1
|
Secco G, Sachetti C, Rossato-Grando LG, Regina Hahn S, Pagnussat LR, da Cruz Fresco PMF, Dallazem Bertol C. Quality of Vancomycin for Injection Formulations in Brazil. CURR PHARM ANAL 2019. [DOI: 10.2174/1573412914666180116143232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
The presence of impurities in vancomycin compromised the safety and contributed
to decrease of its use for years. In Brazil, vancomycin generic drug represents an option to reduce
hospital costs. However, the controversy over the quality of these formulations and their relationship
to effectiveness and safety raised concerns.
Objective and Methods:
To assess in vitro quality of vancomycin injections through uniformity of
weight, pH, clarity of solution, microbiological assay and impurities determination by High Performance
Liquid Chromatography (HPLC).
Results:
The samples were approved in the tests.
Conclusion:
The injectable formulations of vancomycin proved to be safe for use in hospital environment.
This work contributes to increase health professionals’ confidence on generic vancomycin.
Collapse
Affiliation(s)
- Gabriela Secco
- Curso de Farmacia, Instituto de Ciencias Biologicas, Universidade de Passo Fundo, Passo Fundo, RS, Brazil
| | - Cristiane Sachetti
- Curso de Farmacia, Instituto de Ciencias Biologicas, Universidade de Passo Fundo, Passo Fundo, RS, Brazil
| | | | - Siomara Regina Hahn
- Curso de Farmacia, Instituto de Ciencias Biologicas, Universidade de Passo Fundo, Passo Fundo, RS, Brazil
| | - Lidiane Riva Pagnussat
- Servico de Controle de Infeccao Hospitalar, Hospital Sao Vicente de Paulo, Passo Fundo, RS, Brazil
| | | | - Charise Dallazem Bertol
- Curso de Farmacia, Instituto de Ciencias Biologicas, Universidade de Passo Fundo, Passo Fundo, RS, Brazil
| |
Collapse
|
2
|
Lee SH, Tai CL, Chen SY, Chang CH, Chang YH, Hsieh PH. Elution and Mechanical Strength of Vancomycin-Loaded Bone Cement: In Vitro Study of the Influence of Brand Combination. PLoS One 2016; 11:e0166545. [PMID: 27855203 PMCID: PMC5113949 DOI: 10.1371/journal.pone.0166545] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 10/31/2016] [Indexed: 01/19/2023] Open
Abstract
Antibiotic-loaded bone cement (ALBC) is widely used in orthopaedic surgery for both prevention and treatment of infection. Little is known about the effect of different brand combinations of antibiotic and bone cement on the elution profile and mechanical strength of ALBC. Standardized specimens that consisted of one of the 4 brands of bone cement and one of the 3 brands of vancomycin were fashioned, producing 12 combinations of ALBC. Two dosages of vancomycin in 40g bone cement were used to represent the high (4g vancomycin) and low (1g vancomycin) dose groups. Concentrations of vancomycin elution from ALBC was measured for up to 336 hours. The ultimate compression strength was tested at axial compression using a material testing machine before and after elution. In both high-dose and low-dose groups, Lyo-Vancin in PALACOS bone cement resulted in the highest cumulative elution and Vanco in Simplex P bone cement resulted in the lowest elution (458% and 65% higher in high- and low-dose groups, respectively). The mechanical strength was not significantly compromised in all groups with low dose vancomycin (range: 70.31 ± 2.74 MPa to 87.28 ± 8.26MPa after elution). However, with the addition of high dose vancomycin, there was a mixed amount of reduction in the ultimate compression strength after cement aging, ranging from 5% (Vanco in Simplex P, 81.10 ± 0.48 MPa after elution) to 38% (Sterile vancomycin in CMW, 60.94 ± 5.74 MPa after elution). We concluded that the selection of brands of vancomycin and bone cement has a great impact on the release efficacy and mechanical strength of ALBC.
Collapse
Affiliation(s)
- Sheng-Hsun Lee
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan, R.O.C.,Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan, R.O.C
| | - Ching-Lung Tai
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan, R.O.C.,Graduate Institute of Medical Mechatronics, Chang Gung University, No. 259, Wenhua 1st Rd., Guidshan Dist., Taoyuan City, 333, Taiwan, R.O.C
| | - Szu-Yuan Chen
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan, R.O.C.,Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan, R.O.C
| | - Chih-Hsiang Chang
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan, R.O.C.,Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan, R.O.C
| | - Yu-Han Chang
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan, R.O.C.,Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan, R.O.C
| | - Pang-Hsin Hsieh
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan, R.O.C.,Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, No. 5, Fuxing St., Guishan Dist., Taoyuan City, 333, Taiwan, R.O.C
| |
Collapse
|
3
|
Lewis PO, Kirk LM, Brown SD. Comparison of three generic vancomycin products using liquid chromatography-mass spectrometry and an online tool. Am J Health Syst Pharm 2015; 71:1029-38. [PMID: 24865760 DOI: 10.2146/ajhp130516] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Three different generic vancomycin products were compared using liquid chromatography-mass spectrometry (LC-MS) and open-access metabolomic tools. METHODS Single-lot samples of vancomycin hydrochloride from three different manufacturers (Hospira, APP Pharmaceuticals, and Pfizer) were reconstituted and injected into a high-resolution LC-MS system. The mass spectral fingerprints were compared for similarity of nonvancomycin B components using the XCMS Online system through Scripps University. Significance was defined as a p of ≤0.01 and a fold change of ≥1.5. The concentration of vancomycin B in each product was also measured using LC-MS on days 0, 1, 2, 4, 7, 10, and 14. RESULTS Qualitative comparisons of the products using the XCMS Online interface indicated the presence of significant differences among the products at the time of reconstitution; however, these variations seemed to converge after 14 days of storage. The concentration profiles of vancomycin B during refrigerated storage did not differ significantly among the three products. XCMS Online analyses revealed that the Pfizer and Hospira products were the most similar to each other. CONCLUSION While there were no significant differences found in the concentration of vancomycin B among Pfizer, APP, and Hospira products, there were differences in their initial mass spectral analysis after reconstitution. Liquid chromatography-tandem mass spectrometry profiles of the ions or isotopes present in the three products showed significant differences in impurities such as crystalline degradation product (CDP)-1 and CDP intermediate. After 14 days of refrigerated storage, the differences among the products converged, and fewer distinct features could be detected.
Collapse
Affiliation(s)
- Paul O Lewis
- Paul O. Lewis, Pharm.D., BCPS, is Clinical Pharmacy Specialist-Infectious Diseases, Johnson City Medical Center, Johnson City, TN. Loren M. Kirk, B.S., is Pharm.D. Candidate; and Stacy D. Brown, Ph.D., is Associate Professor of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City.
| | - Loren M Kirk
- Paul O. Lewis, Pharm.D., BCPS, is Clinical Pharmacy Specialist-Infectious Diseases, Johnson City Medical Center, Johnson City, TN. Loren M. Kirk, B.S., is Pharm.D. Candidate; and Stacy D. Brown, Ph.D., is Associate Professor of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City
| | - Stacy D Brown
- Paul O. Lewis, Pharm.D., BCPS, is Clinical Pharmacy Specialist-Infectious Diseases, Johnson City Medical Center, Johnson City, TN. Loren M. Kirk, B.S., is Pharm.D. Candidate; and Stacy D. Brown, Ph.D., is Associate Professor of Pharmaceutical Sciences, Bill Gatton College of Pharmacy, East Tennessee State University, Johnson City
| |
Collapse
|