• Can saline be used to reconstitute antibiotics for subconjunctival injection due to water shortage?


    Question:

    Can saline be used to reconstitute antibiotics for subconjunctival injection due to water shortage?


    Answer:

    The procedures for reconstituting medications is highly scrutinized by the Food and Drug Administration (FDA). Licensed pharmacies are heavily regulated and monitored for drug preparation and variations are not allowed unless special waivers are granted by the FDA. Individual physicians, however, can personally make changes to drug preparation and administration as long as they notify the patient that they are making or using the drugs "off-label." This does not absolve the physician from medical or legal liability since there is a deviation from approved protocol. Physicians need to provide adequate informed consent to the patients so that they understand the risks of taking medications that have not been approved by the FDA for use in the proscribed manner. The way medicines are reconstituted can have a significant effect on both the tolerance, side effect profile and efficacy of the medication.

    While sterile saline is safe for administration both on the eye and underneath the conjunctiva (and a pH balanced version of sterile saline is safe for use inside the eye), no blanket statement can be made regarding the safety and efficacy of an antibiotic for subconjunctival injection reconstituted in saline versus distilled sterile water. You should discuss this issue with your eye physician regarding the risks and benefits before undergoing the procedure.


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