Low quality and falsified pharmaceuticals are an unfortunate reality many live with around the world, especially in Low and Middle Income Countries (LMICs). The need for comprehensive analysis in limited resource settings has turned researchers to develop inexpensive tools such as paper-based analytical devices (PADS). The antibiotic PAD (aPAD) utilizes a standard titration assay for beta-lactam antibiotics that has been downscaled to function on paper. The current aPAD methodology uses a glassware addition of sodium hydroxide, carefully prepared triiodide and hydrochloric acid followed by a reaction on the paper test card consisting of a reduction with thiosulfate and a color producing complexation with starch. Through this scheme, the aPAD has the capability to semi-quantify the quality of beta-lactam antibiotics. These drugs, such as amoxicillin and ampicillin, are crucial and widespread in any healthcare system. I performed a field reproducibility test of the aPAD in Eldoret, Kenya. This test, while successful, revealed a need to optimize the process for the end user– pharmacists in LMICs that lack capacity for postmarket surveillance. I created a shortened scheme that requires the placement of triiodide in quantitative amounts onto the aPAD, which will make the final reduction step using thiosulfate redundant. This will simplify both the creation and use of the aPAD and lower cost. Testing was performed to simulate this simplified reaction scheme which gave results similar to the current readout of the aPAD and initial degradation tests show promising results of the “shelf life” of dried triiodide, the crucial new addition to the aPAD.

Fighting low quality pharmaceuticals through the development and optimization of an affordable paper-medium antibiotic assay

255th National Meeting (2018)

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