The Infection Rate of Intralesional Triamcinolone and The Safety of Compounding in Dermatology for Intradermal and Subcutaneous Injection: A Retrospective Chart Review
Luther CA, Griffith JL, Kurland E, Al Shabeeb R, Eleryan M, Redbord K, and Ozog DM. The Infection Rate of Intralesional Triamcinolone and The Safety of Compounding in Dermatology for Intradermal and Subcutaneous Injection: A Retrospective Chart Review. J Am Acad Dermatol 2020.
Journal of the American Academy of Dermatology
BACKGROUND: Intralesional injection of sterile medications remains a mainstay in dermatology, enabling a tailored, low-cost, in-office therapy. Following the 2012 United States outbreak of fungal meningitis from contaminated intrathecally administered corticosteroids, there has been increased regulation of in-office compounding, regardless of administration route. Studies demonstrating the safety data of in-office corticosteroid compounding for intradermal or subcutaneous use are lacking.
OBJECTIVE: To assess the incidence of infection caused by compounded in-office intralesional triamcinolone.
METHODS: A retrospective chart review identified subjects that received in-office intralesional corticosteroid injections in 2016. Medical documentation within 30 days of injection was reviewed for suspected infection.
RESULTS: Charts of 4370 intralesional triamcinolone injections were assessed, 2780/4370 (64%) being compounded triamcinolone with bacteriostatic saline. Eleven suspected localized infections (0.25%) were identified, with 4/11 in the compounding cohort. Of these, 7/11 occurred after injection of an "inflamed cyst." No hospitalizations or deaths occurred. No temporal/locational relationships were identified.
LIMITATIONS: This study was limited to two academic institutions. A 30-day post injection time frame of was used.
CONCLUSION: In-office compounding for intralesional dermal and subcutaneous administration is safe when sterile products are used by medical practitioners. There is no increased risk of compounded triamcinolone relative to non-compounded triamcinolone.
ePub ahead of print