Healthy Clinical Trial
Official title:
Bioavailability of Amoxicillin Dissolved in Human Milk: An Adult Volunteer Study as a First Step Towards Defining Drug Doses for Infants
The investigators propose to study amoxicillin absorption in a 2-stage program that will progressively produce, for the first time, information leading to pediatric pharmacology recommendations for the administration to children of amoxicillin dissolved in human milk. The investigators study will enroll adult volunteers as number of blood extractions, volume of blood required and subject availability, among other issues, generate a number of ethical and logistical constraints that make it almost impossible to carry such an intensive sampling study in infants.
As recommended by the Expert Committee on Selection and Use of Essential Medicines, WHO
(http://www.who.int/selection_medicines/committees/en/index.html), oral solid formulations
are the preferred forms of medicines for children, especially in developing countries,
because of relatively inexpensive and less complicated manufacturing, transporting and
storage processes. Whereas solid dosage forms are advantageous in these pharmaceutical
logistics, administering solid formulations to infants and children is a challenging issue.
Dissolving medicines in water may be acceptable, but safety of drinking water for infants in
developing countries and water solubility of the drug itself are major concerns. These
challenges are exemplified in the treatment of infectious diseases and diarrhea in infants.
Commonly used drugs for infants in low income settings include antibiotics such as
amoxicillin. Expert sources have suggested that drug administration in breast milk may be
effective. However, little data is currently available to support the recommendation to
administer medications dissolved in breast milk to infants.
The second stage of the project will use the information obtained from the first stage,
combined with pre-existing data, to define a rational dosing schedule of the target drug
dissolved in human milk for young children, using population PK modeling and simulation. This
is a study in silico.
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