Development of Rectodispersible Tablets and Granulate Capsules for the Treatment of Serious Neonatal Sepsis in Developing Countries.

Current pediatric antibiotic therapies often use oral and parenteral routes of administration. Neither are suitable for treating very sick neonates who cannot take oral medication and may be several hours away from hospital in developing countries. Here, we report on the development of rectal forms of ceftriaxone, a third-generation cephalosporin. Rectodispersible tablets and capsules were developed and successfully passed 6-month accelerated stability tests. Rabbit bioavailability showed plasma concentrations above the minimal inhibitory concentrations for 3 formulations of rectodispersible tablets and 2 formulations of hard capsules. Clinical batches are currently being prepared for human evaluation with the prospect of offering therapeutic alternatives for treating critically ill neonates. This proof of concept for efficient rectal delivery of antibiotics could help the development of other rectal antibiotic treatments and increase options for noninvasive drug development for pediatric patients.

Ceftriaxone Absorption Enhancement for Noninvasive Administration as an Alternative to Injectable Solutions.

Neonatal sepsis is a major cause of infant mortality in developing countries because of delayed injectable treatment, making it urgent to develop noninjectable formulations that can reduce treatment delays in resource-limited settings. Ceftriaxone, available only for injection, needs absorption enhancers to achieve adequate bioavailability via nonparenteral administration. This article presents all available data on the nonparenteral absorption of ceftriaxone in humans and animals, including unpublished work carried out by F. Hoffmann-La Roche (Roche) in the 1980s and new data from preclinical studies with rabbits, and discusses the importance of these data for the development of noninjectable formulations for noninvasive treatment. The combined results indicate that the rectal absorption of ceftriaxone is feasible and likely to lead to a bioavailable formulation that can reduce treatment delays in neonatal sepsis. A bile salt, chenodeoxycholate sodium salt (Na-CDC), used as an absorption enhancer at a 125-mg dose, together with a 500-mg dose of ceftriaxone provided 24% rectal absorption of ceftriaxone and a maximal plasma concentration of 21 µg/ml with good tolerance in human subjects. The rabbit model developed can also be used to screen for the bioavailability of other formulations before assessment in humans.

Development of rectal self-emulsifying suspension of a moisture-labile water-soluble drug.

Self-emulsifying drug delivery systems, commonly used for oral delivery of poorly soluble compounds, were used to formulate water soluble but moisture labile compounds for rectal application. The objective was to use the oily phase of the system to formulate a liquid, non-aqueous product while obtaining the advantages of self-emulsification, rapid contact with the rectal mucosa and rapid absorption post-administration. Ceftriaxone was used as a model drug and the human bile salt sodium chenodeoxycholate was used as an absorption enhancer. After preliminary screening of 23 excipients, based on their emulsification ability and emulsion fineness in binary and ternary mixtures, a full factorial design was used to screen different formulations of three preselected excipients. The optimal formulation contained 60% of excipients, namely Capryol 90, Kolliphor EL and Kolliphor PS20 in 4 : 6 : 6 ratio and 40% of a powder blend that included 500 mg of ceftriaxone. Characterization of the system showed that it complied with the requirements for rectal administration, in particular rapid emulsification in a small quantity of liquid. Rabbit bioavailability showed rapid absorption of ceftriaxone, achieving 128% bioavailability compared to powder control formulation. These results demonstrated the potential of self-emulsifying formulations for rectal administration of Class 3 BCS drugs.

Preformulation studies of ceftriaxone for pediatric non-parenteral administration as an alternative to existing injectable formulations.

Ceftriaxone, a third generation cephalosporin, has a wide antibacterial spectrum that has good CNS penetration, which makes it potentially suitable for initial treatment of severe neonatal pediatric infections providing suitable formulation. We evaluated its physicochemical and technical characteristics to assess its potential for development as a non-parenteral dosage form. As ceftriaxone is marked only for injectable use, these data are not available. Using HPLC and Karl Fischer titration, sensitivity of ceftriaxone to water, feasibility and impact of pharmaceutical processes and compatibility with common pharmaceutical excipients were assessed. X-ray diffraction studies gave deeper insight into the mechanisms involved in degradation. Chemometrical analysis of near infrared spectra enabled classification of ceftriaxone powder according to exposure conditions or processes applied. The results showed that ceftriaxone was not highly hygroscopic, could be processed in all climatic zones, but should be packaged protected against humidity. Controlling water presence in formulation was shown critical, as ceftriaxone degraded in the presence of water content above 2.4% w/w. To improve flowability, a critical parameter for dry dosage form development, granulation (wet and dry techniques, providing complete drying and moderate force compaction respectively) was shown feasible. Compression with moderate forces was possible, but grinding and high compression forces significantly affected long term ceftriaxone stability and should be avoided. Based on these results, development of ceftriaxone non-parenteral solid or liquid non-aqueous forms appears feasible.

Nonphospholipid fluid liposomes with switchable photocontrolled release.

We created novel nonphospholipid photosensitive liposomes from a mixture of a monoacylated azobenzene amphiphile (AzoC10N(+)) and cholesterol sulfate (Schol). This system belongs to the family of sterol-enriched nonphospholipid liposomes that were shown to form stable large unilamellar vesicles (LUVs) with enhanced impermeability. Fluid bilayers were successfully prepared from AzoC10N(+)/Schol (25/75 molar ratio) mixtures, and LUVs could be derived at room temperature using standard extrusion methods. The isomerization process of the bilayer-inserted AzoC10N(+) was characterized. Leakage from these liposomes could be induced by the photoconversion of AzoC10N(+) from its trans form to its cis form. This photocontrolled release from fluid liposomes contrasts with the case of phospholipid-based azo-containing liposomes, which are generally required to be in the gel phase to be photosensitive. It is proposed that the very high degree of conformational order of the monoalkylated amphiphile and the tight packing of the hydrophobic core of the AzoC10N(+)/Schol liposomes make them responsive to the presence of the bulky cis azo isomer. Interestingly, the liposome impermeability could be fully restored by the photoisomerization of the cis form back to the trans form, providing a sharp on-and-off control of payload release. In addition, these nonphospholipid liposomes display a very limited passive release. Therefore, it is shown that AzoC10N(+)/Schol LUVs can be used as nanocontainers, whose content can be released by light in a controlled and switchable manner.

On the benefits of rubbing salt in the cut: self-healing of saloplastic PAA/PAH compact polyelectrolyte complexes.

The inherent room temperature mending and self-healing properties of saloplastic PAA/PAH CoPECs are studied. After ultracentrifugation of PAA/PAH polyelectrolyte complexes, tough, elastic materials are obtained that undergo self-healing facilitated by salt. At intermediate salt concentrations the CoPECs remain elastic enough to recover their original shape while the chains are mobile enough to repair the cut, thus leading to actual self-healing behavior.

pH-triggered release from nonphospholipid LUVs modulated by the pKa of the included fatty acid.

It has been shown that mixtures of palmitic acid (PA) and cholesterol (Chol) or cholesterol sulfate (Schol) can form fluid bilayers. These bilayers could be extruded using standard extrusion techniques to obtain nonphospholipid large unilamellar vesicles (LUVs). These LUVs displayed a very limited passive permeability, associated with their high sterol content (typically 70 mol %). In addition, they showed a pH-dependent behavior dictated by the electrostatic interfacial interactions, which are drastically modulated by the protonation state of PA. Interestingly, the LUVs prepared with cholesterol were stable at high pH and the release of the content could be triggered by a pH decrease (i.e., the protonation of PA). In contrast, the LUVs including Schol were stable at low pH and a pH increase (leading to the deprotonation of PA) would induce the release. In the present study, we demonstrate that the pH triggering the release in these two systems can be dictated in a predictable manner by selecting a fatty acid with an appropriate pK(a). The pK(a) of the fatty acids was modulated by the presence of an electro-withdrawing group (hydroxyl or fluoro) in the alpha position of the carboxylic function. The fatty acid protonation state is shown to be a critical factor for the modulation of the liposome permeability. The described systems display a remarkable versatility regarding the pH-sensitivity because the nature of the sterol controls the overall pH stability of the LUVs while the fatty acid pK(a) fine-tunes the pH-induced release. Therefore, it is possible to rationally design LUVs with controlled release at a specific pH; this original aspect is beneficial to the use of LUVs for encapsulation, vectorization, and controlled release of active agents.

Cationic detergent/sterol mixtures can form fluid lamellar phases and stable unilamellar vesicles.

In recent studies, it has been shown that mixtures of palmitic acid (PA), and cholesterol or cholesterol sulfate (Schol), in a PA/sterol molar ratio of 30/70 lead to the formation of liquid-ordered (lo) lamellar phases. The extrusion of these systems gave large unilamellar vesicles (LUVs) that displayed a very limited passive permeability, a property associated with their high sterol content. In this study, we showed that the formation of lo-phase bilayers was also possible when mixing a cationic detergent (cetylpyridinium chloride, CPC) and sterol in a 30/70 molar ratio. The existence of this phase was established using IR and 2H NMR spectroscopy. Moreover, 2H NMR allowed us to study the orientation and dynamics of CPC and cholesterol in these self-assemblies. The extrusion of the CPC/Schol bilayers leads to the formation of LUVs, and their passive permeability was found to be very limited, making them interesting candidates as nanovectors.

Origin of the zero-field splitting in mononuclear octahedral dihalide MnII complexes: an investigation by multifrequency high-field electron paramagnetic resonance and density functional theory.

The synthesis, structural characterization, and electronic properties of a new series of high-spin six-coordinate dihalide mononuclear MnII complexes [Mn(tpa)X2] (tpa=tris-2-picolylamine; X=I (1), Br (2), and Cl (3)) are reported. The analysis of the crystallographic data shows that in all investigated complexes the manganese ion lies in the center of a distorted octahedron with a cis configuration of the halides imposed by the tpa ligand. By a multifrequency high-field electron paramagnetic resonance investigation (95-285 GHz), the electronic properties of 1-3 were determined (DI=-0.600, DBr=-0.360, DCl=+0.115 cm-1), revealing the important effect of (i) the nature of the halide and (ii) the configuration (cis/trans) of the two halides on the magnitude of D. The spin Hamiltonian parameters obtained by density functional theory calculations initiated from the crystal structure of 1-3 are in reasonable agreement with the experimental values. The absolute value of D is consistently overestimated, but the sign and the trend over the chemical series is well reproduced. Theoretical models (cis- and trans-[Mn(NH3)4X2], X=I, Br, Cl and F) have been used to investigate the different contributions to D and also to understand the origin of the experimentally observed changes in D within the series reported here. This study reveals that the spin-spin coupling contributions to the D tensor are non-negligible for the lighter halides (F, Cl) but become insignificant for the heavier halides (I, Br). The four different types of excitations involved in the spin-orbit coupling (SOC) part of the D tensor contribute with comparable magnitudes and opposing signs. The general trend observed for halide MnII complexes (DI>DBr>DCl) can be explained by the fact that the halide SOC dominates the D value in these systems with a major contribution arising from interference between metal- and halide-SOC contributions, which are proportional to the product of the SOC constants of Mn and X.