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[e-drug] Extemporaneous compounding of d4T (4)

E-drug: Extemporaneous compounding of d4T (4)

Dear colleagues,

Andy Gray's comments in response to the above topic are accurate. Although
the cost of apparent wastage being claimed seems exaggerated, I believe a
more vital issue to be considered is inaccurate dosing of the patients by
the caregivers or mothers due to complicated preparation and dosing of
"aliquots". Adverse effects of stavudine are quite severe both in short and
long term and every logistic intervention (especially accurate
quantification and forecasting) to ensure that the correct supplies are
available at the right time must be pursued.

In Botswana, the latest guidelines have also emphasised discontinuation of
D4T in favour of less toxic contemporaries like abacavir and accurate
logistics planning and implementation at national, regional and/or district
level by leveraging the services of logistics professionals and development
partners such as PEPFAR, Clinton Foundation, Bill and Melinda Gates Foundation, 
etc. have gone a long way in ensuring stability and security in the supply 
logistics of all ARVS.


Olusegun Omojuwa
Ministry of Health

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