“Protect from light” is a term that caused much annoyance this week.
There's an antibiotic that we use, which is given in single intravenous doses, so our department has been sending out vials by the handful rather than the 100-pack that the company sends out. One of our technicians noticed on the PIL that the expiry date is dependent on storage protected from light.
The single vials are transparent – if we leave a vial outside on a counter in front of a strip light, does it damage the antibiotic? How much light does it take to render this antibiotic useless?
What has been the impact of this on patients past and present? How much hassle do we need to put ourselves and the nurses through to make sure that patients benefit from this antibiotic?
None of our reference sources gave an answer, so I contacted the medicines information department of the company concerned. They were unable to tell me why this line appears in their SPC and literature. Probably it was research on shelf life which only looked at the locked cupboard option, rather than the pharmacy stock room, dispensary, porter bag, ward cupboard (blast of light when it opens every half hour or so), nurses' bench and then finally made up for the patient.
So it's uncertain whether there is any problem at all with light and this antibiotic. We're uncertain if we need to get one of those black bags that photo developers when they open up the back of a 35mm camera to extract film for all transfers. Or perhaps it's all for nothing, a statement inserted “just in case” by a lawyer without any need for clinical use.
On Monday I'll be trying to find someone who understands the chemistry to determine whether we have a problem, until then we are faced with uncertainty.
1-11-08
