Evaluation of the most frequently prescribed extemporaneously compounded medications in a rural setting: a case study from the Delmarva Peninsula.

Extemporaneous drug formulation is essential to provide optimal pharmaceutical care to infants, children, and other special patient populations when medications are not available in a suitable dosage form. This study examined the prescription patterns of extemporaneously compounded preparations from representative sites on the Delmarva Peninsula. Professional pharmacy students assigned to community pharmacy and hospital clinical sites were asked to collect the following data at their respective rotation sites: a list of the most commonly prescribed extemporaneously compounded products to include: drug indication, generic name, dosage form, stability dating, dose regimen, route of administration, and age group. A database was constructed and each compounded prescription was allocated to a therapeutic category based on the American Hospital Formulary Service. Data was obtained from a total of 555 prescriptions, available from 113 entries. The most frequently prescribed therapeutic categories were gastrointestinal agents, skin and mucous membrane agents, and anti-infective agents, accounting for 41%, 26%, and 14% of all prescriptions, respectively. Community pharmacies accounted for 54%, 76%, and 27% of prescriptions in the gastrointestinal, skin care, and anti-infective agents' individual categories, respectively. Hospital pharmacies accounted for 46%, 24%, and 73%, of prescriptions in the gastrointestinal, skin care, and anti-infective agents' individual categories, respectively. Prescriptions containing lidocaine along with other active ingredients, mainly gastrointestinal cocktail and magic mouthwash, were the most commonly filled prescriptions in the gastrointestinal category. Overall, suspensions were the most dispensed extemporaneously compounded dosage form at both community and hospital sites. In an era of personalized medicine, extemporaneous compounding for specialized needs will continue to play an important role in patient therapy.