Sugar and sugar-free liquid formulations of delamanid for patients with rifampicin-resistant TB

Taneja, Reshma; Nahata, Milap C.; Scarim, J.; Pande, P. G.; Scarim, A.; Hoddinott, Graeme; Fourie, C. L.; Jew, R. K.; Schaaf, H. Simon; Garcia-Prats, Anthony J.; Hesseling, Anneke C.

doi:10.5588/ijtld.22.0329

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…The formulations could be made on the spot and kept for 15 days in simple syrup and 30 days in the sugarfree mixture. They had the potential to significantly increase children's access to delamanid and could be used to treat RIFresistant TB in patients of all ages who have trouble swallowing pills, including adults and children (Taneja et al, 2023a). Taneja et al (2023b), again, achieved the development of a 10 mg/ mL clofazimine formulation in syrup and sugar-free carriers using readily available excipients.…”

Section: Liquid Formulationsmentioning

confidence: 99%

Nanotechnological innovations in paediatric tuberculosis management: current trends and future prospects

Ajayi,

Poka,

Witika

2024

Front. Drug Deliv.

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Paediatric Tuberculosis (TB) continues to be a major global cause of morbidity and mortality. Children are more prone to contracting TB, which can spread quickly to extrapulmonary infection sites. Although the pathophysiology of the disease, drug pharmacokinetics, and the therapeutic window in children differ from those of adults, the same drugs used to treat adult TB have long been utilised to treat paediatric TB infections. Since many current formulations such as tablets are unsuitable for children due to difficulty swallowing and risk of choking, adult medications are frequently used by breaking or crushing tablets to obtain a paediatric dose. This can result in inaccurate dosing due to pharmacokinetic differences in children which could subsequently lead to sub-therapeutic or toxic systemic concentrations. In addition, many of the medications used in the treatment of TB and most medicines in general, have a profoundly unpleasant taste to children causing them to reject and spit out medication which contributes to challenges with adherence, ultimately leading to treatment failure. The aforementioned demonstrates a huge need for the development of novel drug delivery formulations that are paediatric-friendly and address the limitations of current dosage forms. This review discusses the currently available oral paediatric formulations, recent developments of novel oral drug delivery systems studied to overcome the current problems associated with the treatment of tuberculosis in paediatrics and provides potential direction for future research through nanotechnology by using a SWOT analysis.

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Section: Liquid Formulationsmentioning

confidence: 99%

Nanotechnological innovations in paediatric tuberculosis management: current trends and future prospects

Ajayi,

Poka,

Witika

2024

Front. Drug Deliv.

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“… Child-friendly formulations of TB medications should be used whenever possible, many of which are available from the Global Drug Facility [ 12 ]. Alternatively, extemporaneous preparations of some drugs can be prepared monthly by a pharmacy specialist [ 19 – 21 ], or caregivers can be trained to cut or crush the adult formulation tablets, mix with water, milk or other locally available food, and administer the full volume of the mixture (Table 1 ) [ 11 ]. …”

Section: General Principles and Considerations In Treating Children W...mentioning

confidence: 99%

Current Treatment of Drug-Resistant Tuberculosis in Children

Schaaf,

Hughes

2023

Indian J Pediatr

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Optimal diagnosis and management of children aged <15 y with rifampicin- or multidrug-resistant tuberculosis (RR/MDR-TB) relies on identification of adults with the disease and pro-active screening of their close contacts. Children may be diagnosed with RR/MDR-TB based on microbiological confirmation from clinical specimens (sputum, gastric washings, stool), but usually the diagnosis is presumptive, with a history of exposure to RR/MDR-TB and clinical/radiological signs and symptoms suggestive of TB disease. RR/MDR-TB should also be considered in children where first-line TB treatment fails despite good adherence to therapy. Composition and duration of all-oral RR/MDR-TB treatment regimens in children are based on site and severity of TB disease, drug resistance profile of the Mycobacterium tuberculosis strain (isolated from the child or from the most likely source patient), inclusion of at least four drugs considered to be effective (with priority given to World Health Organization Group A and B drugs), toxicity and tolerability of medications (and feasibility of adverse effect monitoring in the child’s setting), and availability of child-friendly formulations of TB medications. Individualized RR/MDR-TB regimens are preferable to the standardised 9–12-mo regimen for children, and injectable agents must not be used. Optimal adherence to treatment relies on education, training and support for caregivers and others who are responsible for administering medications to children, as well as close clinical monitoring and early management of adverse effects. Children who are initiated on adequate RR/MDR-TB regimens have high treatment success rates, but efforts to find and treat more children with undiagnosed RR/MDR-TB are crucial to reduce childhood TB mortality.

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Sugar and sugar-free liquid formulations of delamanid for patients with rifampicin-resistant TB

Cited by 2 publications

References 8 publications

Nanotechnological innovations in paediatric tuberculosis management: current trends and future prospects

Nanotechnological innovations in paediatric tuberculosis management: current trends and future prospects

Current Treatment of Drug-Resistant Tuberculosis in Children

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