5 1 10 Guidelines For Using The Test For Bacterial Endotoxins
5 1 10 Guidelines For Using The Test For Bacterial Endotoxins
5 1 10 Guidelines For Using The Test For Bacterial Endotoxins
General Notices (1) apply to all monographs and other texts 639
5.1.10. Guidelines for using the test for bacterial endotoxins EUROPEAN PHARMACOPOEIA 10.0
and gives a result consistent with that obtained with the K = threshold pyrogenic dose of endotoxin per
prescribed method as described in the General Notices (see kilogram of body mass ;
also section 12). M = maximum recommended bolus dose of product
per kilogram of body mass.
The prescribed method for bacterial endotoxins may be stated
in the monograph on a given substance or product. The use of When the product is to be injected at frequent intervals
a method other than the method prescribed in the monograph or infused continuously, M is the maximum total dose
is considered as the use of an alternative method. Where no administered per hour.
method is stated, any of methods A to F of general chapter The endotoxin limit depends on the product and its route of
2.6.14. Bacterial endotoxins can be used. administration and may be stated in the monograph. Values
for K are suggested in Table 5.1.10.-1.
2. METHOD AND ACCEPTANCE CRITERIA For other routes, the acceptance criterion for bacterial
2-1. METHODS AND PRECAUTIONS TO BE TAKEN endotoxins is generally determined on the basis of results
The addition of endotoxins to amoebocyte lysate may result obtained during the development of the preparation.
in turbidity, precipitation or gelation (gel-clot); initially only
the gel-clot method was used in the Pharmacopoeia as an Table 5.1.10.-1
evaluation criterion in the test for bacterial endotoxins. The Route of administration K
advantage was the simplicity of basing the decision to pass or
Intravenous 5.0 IU of endotoxin per kilogram
fail the substance or product to be examined on the absence of body mass
or presence of a gel-clot, visible with the naked eye. The
quantitative methods C, D, E and F were developed later : they Intravenous for radiopharmaceuticals 2.5 IU of endotoxin per kilogram
of body mass
require more instrumentation, but they are easier to automate
for the regular testing of large numbers of samples of the same Intrathecal 0.2 IU of endotoxin per kilogram
of body mass
substance or product.
Parenteral formulations administered 100 IU/m2
Endotoxins may be adsorbed onto the surface of tubes per square metre of body surface
or pipettes made from certain plastics or types of glass.
Interference may appear due to the release of substances from 2-4. CONSIDERATIONS WHEN ESTABLISHING AN
plastic materials. Hence, the materials used must be checked. ENDOTOXIN LIMIT FOR A SPECIFIC SUBSTANCE OR
2-2. ENDOTOXIN LIMIT CONCENTRATION PRODUCT
The endotoxin limit for a substance or product is established
The decision to use the test for bacterial endotoxins as a limit
with consideration of the following aspects.
test implies firstly that an endotoxin limit concentration must
be defined for the substance or product to be examined, and Calculated endotoxin limit. The endotoxin limit is calculated
secondly that the objective of the test is to know whether the as described in section 2-3. This represents a safety limit not
endotoxin concentration in the sample to be examined is below to be exceeded if the product is to be administered to humans.
or above this limit. The quantitative methods C, D, E and F Limit prescribed in an individual substance monograph.
make it possible to determine the endotoxin concentration The limit stated in an individual substance monograph
in the sample to be examined, but for compliance with the frequently reflects what is achievable in a controlled
Pharmacopoeia and in routine quality control the final production environment. The limit prescribed in a
question is whether or not this concentration exceeds a monograph can therefore be lower than the calculated
defined limit. endotoxin limit. However a manufacturer may specify a limit
The dose of the substance or product to be examined that is more stringent than that stated in the monograph.
must be taken into account in setting the endotoxin limit Process capability. The capability of the process to reduce or
concentration : the limit is set so as to ensure that, as long remove bacterial endotoxins during manufacture might result
as the endotoxin concentration in the substance or product in lower endotoxin limits for specific processes.
remains below this limit, even the maximal dose administered
by the intended route per hour does not contain sufficient Additional safety requirements. Precautions are taken
endotoxin to cause a toxic reaction. in consideration of patient population (such as paediatric
use, malnourished or cachectic patients, etc.), specific local
When the endotoxin concentration in the substance or product requirements (e.g. countries might wish to operate with a
exactly equals the endotoxin limit concentration, gelation will lower average body weight of 60 kg instead of 70 kg frequently
occur, as is the case when the endotoxin concentration is much employed in Europe) or any additional safety margins
higher, and the substance or product will fail the test, because requested by the competent authority.
the all-or-none character of the test makes it impossible to Formulation of the product. The limit must take into
differentiate between a concentration exactly equal to the consideration any theoretical bacterial endotoxin load
endotoxin limit concentration and one that is higher. It is only introduced by any other components used for reconstitution
when no gelation occurs that the analyst may conclude that and/or dilution of the product (e.g. water for injections) or
the endotoxin concentration is below the endotoxin limit. introduced by starting materials and/or raw materials.
For substances or products in the solid state, this endotoxin 2-5. MAXIMUM VALID DILUTION
limit concentration per mass unit or per International Unit Which dilution of the substance or product is to be used in the
(IU) of substance or product has to be converted into a test to obtain maximal assurance that a negative result means
concentration of endotoxin per millilitre of solution to be that the endotoxin concentration of the substance or product
examined, as the test can only be carried out on a solution. is less than the endotoxin limit and that a positive result means
The case of substances or products that already exist in the that the lysate detected an endotoxin concentration equal to
liquid state (such as infusion fluids) is discussed below. or greater than the endotoxin limit? This dilution depends on
2-3. CALCULATION OF THE ENDOTOXIN LIMIT the endotoxin limit and on the sensitivity of the lysate ; it is
The endotoxin limit for active substances administered called the maximum valid dilution (MVD) and its value may
parenterally, defined on the basis of dose, is equal to : be calculated using the following expression :
General Notices (1) apply to all monographs and other texts 641
5.1.10. Guidelines for using the test for bacterial endotoxins EUROPEAN PHARMACOPOEIA 10.0
8. PRELIMINARY TEST FOR INTERFERING FACTORS the test (for method A and B). The purpose of the negative
control is to verify the absence of a detectable concentration
Some substances or products cannot be tested directly for the of endotoxin in the water for BET.
presence of bacterial endotoxins because they are not miscible
with the reagents, they cannot be adjusted to pH 6.0-8.0 or they The positive control, which contains the product to be
inhibit or activate enzymatic reaction (such as β-D-glucans). examined at the concentration used in the test, is intended to
show the absence of inhibiting factors at the time and under
Therefore a preliminary test is required to check for the the conditions of the test.
presence of interfering factors ; when these are found the
analyst must demonstrate that the procedure to remove them
has been effective and that by applying this procedure, any 11. READING AND INTERPRETATION OF RESULTS
bacterial endotoxins present have not been removed.
Minute amounts of bacterial endotoxin in the water for BET,
The object of the preliminary test is to test the null hypothesis or in any other reagent or material to which the lysate is
that the sensitivity of the lysate in the presence of the substance exposed during the test, may escape detection as long as they
or product to be examined does not differ significantly from do not reach the sensitivity limit of the lysate. However, they
the sensitivity of the lysate in the absence of the product. may raise the amount of bacterial endotoxin in the solution
A simple criterion is used in methods A and B : the null containing the substance or product to be examined to just
hypothesis is accepted when the sensitivity of the lysate in the above the sensitivity limit and cause a positive reaction.
presence of the product is at least 0.5 times and not more than
twice the sensitivity of the lysate by itself. The risk of this happening may be reduced by testing the
water for BET and the other reagents and materials with the
The test for interfering factors in gel-clot methods A and B most sensitive lysate available, or at least one that is more
requires the use of a sample of the substance or product in sensitive than the one used in the test on the product. Even
which no endotoxins are detectable. This presents a theoretical then, the risk of such a ‘false positive result’ cannot be ruled
problem when an entirely new product has to be tested. out completely.
Hence, a different approach was designed for quantitative
methods C, D, E and F.
12. REPLACEMENT OF METHODS PRESCRIBED IN
Note that methods D and E, which use a chromogenic peptide, MONOGRAPHS
require reagents that are absent in methods A, B, C and F,
and hence compliance of methods A, B, C or F with the 12-1. REPLACEMENT BY ANOTHER PH. EUR. METHOD
requirements for interfering factors cannot be extrapolated to As stated in the General Notices, the test methods given in
method D or method E without further testing. monographs and general chapters have been validated in
accordance with accepted scientific practice and current
recommendations on analytical validation. The methods
9. REMOVAL OF INTERFERING FACTORS described in general chapters 2.6.14. Bacterial endotoxins
and 2.6.30. Monocyte-activation test therefore do not have
The procedures to remove interfering factors must not to be re-validated per se, other than in consideration of their
increase or decrease (for example, by adsorption) the amount use for a specific substance or product in a specific analytical
of endotoxin in the substance or product to be examined. The environment.
correct way of checking this is to apply the procedures to a
spiked sample of the substance or product to be examined, The procedure and the materials and reagents used in the
that is, a sample to which a known amount of endotoxin method must be validated as described for the test concerned.
has been added, and then to measure the recovery of the The absence of interfering factors (and, if necessary, the
endotoxin after the removal process has been conducted. procedure for removing them) is verified on samples of at least
Methods C and D. If the nature of the product to be examined 3 production batches.
results in an interference that cannot be removed by classical
methods (e.g. dilution or centrifugation), it may be possible to The necessary information is sought from manufacturers ;
determine the standard curve in the same type of substance or companies are invited to provide any validation data that they
product freed from endotoxins by appropriate treatment or by have concerning the applicability of the replacement test to
dilution of the substance or product. The endotoxins test is the substances and products of interest ; such data includes
then carried out by comparison with this standard curve. details of sample preparation and of any procedures necessary
to eliminate interfering factors.
Ultrafiltration with cellulose triacetate asymmetric membrane
filters has been found to be suitable in most cases. The filters As stated in general chapter 2.6.30. Monocyte-activation
must be properly validated, because under some circumstances test, the monocyte-activation test is primarily intended as
cellulose derivatives (β-D-glucans) can cause false positive a replacement of the rabbit pyrogen test. Guidelines on
results. which methods to use (A, B or C) and on how to validate
the monocyte-activation test are described in general chapter
Another option to remove interfering factors is a 2-step 2.6.30. Monocyte-activation test.
procedure in which 1) endotoxin within the interfering 12-2. REPLACEMENT BY AN ALTERNATIVE METHOD
sample is fixed on a solid phase, and 2) after removal of the NOT DESCRIBED IN THE PH. EUR.
interfering substance (e.g. by washing) the endotoxin is The use of alternative reagents such as recombinant factor C
detected unimpaired under suitable testing conditions. as a replacement to the amoebocyte lysate eliminates the use
of a reagent extracted from live animals.
10. THE PURPOSE OF THE CONTROLS Replacement of a rabbit pyrogen test or a bacterial endotoxin
test prescribed in a monograph by a test using recombinant
The purpose of the control made up with water for BET factor C reagent or any other reagent as a replacement of the
and the reference preparation of endotoxin at twice the amoebocyte lysate is to be regarded as the use of an alternative
concentration of the labelled lysate sensitivity is to verify the method in the replacement of a pharmacopoeial test, as
activity of the lysate at the time and under the conditions of described in the General Notices.
This test cannot replace or confirm the assessment of the clinical Fungal growth conditions
efficacy of such preparations. Sabouraud-dextrose agar or number of CFU in test suspension :
Sabouraud-dextrose broth 1-5 × 107 CFU/mL
1. PRINCIPLE - for preparation of test suspension
of C. albicans : 20-25 °C, 2-3 days
Antimicrobial activity is determined by adding test
suspensions of micro-organisms (bacteria, fungi or yeasts, - for preparation of test suspension
of A. brasiliensis spores : 20-25 °C, at
separately) to the sample antiseptic product. The mixture least 5 days until good sporulation
is maintained at 33 ± 1 °C for contact times of 5 min for - for testing of the product
bactericidal activity and 15 min for fungicidal or yeasticidal and validation of the test with
activity. Additional contact times may be chosen, according to C. albicans and A. brasiliensis :
the stated use of the antiseptic medicinal product. At the end 20-25 °C, ≤ 5 days
of the contact time, an aliquot is taken and the antimicrobial The recommended solutions and media are described in
activity in this aliquot is immediately stopped by a validated general chapter 2.6.13. Purified water is used. All reagents
method. 2 methods are available : dilution-neutralisation and are sterile prior to use.
membrane filtration.
The procedure is validated to verify its ability to demonstrate The test for bactericidal, fungicidal or yeasticidal activity
the required reduction in the count of viable micro-organisms is performed with the designated strains as described in
by the use of appropriate controls. Table 5.1.11.-1. In addition to these micro-organisms, it may
be necessary to add other bacterial or fungal strains that
2. TEST MICRO-ORGANISMS AND GROWTH represent the indications of the antiseptic medicinal product
CONDITIONS tested.
Prepare standardised stable suspensions of test strains as Single-strain challenges are used. The counts are performed in
stated in section 2-1. Seed-lot culture maintenance techniques duplicate and the arithmetic mean of the results is calculated
(seed-lot systems) are used so that the viable micro-organisms and expressed in CFU/mL.
used for inoculation are not more than 5 passages removed 2-1. PREPARATION OF TEST SUSPENSION
from the original master seed-lot. Grow each of the microbial For harvesting the micro-organisms use a sufficient volume
test strains separately as described in Table 5.1.11.-1. of a 9 g/L solution of sodium chloride R (for bacteria and
C. albicans) or a solution containing 9 g/L of sodium chloride R
and 0.5 g/L of polysorbate 80 R (for A. brasiliensis), to obtain
Table 5.1.11.-1. – Test micro-organisms and growth conditions a test suspension with the number of CFU described in
Strains for bactericidal activity testing Table 5.1.11.-1. Use the suspension within 2 h or within 24 h
if stored at 2-8 °C.
Staphylococcus aureus such as ATCC 6538, NCIMB 9518,
CIP 4.83, NBRC 13276 2-2. PREPARATION OF ANTISEPTIC PRODUCT TEST
SOLUTION
Enterococcus hirae such as ATCC 10541, NCIMB 8192,
CIP 58.55, DSM 3320 The concentration of the antiseptic product test solution shall
be, if possible, 1.25 times the in-use test concentration because
Escherichia coli such as NCIMB 10083, CIP 54.117,
NCTC 10538, DSM 11250
it is diluted to 80 per cent during the test and the method
validation.
Pseudomonas aeruginosa such as ATCC 15442, NCIMB 8626,
CIP 103467, NBRC 13275 2-3. NEUTRALISING AGENTS
Bacterial growth conditions Neutralising agents are used to neutralise the antimicrobial
activity of the antiseptic product. The common neutralising
Casein soya bean digest agar or number of CFU in test suspension : agents are listed in Table 2.6.12.-2 of general chapter 2.6.12.
casein soya bean digest broth 1-5 × 108 CFU/mL Microbiological examination of non-sterile products : microbial
- for preparation of test strains : enumeration tests. The neutralisation time is not less than 10 s
30-35 °C, 18-24 h and subculture at
least twice and not more than 60 s.
- for testing of the product
and validation of the test : 3. METHODS
30-35 °C, ≤ 3 days
Prior to testing, equilibrate the temperature of all reagents
Strain for yeasticidal activity testing
to 33 ± 1 °C.
General Notices (1) apply to all monographs and other texts 643