Reconstitution oral antibiotics

Attention should be paid to the ventilation of any premise and its upkeep. In newly built premises, the ventilation capacity might have been minimised due to energy saving policy, especially in northern countries. Therefore the risk has to be assessed that the ventilation might fail to meet minimal requirements. Any so-called natural ventilation might clear the way for insects to enter, unless specific measures are taken (e.g. insect screens). Air quality can be improved by using a recirculating dust exhaust cabinet which should be available in every community pharmacy, e.g. for the reconstitution of antibiotic oral liquids. 

For parenteral use, the antibiotic is packed in sterile vials as a powder (reconstituted before use) or suspension. For oral use it is prepared in any of the standard presentations, such as film-coated tablets. Searching tests are carried out on an appreciable number of random samples of the finished product to ensure that it satisfies the stringent quahty control requirements for potency, purity, freedom horn pyrogens and sterility. 

An antibiotic for oral suspension, following reconstitution of the dry powder, contains in each 5 mL, 250 mg of the drug in package sizes to prepare 100 mL, 150 mL, or 200 mL of suspension. Which package size should be dispensed for a 20-kg child prescribed to take 50 mg/kg/day total, q.i.d. in divided doses, for a period of 10 days ... 

Potable water can be used for the various antibiotic oral mixtures that are reconstituted from the dry granulate. 

Medicine bottles are often provided with a graduated mark. It is intended, and accurate enough, to measure a quantity to be dispensed to the patient. To adjust the volume during a preparation process it is too inaccurate. This may also apply to the reconstitution of an antibiotic oral mixture in a bottle provided by the manufacturer. In this case it is also relevant that the meniscus cannot be accurately read due to foaming of the mixture. Separate measuring or weighing of the required quantity of water is the right approach. 

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