical steps that were followed to appropriately handle bulk oseltamivir powder to meet the increased demand. METHODS: During a six-week period in August and September of 2009, a task force was created in the Central Pharmacy of Hospital das Clínicas to convert imported oseltamivir phosphate into ready-to-use solution for utilization by physicians and public health authorities. The protocol included dissolution, physico-chemical tests and the bottling of a liquid microdose formulation for emergency room and outpatient dispensing with adequate quality control during all phases. RESULTS: The successful production routine was based on a specially designed flowchart according to which a batch of 33210 g of oseltamivir powder was converted into 32175 solution units during the aforementioned period with a net loss of only 2.6 percent. The end products were bottles containing 50 ml of 15 mg/mL oseltamivir solution. The measured concentration was stable and accurate (97.5 percent - 102.0 percent of the nominal value). The drug was prescribed as both a prophylactic and therapeutic agent. DISCUSSION: Hospital pharmacies are conventionally engaged in the manipulation of medical prescriptions and specialty drugs. They are generally responsible for only small-scale equipment used for manufacturing and quality-control procedures. The compounding of oseltamivir was a unique effort dictated by exceptional circumstances. CONCLUSION: The shortage of oseltamivir solution for clinical use was solved by emergency operationalization of a semi-industrial process in which bulk powder was converted into practical vials for prompt delivery.

Novel antiviral activity of dialdehyde starch

A significant effort worldwide is being directed toward development of novel biocides against drug-resistant bacterial and viruses because of the significant potential human infection risks in the general population. We report here the discovery of a strong antiviral biocide, dialdheyde starch (DAS). Antiviral tests were carried out against three non-envelop viruses, including two bacterial viruses MS2 and PRD1, and one human virus Poliovirus. Dialdehyde starch aqueous suspensions were effective biocides against these three test viruses in a 1 hr exposure test. The antiviral activity was significantly enhanced in a four-hour exposure test, with maximum seven orders of magnitude reductions against MS2 and PRD1, and four-order reduction against Poliovirus. The antiviral activity of dialdehyde starch was found to be pH dependent, being more active in alkaline and acidic conditions than in neutral conditions.