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dissolution and oral bioavailability of different formulations of two essential drugs marketed in Tanzania, the drug content and drug release from all the tested ciprofloxacin formulations were within USP-24 requirements and remained stable during storage at simulated tropical conditions. Oral bioavailability was also not influenced by tropical conditions. The stability of essential drugs (ampicillin, benzylpenicillin, phenoxymethylpenicillin and tetracycline) was not affected during shipment to the tropics after being exposed to much higher temperatures and humidity than recommended by the manufacturer, with temperatures recorded within packs ranging from 23.5 to 42.48C and humidity ranging from 20% to 88%. A controlled longitudinal study on the quality and stability of essential drugs in rural Zimbabwe showed that even under the most adverse tropical conditions, clinically relevant instability of these agents is rare. Evidence of potency is an important aspect to consider whilst procuring data about consumption of antimicrobials in developing countries. However, in order to achieve this, one would have to establish potency for each drug on the market, a difficult, unrealistic and expensive exercise, considering the limited funding for research in developing countries. Otherwise, assumptions would be based on random sampling of imported or locally manufactured drugs. Accurate information relating to national antibiotic consumption would be essential in order to extrapolate the impact of these storage issues.

Emergence of Neisseria meningitidis with decreased susceptibility to ciprofloxacin in Argentina