Meningitis outbreak prompts scrutiny of custom-mixed medications

By LAUREN GENTILE
Capital News Service
LANSING – Custom-mixed medicines, like the steroids shots that sparked the recent meningitis outbreak, are under scrutiny.
These medicines can be made in private and hospital pharmacies and are used to treat a variety of ailments from bronchitis symptoms to vision loss, said Larry Wagenknecht, chief executive officer of the Michigan Pharmacists Association.
“This type of mixing happens every day, every minute, in hospitals, and as long as all precautions of sterilization take place, no one should worry,” Wagenknecht said.

Custom drugs must go through many sterilization processes, he said.
“Sterilization is a key component when mixing drugs and shipping them. With the recent meningitis outbreak, we believe that something must have failed. It doesn’t happen often, but now we can work to make sure it never happens again.”
In Michigan, there were 37 confirmed cases of fungal meningitis and three deaths as of Friday, plus two non-meningitis cases among patients who received epidural injections. The Department of Community Health predicts the numbers to rise since more than 13,000 infected immunizations were given to state residents experiencing back pain.
Products used to make such immunizations are usually name-brand medicines that pharmacists spilt into smaller doses. In general, a shortage of product may have made the manufacturer seek alternative drugs that needed to be custom-made.
David Miller, executive vice president of the International Academy of Compounding Pharmacists in Missouri City, Texas, said, “Because of the incredible number of drugs that are out of stock or back-ordered, compounding pharmacies are working with local hospitals, clinics and physicians to fill that gap.”
There are more than 7,500 accredited compounding pharmacies in the United States with six accredited in Michigan, not including hospital pharmacies. They are in Allen Park, Farmington Hills, Grand Rapids, Saginaw, South Lyon and Ypsilanti.
Angela Minicuci, public information officer for Community Health, said the public shouldn’t worry about the safety of other vaccines or medications.
“This outbreak was very specific to a medication,” she said of the meningitis problems. “We were able to specify it to a certain batch of medication and contact everyone who had the potential of being infected.”
Wagenknecht said a benefit of the outbreak is that patients will have a heightened awareness of their medications.
“Instead of being afraid, patients should want to be informed. Ask as many questions as possible: where is the drug coming from, what is it mixed with?” he said. “Information will help patients have a good understanding of what types of drugs they are receiving.”
Community Health Director James Haveman said the public can rely on such information.
“We are bringing you the facts and making sure that sterilization processes are very important to health care providers. It is our goal to make sure no one has to worry about an epidural or shot making them sick in the future.”
However, Wagenknecht cautioned that there is always a risk with medications.
“Anytime an injection is given, there is a threat of infection, but health care providers always do their best to lower the risk by cleansing the skin and sterilizing the needle before giving the injection to the patient.”