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ABSTRACT Purpose To review microbial contamination rates and examine guidelines about preparation of individual and batch doses using aseptic techniques within pharmaceutical (controlled) and clinical (ward and theatre) environments. Methods Systematic review and meta-analysis. Results A total of 18 studies (7293 doses) were identified for analysis. A lower rate of contamination was found in a pharmaceutical compared to clinical environments when preparing either individual (6.8% v 3.3%; p=0.051; 10 studies (8 clinical 2 pharmaceutical)) or batch doses (8% v 0.05%; p