pharmacists called to the rescue of manufacturers

Rue Danton, in the heart of 6e district of Paris. Behind the counter of the Delpech pharmacy, an institution in the district, two pharmacists welcome the last customers of the day, Friday January 13. Prescriptions in hand, there are ten of them calmly waiting in the queue. Without suspecting that, in the meanders of the basement, a small army of seventy preparers has been working since the morning on the manufacture of masterly preparations.

Capsules, tablets, ointments, syrups, suppositories… These specialists make hundreds of “tailor-made” medicines in their laboratories, which they ship to French pharmacies. “Every time a medicine is missing from the shelves [d’une officine]or that the formulation of the marketed drug is unsuitable for the patient, we are there »summarizes the preparatory manager, Rachida El Hssaini, before taking a look at the large screen fixed to the wall, where the number of orders to be made is displayed in real time.

White blouse and cap screwed on the head, she is preparing, as every day for a month, to launch, with a small team of volunteers, a production of amoxicillin for pediatric use. “We have just cleaned the laboratory and the machines to avoid cross-contamination, she explains. We will now be able to start production. On average, 9,000 capsules are made each evening, the equivalent of 600 treatments. It takes about two hours. »

The Delpech pharmacy, in the 6th arrondissement of Paris, on January 13, 2023.

Overtime

Enough to supply dozens of pharmacies for a few days. Like all pharmacies specializing in magistral preparations and authorized for subcontracting – there are nearly fifty in France – Delpech was called to the rescue in November 2022 by the National Agency for the Safety of Medicines and of health products (ANSM) to compensate for the shortages of this antibiotic prescribed to treat bacterial infections.

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“This is the first time that a coordinated organization of this type has been set up on a national scale”observes Fabien Bruno, the manager of the establishment, just out of a remote meeting with the health authority. “It has become a routine, he adds. We do [des réunions] two or three times a week, to take stock of the evolution of the situation. »

Loader for a semi-automatic capsule filler containing 300 empty capsules.  Preparatory of the Delpech pharmacy, in Paris, on January 13, 2023.

It’s 6 p.m. In the basements, the production of amoxicillin begins. Using a scale, Rachida El Hssaini weighs 150 grams of the raw active ingredient, then puts the powder in a plastic cup. In the adjacent workshop, Vineeta, a pharmacy assistant, arranges 300 empty capsules with a capacity of 500 milligrams (mg) horizontally on a plate, then passes them through a metal capsule filler, which, in a few seconds, stores upright and removes capsule heads. “We then pour the amoxicillin powder from the cup into it, and we scrape the surface of the plate to distribute it evenly in all the capsules. It’s not very complicated “she said, smiling.

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