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This paper presents a two-phase study of spill and leakage of antibiotics in hospitals. The first phase was a screening of spill and leakage at 21 hospital wards in 16 hospitals. Phase two was an extended investigation, where different measures to reduce spill and leakage were implemented and a follow-up screening was made to evaluate the effect of the measures. At the screening, 206 samples were collected. The result was used to classify the wards into four classes: Low, Mean, High, and Very high. Spatial distribution patterns and the effect of compounding systems were also investigated. The screening showed that spill and leakage occur at all wards. Eleven of the 21 wards had High or Very high contamination level. This result also showed that the substances were distributed according to three possible patterns. The compounding systems also had an impact on the spill and leakage. All four wards that used a closed system were found among the six wards with the lowest spill and leakage, while all three wards that used open venting systems were found among the six wards with the highest spill and leakage. The result also showed that it is possible to handle antibiotics with only insignificant spill and leakage, i.e., by using closed systems. Three wards, classified as Very high, were included in the second phase. Measures to decrease spill and leakage and reduce the distribution the substances were implemented. After two month, a follow-up screening was carried out. The result showed lower contamination levels at all three wards and the implemented measures had some effect. Simple and easy-to-do measures can contribute to reduce the spill and leakage that occur. There is still, however, a need to discuss how to handle antibiotics in a safe way to reduce possible spill and leakage and to prevent the distribution of this spill and leakage

Screening of Spill and Leakage of Antibiotics in Hospital Wards