Development of an innovative delivery system for bacillus Calmette-Guérin bladder administration

Purpose To describe the development of an innovative process to deliver bacillus Calmette-Guérin (BCG) to an offsite urology clinic for bladder instillation. Summary The use of BCG, a live virus vaccine for treatment of patients with localized cancer of the urinary bladder, has created many logistical problems for hospitals and infusion center pharmacies. Due to its short stability, the drug cannot be made ahead of time and coordination with a patient’s arrival at an infusion site is challenging. This becomes exceptionally challenging when a urology clinic has limited compounding capacity and/or is distant from the site of BCG medication preparation. This article describes an innovative process involving use of closed-system transfer devices (CSTDs) to allow for the administration of BCG in a urology clinic offsite from a medical center’s infusion center facilities. Conclusion The use of the CSTD allowed the patients to continue to receive bladder instillations at an offsite urology clinic without significantly disrupting compounding workflow at the small infusion center pharmacy that was the nearest to the clinic.