Ajayi Taiwo Oreoluwa, Poka Madan Sai, Witika Bwalya Angel
Department of Pharmaceutical Science, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa.
Front Drug Deliv. 2024 Jan 8;3:1295815. doi: 10.3389/fddev.2023.1295815. eCollection 2023.
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.
儿童结核病仍然是全球发病和死亡的主要原因。儿童更容易感染结核病,结核菌可迅速扩散至肺外感染部位。尽管该疾病的病理生理学、药物药代动力学以及儿童的治疗窗与成人不同,但长期以来一直使用治疗成人结核病的相同药物来治疗儿童结核病感染。由于许多现有的剂型(如片剂)因儿童吞咽困难和窒息风险而不适合使用,成人药物常常通过掰碎或碾碎片剂来获取儿童剂量。这可能会因儿童药代动力学差异导致给药不准确,进而导致全身药物浓度低于治疗水平或产生毒性。此外,许多用于治疗结核病的药物以及大多数药物总体上对儿童来说味道极苦,导致他们拒绝并吐出药物,这给坚持服药带来了挑战,最终导致治疗失败。上述情况表明,迫切需要开发对儿童友好的新型药物递送剂型,并解决现有剂型的局限性。本综述讨论了目前可用的口服儿童剂型、为克服当前儿科结核病治疗相关问题而研究的新型口服药物递送系统的最新进展,并通过SWOT分析利用纳米技术为未来研究提供了潜在方向。