Novel techniques to screen for contaminants in medicinal syrups which have recently led to the death of hundreds of children
Novel techniques to screen for contaminants in medicinal syrups which have recently led to the death of hundreds of children
Dr. Bevin Gangadharan presenting novel methods to detect diethylene glycol and ethylene glycol at Jesus College, Oxford. Photo credit: Yohan Arman, Zitzmann lab.
Since 1937 there have been multiple incidences of diethylene glycol and ethylene glycol poisoning, causing many deaths, due to errors in manufacturing processes and falsification of excipients commonly used in cough and paracetamol syrups. When ingested at clinically significant quantities they cause multiorgan failure, especially acute renal failure and neurological dysfunction. There have been several outbreaks in multiple countries since 2022 with over 300 deaths in children under 5 years old.
Pharmacopeial methods to detect the contaminants rely on gas chromatography with flame ionization detection (GC-FID) that is expensive and not available in all low- and middle-income countries. Less expensive, more widely available and/or relatively simple techniques are needed to validate that the bulk excipients and finished products contain less than the allowable limits of the contaminants which could help to reduce the frequency of these tragedies.
Prof. Nicole Zitzmann and members of her team are working with the Medicines Quality Research Group (within the Nuffield Department of Medicine), the Department of Chemistry and the Rutherford Appleton Laboratory (RAL) of UKRI on a project to evaluate innovative techniques to screen for the contaminants in raw ingredients and syrups.
Yohan Arman and Bevin Gangadharan in the Zitzmann lab are currently evaluating mass spectrometry and diverse lower cost devices and techniques. Last month a workshop was held at Jesus College, Oxford with 80 participants from 27 countries to discuss how to improve screening of contaminated syrups and their data were presented at this meeting.
See the links below for more information about the workshop at Jesus College and the work being done by the team:
- https://www.cghr.ox.ac.uk/research/medicine-quality-research-group/mqrg-projects/the-deg-eg-project-safety-of-medicinal-syrups-for-children
- https://www.iddo.org/news/experts-join-forces-improve-screening-devices-detect-substandard-and-falsified-medicines
- https://www.tropicalmedicine.ox.ac.uk/news/experts-join-forces-to-improve-screening-devices-to-detect-substandard-and-falsified-medicines
- https://massspec.chem.ox.ac.uk/article/diethylene-glycolethylene-glycol-screening-technologies-workshop-jesus-college-oxford
Since April 2021, Oxford University's KAVLI Institute for Nanoscience Discovery is proudly serving as a hub for research groups from seven different departments spanning both the medical and physical sciences, including Professor Nicole Zitzmann's group from the Department of Biochemistry.
