Prevalence, Characteristics, and Challenges of Compounded Sterile and Non-sterile Pharmaceutical Preparations in Tabuk Hospitals: Across-sectional Survey Study

Pharmaceutical extemporaneous compounding is limited by several challenges related to the lack of resources or trained pharmacists. This study aimed to investigate the prevalence, features, and factors influencing extemporaneous compounding in Tabuk hospitals, Saudi Arabia. A cross-sectional study was conducted using a structured questionnaire distributed to hospital pharmacists in Tabuk. Data collection involved face-to-face interviews with both pharmacists and pharmacy technicians engaged in compounding activities. A total of 52 participants were interviewed, including 38 pharmacists and 14 technicians, of whom 32 (61.5%) were males and 30 (57.7%) were at the age range of 31-35 years. Hospital compounding services were predominantly sterile preparations, including intravenous admixtures, total parenteral nutrition (TPN), and chemotherapy reconstitution. Non-sterile compounding was primarily practiced at the Maternity and Children’s Hospital to meet pediatric needs. Pharmacists reported a median of 16 sterile compounding prescriptions (range: 3–100) per pharmacy per day. The main driver of non-sterile compounding was the unavailability of appropriate pediatric formulations. Commonly prepared non-sterile suspensions included captopril, furosemide, hydrocortisone, amlodipine, and baclofen. The absence of compounding services in three hospitals was attributed to a low demand for compounded prescriptions and lack of necessary equipment. Sterile preparations were the most commonly reported compounded products in Tabuk, guided by the United States Pharmacopeia for standards of practice and beyond-use dating. Extemporaneous non-sterile compounding was mainly implemented to compensate for the absence of pediatric formulations in licensed products. Pharmacists identified risks associated with compounding, including calculation errors, formulation failures, and potential microbial contamination.