Do surface active parenteral formulations cause inflammation?

Cyclodextrin-based Pickering emulsions: functional properties and drug delivery applications

Cyclodextrins (CDs) are biocompatible, cyclic oligosaccharides that are widely used in various industrial applications and have intriguing interfacial science properties. While CD molecules typically have low surface activity, they are capable of stabilizing emulsions by inclusion complexation of oil-phase components at the oil/water interface, which results in Pickering emulsion formation. Such surfactant-free formulations have gained considerable attention in recent years, owing to their enhanced physical stability, improved tolerability, and superior environmental compatibility compared to conventional, surfactant-based emulsions. In this review, we critically describe the latest insights into the molecular mechanisms involved in CD stabilization of Pickering emulsions, including covering practical aspects such as methods to prepare CD-based Pickering emulsions, lipid encapsulation, and relevant stability issues. In addition, the rheological and textural features of CD-based Pickering emulsions are discussed and particular attention is focused on promising examples for drug delivery, cosmetic, and nutraceutical applications. The functionality of currently developed CD-based Pickering emulsions is also summarised, including examples such as antifungal uses, and we close by discussing emerging possibilities to utilize the molecular encapsulation of CD-based emulsions for translational medicine applications in the antiviral and antibacterial spaces.

Endothelial Cell Toxicity of Vancomycin Infusion Combined with Other Antibiotics

French guidelines recommend central intravenous (i.v.) infusion for high concentrations of vancomycin, but peripheral intravenous (p.i.v.) infusion is often preferred in intensive care units. Vancomycin infusion has been implicated in cases of phlebitis, with endothelial toxicity depending on the drug concentration and the duration of the infusion. Vancomycin is frequently infused in combination with other i.v. antibiotics through the same administrative Y site, but the local toxicity of such combinations has been poorly evaluated. Such an assessment could improve vancomycin infusion procedures in hospitals. Human umbilical vein endothelial cells (HUVEC) were challenged with clinical doses of vancomycin over 24 h with or without other i.v. antibiotics. Cell death was measured with the alamarBlue test. We observed an excess cellular death rate without any synergistic effect but dependent on the numbers of combined infusions when vancomycin and erythromycin or gentamicin were infused through the same Y site. Incompatibility between vancomycin and piperacillin-tazobactam was not observed in our study, and rinsing the cells between the two antibiotic infusions did not reduce endothelial toxicity. No endothelial toxicity of imipenem-cilastatin was observed when combined with vancomycin. p.i.v. vancomycin infusion in combination with other medications requires new recommendations to prevent phlebitis, including limiting coinfusion on the same line, reducing the infusion rate, and choosing an intermittent infusion method. Further studies need to be carried out to explore other drug combinations in long-term vancomycin p.i.v. therapy so as to gain insight into the mechanisms of drug incompatibility under multidrug infusion conditions.