Primary packaging considerations in developing medicines for children: oral liquid and powder for constitution

Enhanced antimicrobial activity and physicochemical stability of rapid pyro-fabricated silver-kaolinite nanocomposite

The present research aims to enhance the antimicrobial activity of kaolinite surfaces by a one-step cost-effective and energy-efficient dry thermal reaction, producing an antibacterial and antifungal silver-kaolinite (Ag-Kao) nanocomposite agent. Pharmaceutical grade kaolin powder samples, with variable kaolinite structural order-disorder degree, were homogeneously mixed with silver nitrate in a proportion 1:4 AgNO₃:kaolin (w/w) and sintered at 400 °C for 30 min. The composition, microstructure, microtexture and surface characteristics of the pyro-fabricated nanocomposites were characterized by XRD/XRF diffractometry, differential scanning calorimetry DSC, FT-IR spectroscopy, TEM/EDX, zeta potential (mV) measured within the 2-12 pH range, and BET method. Physicochemical stability was evaluated by silver dissociation testing under close-neutral and acidic conditions with Ag content assay using ICP-OES. The resulting Ag-Kao nanocomposites exhibited bulk silver contents ranging from 9.29% to 13.32% with high physicochemical stability in both neutral and acidic mediums (Ag dissociation rate <0.5% in 5 days). Ag nanocrystals exhibited particle sizes ranging from 5 to 30 nm, which were embedded and reinforced within the kaolinite matrix. The sizes of the Ag nanocrystals and their distribution patterns on the edges and faces of kaolinite platelets were controlled by the structural order-disorder degree. Highly ordered kaolinites (Hinckley Index, HI > 1) produced platelet edge-clustered silver nanocrystals due to the abundance of the dangling hydroxyls on platelet edges, while the highly disordered kaolinite (HI < 1) provided homogeneous platelet basal-doped silver nanocrystals due to the presence of some residual charges by exposed basal hydroxyl groups with interplatelet silver diffusivity. At pH 2, the magnitude of the positive surface charge was influenced by the silver nanocrystal size. Nanocomposites with the smallest silver nanocrystals (10-5 nm) exhibited the highest positive zeta potential (+15.2 mV to +17.0 mV), while those with larger silver nanocrystals (up to 30 nm) indicated lower positive zeta potential values (+9.5 mV to +3.6 mV). Under the same testing conditions using the Mueller-Hinton broth microdilution method, the raw kaolin samples did not show any significant antimicrobial activity, while all the pyro-fabricated Ag-Kao nanocomposite samples showed potent antibacterial and antifungal activity at low doses (MIC range 0.1-0.0125 mg/mL). Therefore, modulation of the effective electrostatic surface charge of the kaolinite platelets, via thermal doping of silver within their basal planes and edges, was found to be strongly dependent on the pH as well as the size and microtexture of the silver nanocrystals (mainly controlled by the order-disorder degree HI). The resulting modified nanostructure, with physicochemical stability and the efficient surface properties of the designed pyro-fabricated nanocomposite, led to an enhanced synergistic biophysical antimicrobial activity.

Orphan Formulations in Pediatric Schistosomiasis Treatment: Development and Characterization of Praziquantel Nanoparticle-Loaded Powders for Reconstitution

Praziquantel is a broad spectrum antihelmintic agent and represents the drug of choice for the treatment of schistosomiasis. However, its low aqueous solubility and strong bitter taste highly affect the bioavailability and compliance in pediatric patients. Thus, the purpose of this study was to develop a dry nanosuspension, by a combination of high-pressure homogenization and spray drying, intended for redispersion in a pleasant taste vehicle for extemporaneous use. Three formulations, varying stabilizers to drug ratio, were developed and characterized in terms of particle size distribution, crystallinity, morphology, in vitro dissolution, and sedimentation-redispersibility behavior. A significant reduction in particle size was achieved after the high-pressure homogenization process, and the nanoparticles were further microencapsulated by spray drying technique. The redispersed dried powders exhibited a conserved particle size distribution (in the nanometric range) and certain crystallinity extent, with satisfactory redispersion ability. Besides, the enhancement of the dissolution performance obtained after comminution was conserved, even after drying and redispersion of the extemporaneous powdered formulation. In conclusion, the developed nanoparticle-loaded powders comprise an interesting tool for the administration of praziquantel to preschool-age children.

Pediatric Antibiotic Pack Size Compliance With the Dosage Regimen: A Descriptive Study

BACKGROUND

The unavailability of appropriate pediatric drug pack size is a global issue. Antibiotics are the lifesaving and most frequently prescribed therapeutic agents given to pediatrics. The objective of this study was to assess the compliance of pediatric antibiotic pack size with the standard dosage regimen.

METHODS

A descriptive study design was employed. Data were collected from a community pharmacy in Bahawalpur, Pakistan, between August 1, 2017, and September 30, 2017. Five most commonly prescribed antibiotics were selected and calculations were made to check the appropriateness of packaging size by comparing the quantity of product in the available pack with the dosage regimen recommended by the British National Formulary for Children (BNFC).

RESULTS

Only 16 clarithromycin, 9 amoxicillin, 1 cefotaxime, and 1 metronidazole packaging sizes were sufficient to meet the dosage regimen for treatment. None of the available pack sizes for gentamicin matched the recommended duration of treatment. The study findings revealed that the available pack sizes either had leftover or a shortfall of antibiotic formulation. Highly inappropriate dosage forms (containing either excess and less quantity) of antibiotics were intravenous infusions and oral suspensions.

CONCLUSION

The study concluded that the packaging sizes of antibiotics failed to supply the recommended dosage regimen to pediatrics for common indications. This may contribute to development of antibiotic resistance among pediatric patients. Health policy makers should devise strict rules and regulations to ensure the availability of child-specific antibiotic pack sizes.