Ch17 Microbial Spoilage

Microbial Spoilage, Infection Risk &
Contamination Control
Part 2
Hugo and Russells Pharmaceutical
Microbiology, 8th Edition
Chapter 17
Factors Affecting Microbial

Spoilage of Pharmaceuticals
Types and Size of Contaminant Inoculum
- Before doing a formula, the formulator should
consider the environment and usage to which the
product is likely to be subjected during its life and the
history of similar medicines, why?
to build as much protection as possible against non-standard
encounters, such as additional preservation for a syrup if
osmotolerant yeast contamination is particularly likely
- If microbial failure occurs, identification of the

contaminant(s) & knowledge of microbial ecology are
very useful in tracking down the defective steps in the
design or production process

- Very low levels of contaminants which are unable to
replicate in a product might not cause appreciable spoilage
but, if a surge in contaminant bio-burden occur, the builtin protection could be insufficient and spoilage occurs
- This surge might arise if:
1.
Raw materials were unusually contaminated;
2.
A problem of the plant-cleaning protocol occurred;
3.
Biofilm detached itself from within supplying pipework;
4.
There was demolition or maintenance work in the vicinity of the

manufacturing site
5.
Gross misuse of the product during administration.

- Inoculum size alone is not always a reliable indicator
of spoilage potential.
e.g. a very low level of, aggressive Pseudomonads in a weakly
preserved solution may suggest a greater risk than tablets
containing fairly high numbers of fungal and bacterial spores.
When an aggressive contaminant enters a medicine, there may
be an appreciable lag period before significant spoilage begins,
the duration of which decreases disproportionately with
increasing contaminant loading. However, since there is usually
a long delay between manufacture and administration of
factory-made medicines, growth and attack could start during
this period unless additional steps are taken to prevent it.

- The isolation of a particular m.o. from spoiled
product does not necessarily mean that it was the
initiator of the attack. It could be a secondary
opportunistic contaminant which had overgrown
the primary spoilage organism once the
physicochemical properties had been favourably
modified by primary spoiler.

Nutritional Factors
- Many common spoilage microorganisms have simple
nutritional requirements and metabolic adaptability
This enables them to utilize many of the components of
medicines as substrates for biosynthesis and growth, even
including trace materials contained in them.
Even demineralized water prepared by good ion-exchange
methods normally contains sufficient nutrients to allow
significant growth of many water-borne Gram-negative
bacteria such as Pseudomonas spp.
Thats why when such contaminants fail to grow in a medicine
it is unlikely to be as a result of nutrient limitation but due to
other, non-supportive, physicochemical or toxic properties.

Nutritional Factors
- Most acute pathogens require specific growth
factors normally associated with the tissues they
infect but which are often absent in
pharmaceutical formulations.
Therefore, they will unlikely multiply in them, but they
may remain viable and infective for an appreciable time in
some dry products where the conditions are protective.
- The use of crude vegetable or animal products in a

formulation provides an additionally nutritious
environment.

Moisture Content: Water Activity (Aw)
- Microorganisms require readily accessible water in appreciable
quantities for growth.
- Although some solute-rich medicines such as syrups appear to
be 'wet', microbial growth in them may be difficult, why?
Since the microbes have to compete for water molecules with the large
numbers of sugar and other molecules of the formulation which also
interact with water via hydrogen bonding.
- An estimate of the proportion of the unbound water in a

formulation available to equilibrate with any microbial
contaminants and facilitate growth can be obtained by
measuring its water activity (Aw).
=
vapour pressure of formulation

(under similar conditions )
vapour pressure of water

Moisture Content: Water Activity (Aw), examples:
1. Sucrose Solutions:

Moisture Content: Water Activity (Aw), examples:
2.
NaCl Solutions:
- The scale is different for the %s of different solutes

- The greater the (same) solute concentration, the lower is the water
activity.

- With the exception of halophilic bacteria, most
m.o grow best in dilute solutions (high Aw) and, as
solute conc. rises (lower Aw), growth rates decline
until a minimal, growth-inhibitory Aw is reached.
- Limiting Aw values are of the order of:
Gram-negative rods: 0.95
Staphylococci, Micrococci and Lactobacilli: 0.9
Most yeasts: 0.88

- The Aw of aqueous formulations can be lowered to increase
resistance to microbial attack by the addition of high
concentrations of sugars or polyethylene glycols.
- Since there are trends to eliminate sucrose from medicines,
alternative solutes are used, such as sorbitol and fructose,
which are not thought to encourage dental caries.
- But, syrup-fermenting osmo-tolerant yeasts were found to spoil
products with Aw levels as low as 0.73, while some filamentous
fungi can grow at even lower values, such as Aspergillus glaucus
(0.61)
Thats why even Syrup BP (67% sucrose; Aw= 0.86) has been reported to
occasionally fail to inhibit osmo-tolerant yeasts and hence additional
preservation may be necessary

- Aw can also be reduced by drying, although the dry,
often hygroscopic, medicines (tablets, capsules,
powders) will require suitable packaging to prevent
reabsorption of water and consequent microbial
growth.
- Some tablet film coatings are now available which
greatly reduce water vapour uptake during storage.
These might contribute to increased microbial stability
during storage in particularly humid climates,
although suitable foil strip packing may be more
effective, but also more expensive.

- Without proper packaging, condensed water films can
accumulate on the surface of 'dry products such as
tablets or bulk oils following storage in damp
atmospheres with fluctuating temperatures, resulting
in high localized Aw which can initiate fungal growth.
- Dilute aqueous films similarly formed on the surface
of viscous products such as syrups and creams, or
exuded by syneresis from hydrogels, reach sufficiently
high Aw to permit surface yeast and fungal spoilage.

Redox Potential
- The ability of microbes to grow in an environment
is influenced by its oxidation-reduction balance
(redox potential) since they require compatible
terminal electron acceptors to permit function of
their respiratory pathways.
- The redox potential even in fairly viscous emulsion
may be quite high due to the high solubility of
oxygen in most fats & oils.

Storage Temperature
- Spoilage of pharmaceuticals could occur over the range of
about -20 to 60C, although much less likely at the
extremes.
- The actual storage temperature may determine the
spoilage by particular types of microorganisms.
- Storage in a deep freeze at -20C or lower is used for longterm storage of foodstuffs and some pharmaceutical raw
materials.
- Dispensed total parenteral nutrition (TPN) feeds have also
been stored in hospitals for short periods at -20C to even
further minimize the risk of growth of any contaminants
which might have been introduced during their aseptic
compounding.

Storage Temperature
- Reconstituted suspensions and multi-dose eye
drop packs are sometimes dispensed with the
instruction to 'store in a cool place' such as a
domestic fridge (2-8C), partly to reduce the risk
of in-use contamination.
- On the other hand, Water for Injections is usually
held at 80C or above after distillation (prior to
packing and sterilization) to prevent possible
regrowth of Gram-negative bacteria, and the
release of endotoxins

pH
- Extremes of pH prevent microbial attack.
- Around neutrality bacterial spoilage is more likely, with reports
of Pseudomonads and related Gram-negative bacteria growing
in antacid mixtures, flavoured mouth washes and in distilled or
demineralized water.
- Above pH 8, e.g. with soap-based emulsions, spoilage is rare.
- For products with low pH levels such as the fruit juice-flavoured
syrups (ca. pH 3-4) mould or yeast attack is more likely. Yeasts
can metabolize organic acids and raise the pH to levels where
secondary bacterial growth can occur.
- In food industry low pH adjustment can be made to preserve
foodstuffs (pickling, yoghurt), but this is not practical for
medicines ( why??? ).

Packaging Design
- Packaging should be made in a way to control the
entry of contaminants during both storage and
use.
- The most important dosage form to be protected
are the parenteral drugs because of the high risks
of infection by this route.
- Self-sealing rubber closures must be used to
prevent microbial entry into multi-dose injection
containers following drug withdrawals.

Packaging Design
- Wide-mouthed cream jars will allow the entry of
fingers with their high bioburden of contamination.
Thus, it is better to replace them with narrow nozzle
and flexible screw capped tubes.
- For medicines which rely on their low Aw to prevent
spoilage, packaging such as strip foils must be of
water vapour-proof materials with fully efficient seals.
- Cardboard outer packaging and labels themselves can
become substrates for microbial attack under humid
conditions; therefore preservatives are often included
to reduce their risk of damage.
10

Protection of m.o. within Pharmaceutical Products
- The survival of microorganisms in particular environments
is influenced by the presence of various relatively inert
materials.
- Microbes can be more resistant to heat or desiccation in
the presence of some polymers such as starch, acacia or
gelatin.
- Adsorption onto naturally occurring particulate material
may aid establishment and survival in some environments.
- The presence of some surfactants, suspending agents and
proteins can increase the resistance of microorganisms to
preservatives, over and above their direct inactivating
effect on the agents.
Hazard to Health
Contaminated pharmaceutical products may
present a potential health hazard to the patient.
Contamination with pathogenic bacteria (e.g.
Salmonella spp) forms a special risk since they
can cause infections in a wide range of patients.
The presence of opportunists with limited
pathogenicity also present significant challenge to
compromised patients.
11
Hazard to Health
The outcome of using contaminated products vary
from patient to patient depending on the type &
degree of contamination & how the product to be used
- The most serious effects are expected to be with
contaminated injections as generalized bacteraemic shock
& sometimes death is reported
- Wound or sore in broken skin may become locally infected
which may extend the hospital bed occupancy
Most medicament related infections are difficult to be

recognized by health practitioners which causes the
spread of infection over several months
Hazard to Health - Examples

Gram -ve bacteria:
- G-ve bacteria were responsible for numerous outbreaks.
- Pseudomonas spp have simple nutritional requirements &
multiply significantly in aqueous products
Cornea when scratched or damaged by irritant chemicals offers
little resistance to Pseudomonas and hence contaminated
ophthalmic solutions have resulted in frequent cases of infections;
some leading to loss of sight.
Pseudomonas contaminating antiseptic solutions caused skin
infections in burnt patients resulting in failure of skin grafts &
death.
Infections of eczematous skin & respiratory infections in neonates
were caused by contaminated ointments & creams.
12

Gram -ve bacteria:
- Infections by Salmonella spp were reported & the
m.o. was isolated from products contaminated
with it (tablets, pancreatin, thyroid extracts).
- Oral mixtures & antacid suspensions can support
the growth of Gram -ve bacteria & resulted in
serious effects in immunocompromised patients
(e.g. as a result of antineoplastic chemotherapy)
- Bladder wash out solutions contaminated with
Gram -ve bacteria caused painful infections

Other cases:
- HIV contaminated factor VIII products made from
pooled human blood was reported
- Creutzfeldt-Jackob disease infection from
contaminated injections of human growth
hormone derived from human pituitary
13
Hazard to Health
Microbial toxins:
- G-ve bacteria contain endotoxins (LPS) which can
remain active in products even after cell death &
some can survive moist heat sterilization
- Endotoxins are inactive via oral route but if they enter
blood stream via contaminated infusion fluids (even
in ng level) or via diffusion across membranes from
contaminated haemodialysis solution they can induce
serious physiological effects.
- Endotoxins cause fever, activation of the cytokine
system, endothelial cell damage & these all lead to
septic & often febrile shock.
Factors Determining the Outcome of a

Medicament Borne Infection
Clinical rxns may range from local infections of wounds
or broken skin (contaminated topical prep) to GI
infections (contaminated oral products) to serious
widespread infections such as bacteraemia or septicemia
possibly resulting in death (contaminated infusion)
Clinical rxns resulting from the use of contaminated
medicament may be evident in one patient but not in
another one depending on many factors, among which
are:
1.
Type & Degree of Microbial Contamination
2.
3.
Route of Administration
Resistance of the Patient to Microbial Infections
14

1. Type & Degree of Microbial Contamination
- Microorganisms contaminating medicaments are
classified into true pathogens or opportunistic
pathogens.
- Pathogens rarely occur in products but if present they
cause serious problems, examples:
Clostridium tetani: caused wound infections & cases of
neonatal death resulted from use of contaminated talcum
powder
Salmonella spp: caused outbreaks of salmonellosis due to
ingestion of contaminated thyroid & pancreatic powders

1. Type & Degree of Microbial Contamination
- Opportunists like P. aeruginosa, Klebsiella spp. and
Serratia spp are more frequently isolated from
medicinal products.
The main concern with these organism is that their simple
nutritional requirements enable them to survive in a wide
range of pharmaceuticals, thus they present in high numbres
106-107 CFU/g or ml, although the product itself may not
show visible sign of contamination.
Compromised patients are considered at risk from infection
with these m.o.
- The critical dose of m.o that will initiate an infection is

unknown & varies between spp & within spp.
15

2. Route of Administration
- Ophthalmic & parenteral route:
Contaminated products injected directly into blood stream or instilled into
the eye cause the most serious problems.
Injectable & ophthalmic solutions are often simple & provide sufficient
nutrient for G-ve opportunists.
If contaminated; the product may end up with a bioburden as high as 106 CFU/ml
in addition to the potential production of endotoxins
Total parenteral nutrition fluids provide even more nutritional support for
contaminants
Intrathecal & epidural injections are potentially hazardous procedures,
and thus in practice they are given through bacterial filters.
P. aeruginosa (contaminant of eye drops) has caused serious ophthalmic
infections, including loss of sight. The problem is compounded when the
eye is damaged by improper use of contact lenses or scratched by
fingernails or cosmetic applicators.

2. Route of Administration
- Contaminated orally ingested products have different
fate. This depends on whether the drug was taken on
full or empty stomach as stomach acidity provides a
barrier.
- Contaminants in topical products may cause little
harm if applied on intact skin, why?
because intact skin provides a mechanical barrier &
normal flora competes with the few contaminants.
however, damaged skin (sores, burns, surgery, wounds)
may be rapidly colonized & infected by opportunists
potentially causing serious problems
16

3. Resistance of the Patient to Microbial Infections
- Very important in determining the outcome of a medicament
borne infection
- Hospitalized patients are more exposed and susceptible to
infection than those treated in the general community
- Neonates, the elderly, diabetics and traumatized patients (by
surgery, accidents) are at special risk because they may
have impaired defence mechanisms
- Immunocompromised people (patients with leukaemia, HIV
or treated with immunosuppressants) are most prone to
infections.
Thats why it is better to provide them with all medicines in a
sterile form!
Preservation of Medicines Using

Antimicrobial Agents
Why to add a preservative:
1. To kill any anticipated low levels of contaminants,
where from?
a. Remaining in
manufacturing
non-sterile
medicine
after
b. Entering during storage

c.
Introduced during usage especially the repeated

withdrawal of doses from a multi-dose container
2. To further reduce the risk of spoilage
17

If a medicine is unlikely to encourage growth
or survival of contaminants and the infective
risk is low, then a preservative might be
unnecessary
- Examples: tablets, capsules and dry powders
Preservatives should not be added to deal

with
failures
in
poorly
controlled
manufacturing processes.

Properties of an ideal properties:
- Broad spectrum and rapid activity
to rapidly kill all microbial contaminants as they enter the
medicine
- Non-irritant and non-toxic to the patient

- Selective in reacting with contaminants and not
the formulation ingredients
- Stable and effective throughout the life of the
product
18

But:
- The most active antimicrobial agents are generally non-selective
- The remaining preservatives have only modest antimicrobial
efficacy
- There are no preservatives considered sufficiently non-toxic for
use in highly sensitive areas such as CNS and within the eye
- Rapid killing of all contaminants may only be possible for
relatively
simple
aqueous
solutions,
whereas
for
physicochemically complex systems only inhibition of growth
and slow rate of killing may be realistically achieved.
Factors Influencing Antimicrobial

Activity Within Medicines
Effect of preservative concentration, temperature
and size of inoculum:
- Changes in the efficacy of preservatives vary exponentially with
changes in concentration depending on the type of preservative
Remember the concentration exponent ()!
- Changes in product temperature will alter efficacy in

proportions, related to different types of preservative
Q10!
- If concurrent change in temp & conc more complex scenario

Example: if a 0.1% chlorocresol ( = 6, Q10 = 5) solution completely killed a
suspension of E. coli at 30C in 10 minutes, it would require around 90 minutes to
achieve a similar effect if the temperature was lowered to 20C and slight overheating
during production had resulted in a 10% loss by vaporization in the chlorocresol
concentration (other factors remaining constant)
19

Effect of preservative concentration, temperature
and size of inoculum:
- Preservative molecules are used up as they inactivate
microorganisms and as they interact non-specifically
with the significant quantities of contaminant 'dirt
introduced during use.
This will result in a progressive and exponential decline in the
efficiency of the remaining preservative.
- Preservative 'capacity' : describes the cumulative level

of contamination that a preserved formulation can cope
with before the preservative becomes ineffective.
This will vary with preservative type and complexity of the
formulation.

Most preservatives interact in solution with ingredients of
pharmaceutical formulations to varying extents via a number of
weak bonding attractions as well as with any microorganisms
present.
-
This can result in unstable equilibrium in which only a small

proportion of the total preservative present is 'available' to inactivate
m.o., and the resultant rate of killing may be less than anticipated
from the performance of simple aqueous solutions.
However, the 'unavailable' preservative may still, contribute to the

irritancy of the product.
When solute concentrations are very high and Aw is appreciably

reduced, the efficiency of preservatives is often reduced and may
be even inactive at very low Aw.
-
Thats why it is pointless to include preservatives in very low Aw

products such as tablets and capsules.
20
Factors Affecting the 'Availability'

of Preservatives
1. Effect of product pH
- In the weakly acidic preservatives, the unionized molecules
are the active ones & they have significant efficacy at pHs
where ionization is low.
Benzoic and sorbic acids (pKa = 4.2 and 4.75, respectively) have
limited preservative usefulness above pH 5.
4(p)-hydroxybenzoate esters with their non-ionizable ester group
and poorly ionizable hydroxyl substituent (pKa ca. 8.5) have
moderate protective effect even at neutral pH levels.
The activity of quaternary ammonium preservatives and
chlorhexidine resides with their cations and are effective in
products of neutral pH.
- Formulation pH can also directly influence the sensitivity

of microorganisms to preservatives

of Preservatives
2. Efficiency in multiphase systems
- In a multiphase formulation, such as an oil-in-water
emulsion,
preservative
molecules
distribute
themselves in an unstable equilibrium between the
bulk aqueous phase and
the oil phase by partition
the surfactant micelles by solubilisation
polymeric suspending agents and other solutes by
competitive displacement of water of solvation
particulate and container surfaces by adsorption
any microorganisms present
21

of Preservatives
2. Efficiency in multiphase systems
- Generally, the overall preservative efficiency can
be related to the small proportion of preservative
molecules remaining unbound in the bulk
aqueous phase
Although as this becomes depleted some slow reequilibration between the components can be anticipated
- The loss of neutral molecules into oil and micellar

phases may be favoured over ionized species,
although considerable variation in distribution is
found between different systems.

of Preservatives
3. Effect of container or packaging
- Preservative availability may be
interaction with packaging materials.
reduced
by
- Examples:
The permeation of phenolic preservatives into the rubber
closure of multi-dose injection or eye-drop containers and
their interaction with flexible nylon tubes for creams.
Quaternary ammonium preservative levels in formulations
have been significantly reduced by adsorption onto the
surfaces of plastic and glass containers.
Volatile preservatives such as chloroform are lost by the
routine opening and closing of containers
22
Quality Assurance & the Control of

Microbial Risk
QA forms a scheme of management which
includes all the procedures necessary to provide a
high probability that a medicine will conform
consistently to a specified description of quality.
It includes
- formulation design & development (R&D)
- good pharmaceutical manufacturing practice (GPMP)
- quality control QC
- post marketing surveillance
Quality Assurance & the Control of

Microbial Risk
Risk assessment for each product should be made
starting from raw materials, to administration.
- Risk assessments are complicated due to uncertainties
about the exact contaminant & spoilage expected.
- Usually the manufacturers make the worst-case scenario &
design strategies to cover it fully, so that lesser problems
are also included.
Also, it must be assumed that people administering the

medicament are not highly skilled & aware of
contamination control so that additional detailed
information on administration & even training must be
provided.
23
Quality Assurance in Formulation

Design & Development
The best way to eliminate the risk of contamination &
spoilage is by sterilization, but!
- it incurs high cost so sterile products are kept to be used for situations
were there is high risk of consequent infection from contamination.
In parenteral products, high risk of infection by

contamination & presence of concerns of systemic
toxicity of preservatives resulted in the production of
sterile single-dosage units.
However, with eye-drops the risk is lesser & sterile multidose products with preservatives to protect against inuse contamination is accepted.
Sterile single-dose units are more common in hospitals
where there is increased risk of infection.

Oral & topical routes of admin present low risks of infection &
the emphasis is on the control of microbial content during
manufacturing & subsequent protection of the formulation
from spoilage.
In the design process it is necessary to include features in the
formulation & delivery system that provide protection against
contamination because preservative use should be only
considered when there is clear benefit due to toxicity &
irritancy problems.
Among these features:
- Manipulation of physicochemical properties like Aw
- Elimination of certain ingredient
- Selection of container & preservative individually & collectively
contribute to the stability of the product.
24

Laboratory tests (preservative effectiveness tests) were designed to
challenge the product with artificial bioburden. It should be part of
the formulation development & stability trials to ensure that
activity is likely to remain through out shelf life.
Preservative efficacy tests could be single challenge test where
large inoculum of each m.o is introduced into the product & rate of
inactivation is determined by VC at different time intervals, or
multiple challenge test, where the product is exposed to repeated
inoculation at set intervals & the efficiency of inactivation is
monitored until the system fails.
BP, USP & EP describe single challenge test.
Problems with these tests:
- Does the performance of these tests gives reliable prediction of real in-use
efficiency?
- Repeated cultivation on
aggressiveness of strains
microbiological
media
results
in
reduced
Good Pharmaceutical
Manufacturing Practice (GPMP)
GPMP is concerned with control of ingredients,
plant construction, process validation, production
& cleaning.
QC is part of GMP that deals with testing, specs,
documentation & assessing conformance to
specs.
Relying on finished product testing may result in
financial loss if non-compliance was detected at
this late stage, besides microbiological test
methods have poor precision & accuracy, so that
end product testing may not detect failures.
25
Good Pharmaceutical
Assurance of overall product quality can only come from detailed
specs, control & monitoring of all stages of manufacturing process
not just from testing finished product.
e.g. real estimate of product microbial quality comes from knowledge of
bioburden of starting raw material, temp record of the granules, moisture
level of the granules, validation record of the machine cleaning, foil strip
packaging & testing of finished tablets.
Each batch should meet all its specification, but this does not
necessary means that all tests should be performed on finished
product. The manufacturer can carry out Parametric release.
Parametric release: is to provide assurance that the product is of
stipulated quality based on evidence of successful validation of the
manufacturing process & review of the documentation on process
monitoring carried out during manufacturing to provide the desired
assurance of product quality.
Good Pharmaceutical
Points to be considered to assure finished product microbial
quality:
- Raw materials:
Raw materials to be free from pathogenic microorganisms & with low bioburden. For
ingredients from bovine source, exclude suppliers of materials were BSE is endemic
- Manufacturing plant:
identify areas where m.o. can thrive & colonize to treat & clean them. The design &
construction should allow for thorough cleaning. (machines are made from materials
that can be cleaned & disinfected, some machines are provided with clean-in place
systems)
- Manufacturing process:
some products may require addition of some steps to reduce bioburden or improve
lethal sterilization (e.g. include ultra filtration step rather than conventional
sterilization cylcle)
- Validation to the cleaning system:

to challenge the ability of cleaning system to remove deliberately introduced
contaminant
26
Quality control (QC)

The current methods for counting & detecting
some microbes in non sterile products have poor
accuracy & precision, examples:
- low no. m.o. sometimes damage the product but cant
be isolated
- products with active spoilage yields very low microbial
count
- m.o. in high no. but it is not the primary spoilage
agent nor pathogenic
Uneven distribution of m.o present serious

sampling problem

Pharmacopeias (Ph Eur, BP & USP) have included
quantitative & qualitative standards for non-sterile
products.
- There are maximum total microbial levels & exclusion of
specific m.o depending on route of administration.
- Example: for oral drugs, the count per ml or gram should
be:
no more than 103 total aerobic m.o.
no more than 102 fungi
no E. coli
- Higher levels are permissible if the product contains raw

material of natural origin.
27

Endotoxin Test:
- Endotoxin (pyrogen) levels in parenterals must be very low
to prevent endotoxic shock.
- Formerly this was tested by injecting rabbits & noting any
febrile response.
- Nowadays the test is performed using Limulus amoebocyte
lysate (LAL) test (gel clot method) where an amoebocyte
lysate from the horseshoe crab Limulus polyphemus reacts
specifically with microbial lipopolysaccharides to give a gel
& opacity even at very high dilutions.
- Tissue culture test are under development where the
ability of endotoxins to induce cytokine release is
measured directly
Post market surveillance

It is impossible to guarantee that a medicine
will never fail under real life conditions, but a
proper quality assurance system must include
procedures to monitor in use performance &
respond to customer complaints in order to
re-evaluate the constructed & implemented
schemes for product safety & check whether
they need modification.
28

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Microbial Spoilage, Infection Risk &

Factors Affecting Microbial

- If microbial failure occurs, identification of the

Factors Affecting Microbial

Raw materials were unusually contaminated;

A problem of the plant-cleaning protocol occurred;

Biofilm detached itself from within supplying pipework;

There was demolition or maintenance work in the vicinity of the

Gross misuse of the product during administration.

Factors Affecting Microbial

Factors Affecting Microbial

Factors Affecting Microbial

Factors Affecting Microbial

- The use of crude vegetable or animal products in a

Factors Affecting Microbial

- An estimate of the proportion of the unbound water in a

vapour pressure of formulation

Factors Affecting Microbial

Factors Affecting Microbial

- The scale is different for the %s of different solutes

Factors Affecting Microbial

Factors Affecting Microbial

Factors Affecting Microbial

Factors Affecting Microbial

Factors Affecting Microbial

Factors Affecting Microbial

Factors Affecting Microbial

Factors Affecting Microbial

Factors Affecting Microbial

Factors Affecting Microbial

Factors Affecting Microbial

Most medicament related infections are difficult to be

Hazard to Health - Examples

Hazard to Health - Examples

Hazard to Health - Examples

Factors Determining the Outcome of a

Type & Degree of Microbial Contamination

Factors Determining the Outcome of a

Factors Determining the Outcome of a

- The critical dose of m.o that will initiate an infection is

Factors Determining the Outcome of a

Factors Determining the Outcome of a

Factors Determining the Outcome of a

Preservation of Medicines Using

b. Entering during storage

Introduced during usage especially the repeated

2. To further reduce the risk of spoilage

Preservation of Medicines Using

Preservatives should not be added to deal

Preservation of Medicines Using

- Non-irritant and non-toxic to the patient

Preservation of Medicines Using

Factors Influencing Antimicrobial

- Changes in product temperature will alter efficacy in

- If concurrent change in temp & conc more complex scenario

Factors Influencing Antimicrobial

- Preservative 'capacity' : describes the cumulative level

Factors Influencing Antimicrobial

This can result in unstable equilibrium in which only a small