General Infection Prevention & Control (IPAC)

Physicians can only prepare their own compounds (e.g., allergy shots, sub-lingual serums) with approval from CPSA. To learn more about the compounding approval process, please contact CPSA’s Infection Prevention and Control program at (780) 969-5001 or ipac@cpsa.ab.ca.

Compounds made for subdermal and intradermal injections are required to be sterile and must be compounded in a location that meets the National Association of Pharmacy Regulatory Authorities (NAPRA) requirements. NAPRA standards must also be met to compound sublingual serums safely.

CPSA advises all physicians to obtain compounded products from an approved location, such as a compounding pharmacy or a regulated and routinely monitored commercial facility.

As a rule of thumb, a needle must never be reused. After each prick or scratch of the skin, the needle(s) need to be safely discarded. Never place a used needle back into an allergen well. Wiping off a needle between uses is ineffective at removing germs, increases the likelihood of a needlestick injury and can negatively impact the accuracy of testing.

1. Always protect the bulk supply of allergen from contamination. Needles and droppers that have contacted the patient’s skin should never go back (i.e., “double-dip”) into a well or vial.
2. Avoid any “topping up” of allergen in wells when amounts are low. Instead of mixing new allergen product with old, discard the well or tray and use a new one.
3. Follow the instructions set out by the allergen manufacturer regarding handling, storage, refrigeration and re-use after opening and expiry of the allergen product.

Yes. The goal should be to drop the allergen onto skin without the dropper touching skin. If the dropper touches the patient’s skin, it cannot be placed back into a well of allergen as this contaminates the supply. Once the drop has been placed on the skin, use only new, sterile needles to scratch the skin. Safely discard the needle after each scratch.

Compounding is the combining, or mixing together, of two or more ingredients (of which at least one is a drug or pharmacologically active component) to create a final product in an appropriate form for dosing. It can involve raw materials or the alteration of the form and strength of commercially available products. Compounding also includes the process of reformulating a drug for a for a new therapeutic/medical use.

Compounding does not include mixing, reconstituting or any other manipulation that is performed in accordance with the directions on an approved drug’s label. (Source)

Multi-needle medical devices (e.g., spider-like plastic frames with eight small needles attached) are a safe, effective and efficient way to deliver testing. If single needles are used, a new, sterile needle is required for every skin prick or scratch. Discard any needle(s) after contact with a patient. Medical devices used for skin prick testing must have validated instructions for use and a medical device licence from Health Canada.