Medicines quality assurance to fight antimicrobial resistance

Nwokike, Jude; Clark, Aubrey; Nguyen, Phillip P

doi:10.2471/blt.17.199562

Cited by 52 publications

(46 citation statements)

References 5 publications

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“…It has been previously estimated that one in 10 medicinal products in low-and middle-income countries is substandard or falsified (Nwokike et al, 2018). Given that the identity of antimicrobials declared in the label was confirmed in all cases, we do not believe that outright falsification is a major issue here.…”

Section: Ta B L E 1 (Continued)mentioning

confidence: 72%

“…It has been estimated that in African countries about 50% of antimicrobials available in the market correspond to non‐standard and non‐registered veterinary medicines (Clifford et al., ). There is a concern that inadequate formulation of these products may lead to exposure to sub‐therapeutic levels of antimicrobials, therefore promoting resistance among bacterial populations (Nwokike, Clark, & Nguyen, ). Recent studies on the quality of antimicrobial products used in shrimp and catfish farming in Vietnam indicated that only ~8% and ~29% products contained an AAI within ±10% (accepted level of variation) (Phu, Phuong, Scippo, & Dalsgaard, ; Tran, Tran, Phan, & Dalsgaard, ).…”

Section: Introductionmentioning

confidence: 99%

“…Quality testing of AAIs is very costly, and there is a lack of unbiased information about this issue in animal production in most countries. It has been previously estimated that one in 10 medicinal products in low‐ and middle‐income countries is substandard or falsified (Nwokike et al., ). Given that the identity of antimicrobials declared in the label was confirmed in all cases, we do not believe that outright falsification is a major issue here.…”

Section: Introductionmentioning

confidence: 99%

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Labelling and quality of antimicrobial products used in chicken flocks in the Mekong Delta of Vietnam

Yen

Phu

Cương

et al. 2019

Veterinary Medicine & Sci

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Background The Mekong Delta of Vietnam is a hotspot of antimicrobial use (AMU), but there is no information on the quality of the labelling and strength of antimicrobial products used in poultry production. Methods Based on a large random sample of farms, we identified the 20 most used antimicrobial products in the area, and investigated their antimicrobial active ingredient (AAI) content by UPLC‐MS/MS (91 analytical tests). Results Only 17/59 (28.8%) batches contained all AAIs within 10% of the declared strength. Worryingly, 65.0% products provided in their label preparation guidelines for both therapeutic and prophylactic use. Withdrawal times for both meat and eggs were stated in 8/20 (40%) products. Conclusion Results highlight deficiencies in quality and labelling contents that undermine authorities’ efforts to discourage inappropriate use of antimicrobials.

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Section: Ta B L E 1 (Continued)mentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Labelling and quality of antimicrobial products used in chicken flocks in the Mekong Delta of Vietnam

Yen

Phu

Cương

et al. 2019

Veterinary Medicine & Sci

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“…Poor quality antibacterial agents are real threats for the public health, mainly because of the phenomena of resistance that they can cause [4] [5]. Several cases of resistance has been reported notably, the case of the management of urinary tract infections which were successfully treated with colistin.…”

Section: Discussionmentioning

confidence: 99%

“…These drugs notably increase the risks of treatment failure in various diseases but can also be at the origin of drug poisoning [3]. Moreover, suboptimal dosages of antibacterial agents undoubtedly contribute to the emergence of bacterial resistance [4] [5].…”

Section: Introductionmentioning

confidence: 99%

Substandard/Falsification Antibacterial Agents: A Systematic Review of Liquid Chromatographic and Spectrophotometric Methods for Their Detection

Tshilumba¹,

Muindu²,

Kasongo³

et al. 2019

AJAC

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Falsified antibacterial agents continue to pose serious public health problems around the world. They are notably responsible for resistance emergence in the treatment of infectious diseases that can lead to death. The aim of this study was to summarize the literature on the methods developed and validated to detect poor quality antibacterial agents in order to assess the impact of these available methods in the fighting against Counterfeit/substandard medicines. Thus, studies published in the time from January 2000 to July 2017, were accessible via Google Scholar and Pubmed and allowed to analyze 41 papers. The majority (30) of developed and validated methods concerned LC methods, 9 regarded UV/V is spectrophotometry and two studies simultaneously developed both methods. Antibacterial agents belonging to beta-lactams group were the most concerned by the methods developed and validated (39%), followed by quinolones (18%) and macrolides (12%). Regarding active ingredients, amoxicillin (12%) was the most concerned by the development and validation methods. In spite of several available methods to detect substandard drugs, antibacterial agents for which methods were developed and validated were the most concerned by worldwide detected non-conformities. The fight against this scourge should not be only limited by their detection, but it also requires an effective involvement of different actors notably: health authorities, international organizations, pharmaceutical industries etc.

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