What type of compounded sterile products (CSPs) should never utilize bacteriostatic diluents?

Bacteriostatic diluents are specifically designed to inhibit the growth of bacteria and are commonly used in certain compounded sterile products. However, when it comes to epidural injections, their use is contraindicated because any potential bacterial growth inhibition could interfere with the healing process if an infection were to occur. Epidural injections are placed directly into the epidural space in the spinal cord, where a sterile environment is critically important. The introduction of bacteriostatic agents could increase the risk of complications or infections, making the use of such diluents inappropriate in this context.

In contrast, intravenous solutions typically utilize bacteriostatic diluents when appropriate, as they can be delivered quickly into the bloodstream. Oral medications do not require sterile compounding practices and typically do not utilize bacteriostatic diluents in their formulation. Topical ointments, while also not requiring sterility, may use bacteriostatic agents, but their application is not internal, reducing the risk associated with infection.

Thus, avoiding bacteriostatic diluents in epidural injections is essential for maintaining the integrity and safety of the procedure.