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April 2000

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Subject:
From:
Anthony Cundell <[log in to unmask]>
Reply To:
The Pharmaceutical Microbiology Mail List <[log in to unmask]>
Date:
Mon, 3 Apr 2000 08:53:30 -0400
Content-Type:
text/plain
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I would add the CDC/APHA guideline for food for HIV positive individuals.  They recommend that you lay-off the soft cheese, deli meats, hot dogs, etc.

>>> rfriedel <[log in to unmask]> 03/31 9:24 AM >>>
I agree with many of your comments.  As I have stated in the USP articles on
water activity, the stresses of compression, shearing, heat and drying are
inimical to the microorganisms which may be present.  At what point do we
stop and conclude that an immunocompromised patient should receive a sterile
dosage form.  Much of the hoopla regarding contamination incidents has been
centered around foods.  While coming to work a few days ago, there was
another incident of Listeria contamination in hot dogs.  Foods provide much
more nutritional capacity that a pharmaceutical product, particularly the
materials used to make tablets.

Now matter how much we try, laboratory contamination simulations do not in
any way mimic reality.  However, they do give us a warm, "fuzzy" feeling of
accomplishment; especially when they give the false illusion of actually
simulating reality.

It all started out with Salmonella contamination of thyroid medicine in
Sweden during the 1960's.  The article is:

Kallings, L.O., Ringertz, O. & Silverstolpe.  (1966) "Microbiological
Contamination of Medical Preparations" Acta Pharm Suec,  Jun;3(3):219-28.

Bob Friedel
Quality Assurance Manager
Perritt Laboratories
http://www.perritt.com 
[log in to unmask] 



----- Original Message -----
From: George Spite <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, March 30, 2000 10:01 PM
Subject: Re: [PMFLIST] Dry dosage forms microbial testing.


> Frank,
>
> Yes I would think sporeformers could survive in dry dose products.
>
> I would think ingestion of sporeformers that have been stressed by
> compression and dryness would not lead to significant growth in the harsh,
> competitive gastrointestinal tract.
>
> If I recall my food poisoning facts I think you need to ingest around
> 1,000,000 or more aerobic sporeformers, such as B.cereus, to experience
> pathogenic effects.  I experienced this with a fellow FDA investigator
after
> consuming bean sprouts at a salad bar.  The third investigator suffered no
> ill effects as he had no sprouts - he was smart - that's why he was the
lead
> investigator.  The health dept. found B. cereus in the millions from
sprout
> samples.
>
> We don't test for sporeformers in raw materials....yet!!!!
>
> There was USP talk about testing for the presence of Clostridia in
finished
> products.  Don't know where that's at presently.
>
> Where do we draw the line for what to test oral products for?  Do we look
> for parasite eggs, viruses, etc.?
>
> Or do we look at reported incidences of known illness causing
> contaminations -of sporeformers and others- and go from there?
>
> These questions were posed before by fellow forumeers over the last
several
> years.
>
> Then there is the concern for the immunocompromised population.  When they
> take tablets do they handle them with sterilized fingers and drink sterile
> water out of sterile glasses while breathing in sterile air?  Is the food
> sterile that they consume much more of than the tablets they take?
>
> What numbers of specific microbes does one have to ingest to become ill?
> The reference I read dealt with volunteers and the lowest number was 200
cfu
> of Shigella (flexneri?) caused ill effects orally.  E. coli and Salmonella
> ranged in the millions for symptoms to occur.  S. aureus has to number in
> the millions to produce the enterotoxins for oral pathogenicity according
to
> the FDA's bad bug website article and the ideal environment for
enterotoxin
> production is a cream puff not a dry tablet or capsule.  Staph. aureus and
> E. coli can be found in normal human GI tracts and the nasopharynx.
>
> To my knowledge long ago and far away there was only one incidence of
> Salmonella in a thyroid tablet for which I know no details about.  If
anyone
> has the details on that incident please enlighten me. To my knowledge
there
> hasn't been any other incidence of pathogen contamination of solid oral
> pharmacuetical products nor dry raw materials going into them.  If anyone
> has more info please share.
>
> Thank you,
>
> George Spite
>
> ----- Original Message -----
> From: Settineri, Frank <[log in to unmask]>
> To: <[log in to unmask]>
> Sent: Thursday, March 30, 2000 7:17 AM
> Subject: Re: [PMFLIST] Dry dosage forms microbial testing.
>
>
> > What about spore formers?  Since they could be found in products with
low
> > water activities, would testing the products still be unwarranted?
> >
> > Frank Settineri
> > 908-730-1222
> >
> >         ----------
> >         From:  George Spite [SMTP:[log in to unmask]] 
> >         Sent:  Tuesday, March 28, 2000 8:01 PM
> >         To:  [log in to unmask] 
> >         Subject:  [PMFLIST] Dry dosage forms microbial testing.
> >
> >         R. Friedel recently published in the PF regarding microbial
> testing
> > decisions based on water activity of raw materials. Also Anthony Cundell
> > addressed water activity and the need or lack of need to routinely test
> > finished dry dosage drugs - water activity 0.3 or less.
> >
> >         I am interested in responses from fellow forumeers as to whether
> > they consider it necessary to test dry doses microbially. Such testing
was
> > proposed by the USP -where is it now?
> >
> >         I recently completed a study inoculating dry dose forms coated,
> > uncoated, capsules and granulations-for-capsules with up to 10,000
> cfu/dose
> > unit. As expected E. coli, S. aureus, Ps. aeruginosa, Salmonella, and C.
> > albicans died off in 3 to 7 days. A. niger was reduced in numbers. A
> > colleague had performed a similar study at another company earlier and
> > generated similar results. Has anyone reading this done or heard of such
> > studies?
> >
> >         Wouldn't such results along with Friedel's and Cundell's
opinions
> > put a near kabosh on testing of dry dose forms? Note: the microbes were
> > inoculated onto the tablets, etc. If they were in the granulation before
> > compression wouldn't kill off be even quicker - instantaneous? Can
anyone
> > share any microbial study information or articles on microbe challenges
> > using inoculated granulations then compressing or encapsulating them?
> >
> >         Wouldn't these findings and opinions also put the kabosh on
> > environmental testing of non-sterile dry dose form manufacturing areas?
> > Considering these results what is the rationale for the tight limits I
> have
> > read about for manufacturing equipment surface sampling - 1 to 2 cfu per
> sq.
> > cm - some limits are even tighter for non-sterile (he states as he takes
> his
> > coated tablet dosage form in his fingers and gulps it down with city
> > water)?
> >
> >
> >
> >         Thank you,
> >
> >         George Spite
> >
> >
> >
> >
> > ------------------
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> >
> >
>
>
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>


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The PMFList (http://microbiol.org/PMFList_info.htm) is operated from
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