Reduced 
            Availability of Trimethoprim/Sodium Sulfadiazin and Doxycyclin Hyclate 
            in Drinking Water Systems
          Chris Vervaet, PhD
          Jody Voorspoels, PhD
          Filip Kiekens, PhD
          Jean Paul Remon, PhD
           
          Laboratory of Pharmaceutical Technology, Ghent University, 
            Gent, Belgium.
           
          KEY 
            WORDS: Medication administration, dissolution, drinking systems, 
            trimethoprim, doxycyclin hyctate
           
          ABSTRACT
          The availability of drugs in the reservoir and at the 
            nipples of a drinking water system was documented following the addition 
            of Trimazin®, a powder formulation containing sodium sulfadiazin (Na-SD) 
            and trimethoprim (TMP) or doxycyclin hyclate powder (DoxHCl), to the 
            system using a standard mixing methodology. The theoretical concentration 
            of Na-SD, a highly water-soluble drug, was obtained immediately after 
            addition of the Trimazin® powder, whereas the TMP concentrations were 
            highly variable and did not yield their theoretical concentration 
            due to the poor dissolution kinetics of TMP at the test conditions. 
            The availability of DoxHCl was far below its theoretical concentration 
            (200 mg/L), because the drug concentration in the water system did 
            not exceed 30 mg/L. Adding 0.1% (w/v) citric acid to the water increased 
            the DoxHCl concentrations to a maximum of 125 mg/L. This study shows 
            that drug availability from a drinking water system can be well below 
            the anticipated drug concentrations, due to solubility or dissolution 
            rate problems. Therefore, the mixing methodology should be validated 
            if drugs are administered via drinking water.
          INTRODUCTION
          From an economic point of view, drug administration 
            to a group of domesticated animals through medicated feed or drinking 
            water is preferred over time-consuming and costly individual drug 
            administration. Although the feed route is usually restricted to prophylactic 
            treatment, medicated drinking water is often administered to sick 
            animals for therapeutic purposes because they often lack appetite 
            but continue to drink.1,2 However, water as a drug medium offers several 
            challenges and limitations. The main obstacles are the drugs 
            solubility and stability in water. The solubility issue of powder 
            formulations intended for use in drinking water systems is often solved 
            by commercial formulations containing highly soluble salts or by the 
            addition of suitable excipients. However, rapid and complete dissolution 
            of the drug when adding the formulation to the water reservoir should 
            not be taken for granted, because the water quality and design of 
            the drinking water system (eg, characteristics of the mixing unit) 
            could affect the drugs dissolution kinetics. Because incomplete 
            dissolution of the drug could result in a reduced availability, a 
            suboptimal dosing regimen, and blocking the water system at the drinking 
            points, drug addition to the drinking system should be validated by 
            monitoring the drug concentration (not only in the water reservoir, 
            but also at the drinking nipples). The goal of this study was to document 
            the availability of drugs from drinking water systems on a pig farm, 
            using daily used methodology to transfer and mix the drug formulation 
            into the water reservoir. A commercially available trimethoprim-sulfonamide 
            formulation was added to the water and the drug distribution throughout 
            the water system was monitored; a second part of the study deals with 
            the availability of doxycyclin hyclate at the drinking points.
          MATERIALS AND METHODS
          Trimethoprim-Sodium Sulfadiazin
          Materials: Trimazin® 30%, a water-dispersible 
            powder for oral administration containing 25% (w/w) sulfadiazin (as 
            a sodium salt), 5% (w/w) trimethoprim, and a-lactose monohydrate (as a filler), was provided by Kela Laboratoria (Hoogstraten, 
            Belgium). Sodium sulfadiazin (Na-SD) and trimethoprim (TMP) used for 
            analytical purposes were purchased from Sigma Aldrich (Bornem, Belgium). 
            All reagents used during chromatographic analysis were analytical 
            or HPLC grade.
          Field experiment: One 
            container (±1 kg) of the Trimazin® formulation (Kela) was dispersed 
            in a bucket of lukewarm (±35˚C) water (±10L). The resulting suspension 
            was immediately added to a stainless steel tank (maximum volume, 740 
            L) partially filled with well water (temperature, 8˚C). Both 
            the bucket and the Trimazin®-container were rinsed with water from 
            the tank. The drug/water mixture was homogenized for several minutes 
            using the mixing unit built into the tank. The water reservoir was 
            connected to a series of nipples (freely accessible for the pigs) 
            through a set of pressurized tubes. If the pressure inside the tubes 
            dropped below a threshold value due to water consumption by the pigs, 
            a pump restored the pressure to a pre-set level. Simultaneously, the 
            stirrer inside the tank was started to homogenize the drug mixture 
            inside the tank. 
          Samples 
            (10 mL) were taken from the tank just below the water surface and 
            at 3 drinking points 0, 30 minutes and 1, 2, 3, 4, 7, and 9 hours 
            after addition (and homogenization) of the drug mixture to the water 
            system. At the 3 nipples, 2 fractions were collected at each sampling 
            point. The first sample was taken immediately after opening the valve 
            of the nipple, and the tubing was purged for 1 minute before the second 
            sample was taken. Half of each sample volume was immediately transferred 
            into borosilicate glass tubes (Corning Glass Works, Corning, NY, USA), 
            the remaining part was filtered through a 0.22 µm cellulose acetate 
            (CA) filter (Minisart, Sartorius, Vilvoorde Belgium). Awaiting HPLC 
            analysis of the samples, all solutions were frozen immediately by 
            transferring the sample tubes into an ethanol bath cooled to -70˚C 
            with solid CO2. The Na-SD and TMP concentration in the 
            samples was determined using a validated HPLC method.3
          Laboratory experiments: 
            The field experiment was simulated at lab-scale by dispersing 1g Trimazin® 
            in 800 mL well water. These dispersions were put in a refrigerator 
            (8˚C) and continuously mixed. Samples from these media were taken 
            at the same time intervals as during the field experiment. The pH 
            of each solution was measured after filtration through a 0.22 µm CA-filter 
            (Minisart, Sartorius, Vilvoorde, Belgium).
          Drug loss during filtration due to adsorption onto the 
            filter medium was assessed by HPLC analysis of filtered and unfiltered 
            samples (n = 3) of a Trimazin® solution (addition of 1 g powder to 
            800 mL well water, followed by 20 minutes of sonication to ensure 
            complete dissolution of the samples). 
          Doxycyclin Hyclate
          Materials: Doxycyclin hyclate 
            and citric acid monohydrate were purchased from Ludeco (Brussels, 
            Belgium). All reagents used during chromatographic analysis were analytical 
            or HPLC grade.
          Field 
            experiment: During the study, 120 g doxycyclin hyclate (DoxHCl) was 
            added to a stainless steel tank filled with 600 L tap water, yielding 
            a theoretical DoxHCl concentration of 200 mg/L. In a second field 
            experiment, 600 g citric acid was dissolved in the tap water available 
            in the tank before the addition of 120 g DoxHCl. The water system 
            was equipped with a pump for continuous circulation of the water through 
            a closed loop system, providing the required mechanical agitation 
            for homogeneous distribution of the drug in the water reservoir. The 
            aqueous drug solution is transported toward the drinking points (the 
            nipples situated in the boxes of the piglets) using a series of pressurized 
            tubes. If the pressure inside the tubing decreased due to excessive 
            water uptake, solution from the loop was pumped (using an automatic 
            valve) into the tubes to maintain the required pressure at the drinking 
            points. In the tank and at 3 nipples, samples (10 mL) were taken at 
            specific time intervals after drug addition to the water system (0, 
            0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, and 24 hours). These samples were 
            immediately frozen at -20˚C until HPLC 
            analysis. The doxycyclin concentration in the samples was determined 
            using the validated HPLC method described by Santos et al.4
          RESULTS and DISCUSSION
          Trimethoprim and Sodium Sulfadiazin
          As the exact volume of water in 
            the drinking system, the exact fill weight of the Trimazin® formulation 
            in the container, and the exact drug dosage in the formulation are 
            unknown, the theoretical concentration of Na-SD was taken as the average 
            drug concentration (n = 8) (406.2 ± 5.4 µg/mL) of the samples taken 
            from the tank over the entire test period. Laboratory experiments 
            showed that Na-SD (as a highly water soluble drug) dissolved instantaneously 
            after its addition to water with limited mechanical agitation. The 
            theoretical concentration of TMP (74.7 µg/mL) was calculated from 
            the theoretical Na-SD concentration, taking into account the ratio 
            of both drugs as mentioned on the label. 
          Figures 
            1A and B show the average concentration at the drinking points (n 
            = 3) of sodium sulfadiazin (Na-SD) and trimethoprim (TMP), respectively, 
            in relation to their theoretical concentration. The theoretical concentration 
            (Ctheor) of Na-SD was obtained almost immediately at the nipples 
            and was maintained throughout the entire test period, indicating an 
            optimal availability of the drug. A similar profile was seen for the 
            samples taken from the reservoir and at the nipples before purging. 
            Although the purged samples yielded their Ctheor immediately after drug 
            addition (t = 0 minutes), the Na-SD concentrations of the samples 
            taken at t = 0 minutes and t = 30 minutes without purging were considerably 
            lower, indicating that purging is required before an undiluted drug 
            solution reaches the drinking points.
          Unlike 
            Na-SD, the concentration of TMP (Fig. 1B) at most sampling points 
            was below its theoretical value and highly variable. The concentration 
            profiles measured within the tank and at the nipples without purging 
            showed the same trend (data not shown). Filtering these samples before 
            analysis showed that the TMP-concentration decreased and reduced the 
            variability, indicating that part of the drug remained in suspension 
            throughout the entire experiment. The reduction in TMP recovery after filtration can partly 
            be explained by the absorption of dissolved TMP molecules to the cellulose 
            acetate-membrane during filtration of the samples (the loss ranged 
            from 3.6% to 6.4%; no loss was detected for Na-SD), but it is mainly 
            because of retention of the drug fraction in suspension throughout 
            the entire experiment. 
          Simulation 
            of the experimental conditions at laboratory scale using the same 
            well water at 8˚C showed that Na-SD, as expected, yielded its 
            Ctheor immediately after addition to the water. However Ctheor of TMP was only reached after about 2 hours of continuous 
            mixing (Fig. 2; filtered samples). The higher TMP concentration of 
            the unfiltered samples (Fig. 2) during the initial 2 hours of the 
            test confirms that part of the drug remains suspended and that the 
            dissolution kinetics of this drug were poor under these conditions 
            (the temperature and pH of the well water were 8˚C and 8.62, 
            respectively).5
          The 
            slightly lower TMP concentration of the filtered samples after 3, 
            4, and 7 hours are probably due to the limited absorption of TMP to 
            the filter membrane. Because the close correlation between Ctheor and 
            the actual concentration at the end of the test indicated that no 
            chemical degradation occurred, these data confirm that the low TMP 
            concentrations seen during the field experiment are due to the low 
            efficiency of the intermittent mixing system used in this study. Even 
            after 9 hours, about 25% of the drug was not dissolved; the remaining 
            part was suspended throughout the system or sedimented in the reservoir 
            and tubes. The data obtained under these specific test conditions 
            stress the importance of an adequate mixing procedure (optimizing 
            the duration and intensity of the mixing) to ensure maximum drug availability 
            from the drinking system. 
          Doxycyclin Hyclate
          Figure 
            3 shows that the actual concentration of DoxHCl was far below the 
            theoretical concentration (200 mg/L). The maximum concentration in 
            the tank and at the nipples did not exceed 30 mg/L. Instability of 
            DoxHCl in water can not account for the loss in drug concentration 
            shown by Santos et al.4 After 24 hours, about 85% DoxHCl was recovered 
            from medicated drinking water stored in metal containers. Although 
            DoxHCl is described in literature as a good water-soluble drug (1 
            part drug in 3 parts water; Merck Index), the limited availability 
            of this compound is probably related to its solubility because laboratory 
            experiments showed that the solubility of DoxHCl in the tap water 
            was about 400 mg/L (at room temperature). Dissolving 0.1% (w/v) citric 
            acid into the water before drug addition yielded higher DoxHCl concentrations. 
            Its solubility in tap water increased to about 4 g/L. However, the 
            concentrations obtained in the water system were still far below 200 
            mg/L (Fig. 3). Possible explanations for this observation are 1) that 
            despite continuous homogenization of the water through a closed loop 
            system, the mixing kinetics for such a large volume are insufficient; 
            or 2) that if the drug dissolved completely, a large portion of the 
            drug adhered to the inner surface of the water system (reservoir or 
            tubing). Again, these data show the importance of monitoring the drug 
            concentrations at various points in the water system and of designing 
            a proper formulation to ensure complete drug dissolution and optimal 
            availability of the drug.
          Both 
            field experiments indicated that drug availability from a drinking 
            water system can be well below the expected drug concentrations, mainly 
            due to solubility and dissolution rate problems. The mixing methodology 
            used in combination with the specific water system should be validated 
            to ensure complete drug dissolution, especially if poorly soluble 
            drugs are administered. These data also stress the need for a proper 
            cleaning procedure after administration of medicated drinking water 
            because any residual drug (suspended in the system or adhered to the 
            surfaces) will be released over a longer period, exposing the animals 
            to a subtherapeutic dose. Because many drugs administered through 
            drinking water systems are antibacterial drugs, resistance of the 
            microorganisms to the drugs is a major issue under these circumstances. 
            In addition, residuals in the water system might interact with subsequent 
            drug therapies, possibly causing intoxication, as recently described 
            by Croubels et al.6
          REFERENCES
          1. Larrabee 
            WL: Formulation of drugs for administration via feed or drinking water, 
            in Formulation of Veterinary Dosage Forms. New York: Marcel Dekker, 
            1983:175203. 
          2. Brooks PH: Water: Forgotten nutrient and novel 
            drug delivery system. Feed Compounder 7:2427, 1994. 
          3. Bonazzi 
            D, Andrisano V, Di Pietra AM, Cavrini V: Analysis of trimethoprimsulfonamide 
            drug combinations in dosage forms by UV spectroscopy and liquid chromatography. 
            Il Farmaco 49: 381386, 1994. 
          4. Santos 
            MDF, Vermeersch H, Remon JP, et al: Validation of a high-performance 
            liquid chromatographic method for the determination of doxycycline 
            in turkey plasma. J Chromatog Biomed Appl 682:301308, 1996. 
            
          5. Meshali 
            MM, El-Sabbagh H, Ramadan I: Simultaneous solubility and dissolution 
            rate of sulphamethoxyzole and trimethoprim in binary mixtures. Pharmazie 
            39:407408, 1984. 
          6. Croubels, 
            S., Vrielinck, J., Baert, K., et al: A special case of acute tiamulin-salinomycin 
            intoxication in pigs due to residual tiamulin four months after medication: 
            Vl. Diergen. Tijdschr 70:5458, 2001.
           
           
          Figure 1. 
            Concentration of sodium 
            sulfadiazin (Na-SD) and trimethoprim (TMP) at the nipples (n = 3) 
            of the drinking water system (containing well water at 8˚C), 
            after the addition of ±1 kg Trimazin® formulation. The tubing was 
            purged for 1 minute before collecting the samples. (A) 
            Na-SD concentration of an unfiltered () 
            sample. The theoretical Na-SD concentration (dashed 
            line) was 406.2 mg/L. (B) TMP concentration of a filtered sample () and an unfiltered sample (). The theoretical TMP-concentration (dashed line) was 
            74.7 mg/L.
           
          Figure 2. Dissolution 
            profile of trimethoprim (TMP) in well water (8˚C, continuous 
            stirring) as a function of time under laboratory conditions: mean 
            TMP concentration (n = 3) of a filtered sample () and an unfiltered sample (). The theoretical TMP-concentration (dashed 
            line) was 64.1 mg/L.
           
           
          Figure 3. Mean 
            concentration of doxycyclin hyclate (DoxHCl) at the nipples (n = 3) 
            () 
            and in the tank  (n) of the drinking water system (600 L) after 
            the addition of 120 g DoxHCl at 0 minutes. The closed symbols represent 
            the mean DoxHCl-concentrations (: at the nipples; n: 
            in the tank) when 0.1% (g/v) citric acid was added to the water reservoir 
            before drug addition. The theoretical DoxHCl-concentration (dashed 
            line) was 200 mg/L.