Recommendations and current practices for the reconstitution and storage of botulinum toxin type A - 11/08/12
Reprint requests: David M. Ozog, MD, Department of Dermatology, Division of Mohs Micrographic Surgery, Henry Ford Hospital, 3031 W Grand Blvd, Suite 800, Detroit, MI 48202.Abstract |
Background |
Current guidelines from the Centers for Disease Control and Prevention (CDC) regarding the reconstitution and storage of botulinum toxin type A (BT-A) differ from those of the Centers for Medicare and Medicaid Services and current clinical practice. CDC guidelines require single-patient use of BT-A vials. Strict adherence to these guidelines creates waste and a significant financial impediment, and does not confer increased protection from infection, assuming standard safe injection practices are followed.
Objective |
This study examines current clinical practices and provides expert consensus recommendations regarding the reconstitution and storage of BT-A. A review of the literature on the sterility and efficacy of BT-A stored beyond the recommended time period of 4 hours is also presented.
Methods |
An Internet-based survey was used to analyze the current practices of physician members of the American Society for Dermatologic Surgery who administer botulinum type A toxins.
Results |
After reconstitution, the majority of physicians (68.6%) routinely store BT-A for a period of greater than 1 week and safely use each toxin vial for more than one patient. Not a single case of infection was observed.
Limitations |
This was a single survey with a 32.2% response rate.
Conclusion |
A single vial of BT-A can be safely administered to multiple patients, assuming standard safe injection techniques are followed. After reconstitution, Our data suggest that BT-A can be stored beyond the recommended time period of 4 hours.
El texto completo de este artículo está disponible en PDF.Key words : Botox, Botox reconstitution, Botox storage, botulinum toxin, botulinum toxin consensus recommendations, botulinum toxin reconstitution, botulinum toxin storage
Abbreviations used : BT-A, CDC, CMS
Esquema
| Funding sources: None. |
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| Conflicts of interest: None declared. |
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| Disclosure: Dr Hanke served as an investigator for Allergan, Medicis, Merz, and Galderma, receiving grants. Dr Coleman served as a consultant for Allergan and Merz, receiving grants. Dr Carruthers has been on the advisory board and served as an investigator for Allergan and Merz, receiving honoraria. Dr Cohen served as a consultant and investigator for Allergan, Medicis, and Merz, receiving grants and honoraria. Dr Moy served as an investigator for Inamed, receiving grants and is a stockholder of Claro. Dr Dover served as an investigator for Allergan, receiving grants. Drs Liu and Ozog have no conflicts of interest to declare. |
Vol 67 - N° 3
P. 373-378 - septembre 2012 Regresar al número
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