Efficacy of Expired Antibiotics: A Real Debate in the Context of Repeated Drug Shortages

Davido, Benjamin; Michelon, Hugues; Mamona, Christel; de Truchis, Pierre; Jaffal, Karim; Saleh-Mghir, Azzam

doi:10.3390/antibiotics13050466

Antibiotics

2024

DOI: 10.3390/antibiotics13050466

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Efficacy of Expired Antibiotics: A Real Debate in the Context of Repeated Drug Shortages

Benjamin Davido,

Hugues Michelon,

Christel Mamona

et al.

Abstract: This narrative review aims to discuss the main interest in and cautions associated with the use of expired antibiotics in the context of repeated shortages, notably in Europe. Articles concerning the topic of expiry dates related to antibiotic use were reviewed using keywords in the PubMed®/MEDLINE and Google Scholar databases to identify the most extensive evidence-based documentation. The present review evaluates the potential interest and efficacy of using expired drugs and their possible related adverse ev… Show more

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Cited by 2 publications

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Quality evaluation of selected expired fluoroquinolones medicines obtained from the public hospitals in Jimma zone, Oromia regional state, Ethiopia

Getahun,

Belew,

Hasen

et al. 2024

Front. Med.

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BackgroundThe problem of medicine expiration presents a notable obstacle, resulting in considerable financial losses. Nevertheless, there is currently limited data indicating that certain medications do not experience a significant decrease in effectiveness after their expiration date. Therefore, the aim of the study was to assess the physico-chemical quality of expired fluoroquinolone antibiotics.MethodsThe expired samples of fluoroquinolone antibiotics were purposively collected from public hospitals in the Jimma zone of the Oromia regional state, Ethiopia. A World Health Organization quality evaluation sampling strategy was employed. Then, simple random sampling techniques were utilized for the selection of tablets for the laboratory quality control test. The assay, identification, and dissolution were performed in accordance with the United States Pharmacopeia (USP) guidelines, as well as failure mode and effect analysis (FMEA) techniques.ResultsThe finding revealed that about 100% (7/7) expired samples passed pharmacopeia quality specifications for identity and assay tests. However, of the seven expired brands, about 14.3% (1/7) of the sample (Code-002) was unable to release its API content within the USP criteria of 30 min. The risk-based quality evaluation revealed that assay was the most critical quality attributed to ciprofloxacin tablets (RPN = 189), followed by identity (RPN = 100). Assay was also the most critical quality attribute (RPN = 378), followed by identity (RPN = 100) for Norfloxacin tablets. The risk-based desirability function approach showed that 75% (3/4) of ciprofloxacin products were of good quality, and 25% (1) were found to be of acceptable quality, while the desirability function of norfloxacin tablets was found to be excellent 1 (33.3%), good 1 (33.3%), and acceptable 1 (33.3%).ConclusionThe study revealed that medications can maintain their quality beyond their labeled expiration date. By combining pharmacopeial standards with risk-based approaches like failure mode and effect analysis (FMEA), the study provides a comprehensive evaluation framework. This approach not only confirms the continued effectiveness of expired fluoroquinolone antibiotics but also underscores the potential waste reduction and cost-saving benefits. This could significantly contribute to addressing healthcare challenges in low-resource settings, promoting more efficient pharmaceutical resource utilization.

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Quality evaluation of selected expired fluoroquinolones medicines obtained from the public hospitals in Jimma zone, Oromia regional state, Ethiopia

Getahun,

Belew,

Hasen

et al. 2024

Front. Med.

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Insights Into Medicine Expiry Awareness Among the Population of Rural South India: A Mixed-Methods Approach

Datchanamourtty,

Vasigar

2024

Cureus

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Background: The practice of noticing the expiry date of medicines has improved in recent decades. But, still, there are various factors that hinder this practice and make people use medicines that are expired. This study was conducted to assess the knowledge of the expiry date of medicines among the rural population at Thiruvennainallur, in Tamil Nadu, India, and to explore the barriers that hinder the viewing of the expiry date of medicines among the rural population. Methodology: The study involved both the quantitative phase and the qualitative phase. In the quantitative phase, consenting participants who were residing in the service areas of our Rural Health Training Center (RHTC) at Thiruvennainallur were recruited as study participants by systematic random sampling technique. For the qualitative phase, we conducted in-depth interviews with the study participants using the purposive sampling method. Results: Out of 182 participants, the number of females (92, 50.5%) was more when compared to males. The majority of the participants were married (152, 85.7%). Around 84 (46.2%) of participants had completed secondary education, and 80 (44%) belonged to Class IV socioeconomic status. About 80.2% purchased medicine using a prescription. The majority of the participants had the awareness that manufactured medicines can be used only for a limited period of time (70.3%) and awareness that expired medicines can cause harm (155, 85.2%). Tablets (159, 87.4%) were the most common form of medicine used. The majority, around 63 (34.6%) of the respondents, considered illiteracy as a reason for not checking the expiration date of medicines. Conclusion: Lack of knowledge regarding the expiry date of medicine and not considering it as necessary were the major reasons for not noticing the expiry date of medicine by the majority of the respondents. Creating awareness about the ill effects of expired medicines would improve the practice of noticing the expiry date of the medicine.

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Efficacy of Expired Antibiotics: A Real Debate in the Context of Repeated Drug Shortages

Cited by 2 publications

References 32 publications

Quality evaluation of selected expired fluoroquinolones medicines obtained from the public hospitals in Jimma zone, Oromia regional state, Ethiopia

Quality evaluation of selected expired fluoroquinolones medicines obtained from the public hospitals in Jimma zone, Oromia regional state, Ethiopia

Insights Into Medicine Expiry Awareness Among the Population of Rural South India: A Mixed-Methods Approach

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