Development of a reectal antibiotic formulation for community based management of neonatal sepsis
Rationale: Deaths from neonatal sepsis are avoidable. Most occur at home in areas where home delivery rates are high and unhygienic conditions are common. When a newborn has sepsis, death can occur within hours, but parents often refuse to proceed to a hospital and have the child admitted even if transport is provided. A 2007 Consultation of Saving Newborn Lives recommended a simpler regimen that could enable initiation of management (or complete management) closer to the home and increase family acceptance of treatment. Rectal delivery of drugs for severely ill patients has been shown to be successful for malaria.
Approach: We propose to develop a rectal formulation of an existing injectable antibiotic targeting the main pathogens of neonatal sepsis, which can be given immediately at home for life-threatening sepsis in the newborn. The right antibiotic, in a stable and bioavailable formulation, could be used for the community-based treatment of neonatal sepsis administered by relatively unskilled personnel.
Objective and Impact: Our vision is to develop this into an affordable product (<0.5 USD/dose) to be widely available for neonates in inaccessible areas worldwide.
Innovation: Current medication is injectable, and can only be given at a hospital. This is because a hospital is where patients in advanced countries can go. A suppository that can substitute for effective injectable treatment would be more relevant to the context where most neonates die from sepsis, more acceptable than injectables, used by relatively unskilled personnel, and can save lives.