The risk of microbial infection and spoilage arising from microbial contamination during manufacture, storage and use could be eliminated by presenting all medicines in sterile, impervious, single-dosage units.
QUALITY ASSURANCE
IN FORMULATION DESIGN AND DEVELOPMENT
The risk of microbial infection and spoilage
arising from microbial contamination during manufacture, storage and use could be eliminated by presenting all
medicines in sterile, impervious, single-dosage units. However, the high cost of this strategy restricts
its use to situations
where there is a high
risk of consequent infection from any contaminants. Where the risk is assessed
as much lower, less
efficient but less
expensive strategies are adopted. The high risk of infection by contaminants
in parenteral
medicines, combined with concerns about the systemic toxicity of preservatives, almost
always demands sterile single-dosage units. With eye drops
for domestic use the risks
are perceived to be lower, and sterile multidose products with preservatives
to combat the anticipated in-use contamination are accepted; sterile single-dose
units are more
common in hospitals where there is an increased risk of infection. Oral and topical routes of administration are generally perceived to present relatively low risks of infection and the emphasis is more on the control
of microbial content
during manufacture and subsequent protection of the formulation from chemical and physico-chemical spoilage.
As part
of the design
process, it is necessary to include
features in the formulation and delivery system that provide as much suitable
protection as possible
against microbial contamination and spoilage. Owing
to potential toxicity
and irritancy problems,
antimicrobial preservatives should only be considered where there is clear
evidence of positive
benefit. Manipulation of physico-chemical parameters, such as Aw, the elimination of particularly susceptible ingredients (e.g. natural
ingredients such as tragacanth powder, used as a thickening agent), the selection of a preservative or the choice
of container may individually and collectively contribute
significantly to overall medicine
stability. For ‘dry’
dosage forms where their very low Aw
provides protection against
microbial attack, the moisture vapour properties of packaging materials require careful
examination.
Preservatives are
intended to offer
further protection against environmental microbial contaminants. However, as they are relatively non-specific in their reactivity, it is difficult
to calculate with any certainty what proportion of preservative added to all but the simplest medicine will be available for inactivating such contamination. Laboratory tests have been devised to challenge the product with an artificial
bioburden. Such tests should
form part of formulation development and stability trials to ensure that suitable activity is likely to remain throughout the life of the product. They
are not normally used in routine manufacturing QC.
Some ‘preservative
challenge tests’ (preservative efficacy tests) add relatively large
inocula of various
laboratory cultures to aliquots of the product
and determine their rate of inactivation by viable counting methods (single challenge tests), while others reinoculate repeatedly at set intervals, monitoring the efficiency of inactivation until the system fails
(multiple challenge test).
This latter technique may give a better estimate
of the preservative capacity
of the system than the single challenge approach, but is both time-consuming and expensive. Problems arise when deciding whether the
observed performance in such tests gives
reliable predictions of real
in-use efficacy. Although test organisms should bear some similarity in type and spoilage potential
to those met in use, it is known
that repeated cultivation on conventional microbiological media (nutrient agar, etc.)
frequently results
in reduced virulence of strains. Attempts to maintain spoilage activity by inclusion of formulation ingredients in culture media give varied
results. Some manufacturers have been able to maintain active
spoilage strains by cultivation in unpreserved, or diluted aliquots, of formulations.
The British Pharmacopoeia and the European
Pharmacopoeia describe a single challenge preservative test that routinely uses four test organisms (two bacteria, a yeast
and a mould), none of which has any significant history of spoilage potential and which are cultivated on conventional media. However, extension of the basic
test is recommended in some situations, such as the inclusion of an osmotolerant yeast
if it is thought such
in-use spoilage might be a problem. Despite
its accepted limitations and the cautious
indications given as to what
the tests might
suggest about a formulation, the test does
provide some basic, but useful indicators of likely in-use
stability. UK product licence
applications for preserved medicines must demonstrate that the formulation at least meets the
preservative efficacy criteria
of the British Pharmacopoeia or a similar
test.
The concept
of the D-value
as used in sterilization
technology has been applied
to the interpretation of challenge testing. Expression of the rate of
microbial inactivation in a preserved system in terms of a D-value
enables estimation of the nominal
time to achieve a prescribed proportionate level of kill. Problems arise, however,
when trying to predict the behaviour of very
low levels of survivors, and the method
has its critics as well as its
advocates.
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