Drug-drug cross contamination in the Swisslog fully automated medication handling system.

ABSTRACT

OBJECTIVE: The risk of drug-drug cross contamination in drug dispensing robots in hospital pharmacies causes cumbersome restraints to be put on the production of the robot for example by scheduling high-risk drugs to be dispensed at the end of the day. However, we were unable to find published data on the matter, and therefore performed a worst-case scenario study to assess the magnitude of the problem. METHODS: We measured dexamethasone residue left on the suction cup after the production of 100 and 400 dexamethasone tablets, and after 20 paracetamol tablets used as a negative control. RESULTS: We found that 32.9 µg and 49.5 µg of dexamethasone had been transferred to the suction cup in the two experiments. This is approximately 1 per mille of the dexamethasone content in a 40 mg tablet. CONCLUSION: We conclude that uncoated dexamethasone does shed measurable residue in the robot. It remains unknown to what extent this residue contaminates the subsequent production.