Lipscomb Pharmacy Professor Explains Science of Compounding Medicines
by Heather Graf
NASHVILLE,Tenn. - A deadly meningitis outbreak that began in Nashville is still growing, along with fear and confusion about how we got to this point.
There are now 47 confirmed cases, 29 of them right here in Tennessee.
In addition, 23 states across the country received vials of the contaminated drug from a compounding pharmacy outside of Boston.
The Dean of Lipscomb University's Pharmacy School calls compounding the "heart and soul" of his profession, and says it's been that way for years.
He also says there's a distinct difference between compounding and manufacturing.
"It's not uncommon or unexpected to find compounding of medications in pharmacies of all types, across the country," said Dean Roger Davis. "The difference in compounding versus manufacturing is really a question of volume."
In the case of the Massachusetts-based New England Compounding Center, the pharmacy chose to produce and ship some 17,000 doses of a steroid drug that was only later found to be contaminated.
In doing so, health officials are now questioning whether the pharmacy broke the law, because it wasn't licensed to produce such mass quantities of medication.
Davis says that's when compounding can become dangerous.
"When you manufacture in large volumes, there is always the possibility that a small error can be multiplied, because it will be divided into smaller sub lots for distribution, and so there's a concern that even when procedures are followed, if any error occurs, it can multiply," he said.
Davis also hopes people won't let this particular situation discredit compounding altogether.
"I hope the public can differentiate between those two situations," he said. "They should take a lot of confidence in the preparation and the process that is effected in most pharmacies across this state and across the country."
It's a lesson he and the other pharmacy professors at Lipscomb University teach their students early on: rules and regulations are in place for a reason.
"There are certain procedures and processes that have to be followed all the time, and this is an example - could be - an excellent example of why all those things are in place or necessary," he said. "There's nothing that should ever be shortcut in that process of preparing sterile compounded products."
On Friday, the Tennessee Department of Health said it's now telling hospitals and clinics across the state not to use any product of any kind that came from that pharmacy in Massachusetts.
So far, five people have died after getting one of the tainted steroid injections used to treat back pain. Virginia and Maryland have each had one death. The other three deaths are all in Tennessee.
Meanwhile, infected patients continue to fight for their lives at local hospitals.
This is a rare form of fungal meningitis that is not contagious.