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¶¶Òô´ó¹Ï Policy Statement on the Use of Single-Dose and Multiple-Dose Vials and Solution Containers

The American Society for Gastrointestinal Endoscopy (¶¶Òô´ó¹Ï) promotes the highest standards for endoscopic practice, including the safe use of sterile parenteral medications during endoscopic procedures. ¶¶Òô´ó¹Ï bases its policy for the use of single-dose and multiple-dose vials and solution containers on the Centers for Disease Control and Prevention’s (CDC’s) 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings.

Practitioners must adhere to basic principles of aseptic technique when administering parenteral medications. Whenever possible, use of single-dose vials is preferred over multiple-dose vials, particularly when medications will be administered to multiple patients. ¶¶Òô´ó¹Ï does not support the administration of medications from single-dose vials or ampules to multiple patients or the practice of combining residual contents for subsequent use. Bags or bottles of intravenous solution should not be used as a common source of supply for multiple patients.

¶¶Òô´ó¹Ï recognizes that shortages of sterile parenteral medications have occurred and have impacted the delivery of care. However, ¶¶Òô´ó¹Ï’s overarching priority is the protection of patients from harm, and ¶¶Òô´ó¹Ï does not support any practice that could lead to increased risk of transmissible disease. ¶¶Òô´ó¹Ï accepts the CDC’s conclusion that “shortages of some essential medications may warrant implementation of meticulously applied practice and quality standards to subdivide contents of single-dose/single-use vials, as stated in the United States Pharmacopeia (USP) General Chapter 797 Pharmaceutical Compounding-Sterile Preparations,” a practice that would be feasible only in a strictly controlled setting with individuals fully knowledgeable about, and compliant with, all USP requirements.