Sustained Simultaneous Delivery of Metronidazole and Doxycycline From Polycaprolactone Matrices Designed for Intravaginal Treatment of Pelvic Inflammatory Disease

J Pharm Sci. 2018 Mar;107(3):863-869. doi: 10.1016/j.xphs.2017.09.033. Epub 2017 Oct 31.

Abstract

Poly(ɛ-caprolactone) (PCL) intravaginal matrices were produced for local delivery of a combination of antibacterials, by rapidly cooling a mixture of drug powders dispersed in PCL solution. Matrices loaded with different combinations of metronidazole (10%, 15%, and 20% w/w) and doxycycline (10% w/w) were evaluated in vitro for release behavior and antibacterial activity. Rapid "burst release" of 8%-15% of the doxycycline content and 31%-37% of the metronidazole content occurred within 24 h when matrices were immersed in simulated vaginal fluid at 37°C. The remaining drug was extracted gradually over 14 days to a maximum of 65%-73% for doxycycline and 62%-71% for metronidazole. High levels of antibacterial activity up to 89%-91% against Gardnerella vaginalis and 84%-92% against Neisseria gonorrhoeae were recorded in vitro for release media collected on day 14, compared to "nonformulated" metronidazole and doxycycline solutions. Based on the in vitro data, the minimum levels of doxycycline and metronidazole released from PCL matrices in the form of intravaginal rings into vaginal fluid in vivo were predicted to exceed the minimum inhibitory concentrations for N. gonorrhea (reported range 0.5-4.0 μg/mL) and G. vaginalis (reported range 2-12.8 μg/mL) respectively, which are 2 of the major causative agents for pelvic inflammatory disease.

Keywords: combination of antibacterials; doxycycline; intravaginal; matrices; metronidazole; pelvic inflammatory disease; poly (ɛ-caprolactone).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intravaginal
  • Anti-Bacterial Agents / therapeutic use*
  • Anti-Infective Agents / therapeutic use*
  • Cell Line, Tumor
  • Delayed-Action Preparations / therapeutic use*
  • Doxycycline / therapeutic use*
  • Drug Delivery Systems / methods
  • Female
  • Gardnerella vaginalis / drug effects
  • Humans
  • Metronidazole / therapeutic use*
  • Microbial Sensitivity Tests / methods
  • Neisseria gonorrhoeae / drug effects
  • Pelvic Inflammatory Disease / drug therapy*
  • Polyesters / therapeutic use*
  • Vagina / microbiology

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents
  • Delayed-Action Preparations
  • Polyesters
  • Metronidazole
  • polycaprolactone
  • Doxycycline