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Comparative Study
. 2018 Aug;99(2):477-481.
doi: 10.4269/ajtmh.17-0779. Epub 2018 Jun 7.

Toward Point-of-Care Drug Quality Assurance in Developing Countries: Comparison of Liquid Chromatography and Infrared Spectroscopy Quantitation of a Small-Scale Random Sample of Amoxicillin

Norah Alotaibi  1 , Sean Overton  1 , Sharon Curtis  1 , Jason W Nickerson  2   3 , Amir Attaran  2 , Sheldon Gilmer  4 , Paul M Mayer  1
Affiliations
Comparative Study

Toward Point-of-Care Drug Quality Assurance in Developing Countries: Comparison of Liquid Chromatography and Infrared Spectroscopy Quantitation of a Small-Scale Random Sample of Amoxicillin

Norah Alotaibi et al. Am J Trop Med Hyg. 2018 Aug.

Abstract

Substandard antibiotics are thought to be a major threat to public health in developing countries and a cause of antimicrobial resistance. However, assessing quality outside of a laboratory setting, using simple equipment, is challenging. The aim of this study was to validate the use of a portable Fourier transform infrared (FT-IR) spectrometer for the identification of substandard antibiotics. Results are presented for amoxicillin packages from Haiti, Ghana, Sierra Leone, Democratic Republic of Congo, India, Papua New Guinea, and Ethiopia collected over the course of 6 months in 2017, including two field trips with the FT-IR to Ghana and Sierra Leone. Canadian samples were used as a control. Regarding drug quality, of 290 individual capsules of amoxicillin analyzed, 13 were found to be substandard with total active pharmaceutical ingredients (API) lying outside the acceptable range of 90-110%. Of these 13, four were below 80% API. The FT-IR reliably identified these outliers and was found to yield results in good agreement with the established pharmacopeia liquid chromatography protocol. We conclude that the portable FT-IR may be suitable to intercept substandard antibiotics in developing countries where more sophisticated techniques are not readily available.

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Figures

Figure 1.
Figure 1.
Plot of the % deviation (%D) in content mass from each capsule, as a function of country of origin. The dashed lines represent the allowable %D.
Figure 2.
Figure 2.
Plot of the % active pharmaceutical ingredients (API) for each capsule as determined by liquid chromatography–ultraviolet (LC–UV) analysis, as a function of country of origin. The dashed lines represent the acceptable limits in percentage API (%API).
Figure 3.
Figure 3.
Plot of the % active pharmaceutical ingredients (API) for each capsule as determined by Fourier transform infrared (FT-IR) analysis, as a function of country of origin. The dashed lines represent the acceptable limits in percentage API (%API).
Figure 4.
Figure 4.
Plot of the % active pharmaceutical ingredients (API) for each capsule as determined by Fourier transform infrared (FT-IR) analysis compared with that from liquid chromatography–ultraviolet (LC-UV). The solid line represents 1:1 agreement. The dashed box highlights the area of acceptable percentage API (%API).
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References

    1. Hollein L, Kaale E, Mwalwisi YH, Schulze MH, Holzgrabe U, 2016. Routine quality control of medicines in developing countries: analytical challenges, regulatory infrastructures and the prevalence of counterfeit medicines in Tanzania. TrAC-Trends Anal Chem 76: 60–70.
    1. WHO , 2012. Substandard/Spurious/Falsely-Labelled/Falsified/Counterfeit Medical Products. Report A/MSM/1/INF/1. Geneva, Switzerland: World Health Organization.
    1. Interpol , 2014. 2004–2014—Ten years of Combating Pharmaceutical Crime: Review and Prospects, Dublin, Ireland 19–20 November 2014. INTERPOL Background Note. Lyon, France: INTERPOL.
    1. Pezzola A, Sweet CM, 2016. Global pharmaceutical regulation: the challenge of integration for developing states. Glob Health 12: 85. - PMC - PubMed
    1. Nickerson JW, Attaran A, Westerberg BD, Curtis S, Overton S, Mayer PM, 2016. Fatal bacterial meningitis possibly associated with substandard ceftriaxone—Uganda, 2013. MMWR Morb Mortal Wkly Rep 64: 1375–1377. - PubMed

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