New strategies for the preparation of antineoplastic drugs are needed for the protection of health care workers during the coronavirus disease 2019 (COVID-19) pandemic era, these findings, from a survey featured in a letter to the editor, were published in the Journal of Oncology Pharmacy Practice.

Antineoplastic drug preparation guidelines included the use of class II biological safety cabinets, a surgical mask, 2 pairs of gloves, a head cap, and gown. Information about this disposable personal protective equipment (PPE) use during drug admixture at 18 hospitals in Japan between January to March of 2019 and 2020 were retrospectively surveyed and categorized as before and during the pandemic, respectively.

The study observed no statistical difference between the number of patients who received antineoplastic drugs before and during the pandemic (P =.92). However, the clinicians did report a significant decrease in their use of surgical masks (P <.01) and gowns (P =.02). The number of head caps was observed to decrease, although it was nonsignificant (P =.17).

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The clinicians reported, that due to global PPE shortages, surgical masks and gowns were reused for up to 7 days. One hospital reported no head cap usage in 2020.

Although no strategy for the minimization of exposure to antineoplastic drugs has been recommended, the study authors suggested that class III biological safety cabinets may be a solution for protecting health care workers during the current global shortage of PPE. They advised that at this time guidelines for the reuse of PPE may be unavoidable until a novel strategy for the preparation of antineoplastic drugs is formulated.


Mitsuboshi S, Yoshino M, Hosokawa H, Isobe H, Kobayashi K. Use of personal protective equipment while admixing antineoplastic drugs during the COVID-19 pandemic era: questionnaire survey in Niigata, Japan [available online May 29, 2020]. J Oncol Pharm Practice. doi:10.1177/1078155220932342