In this article, we will discuss the answer to a very common but confusing question regarding penicillin hypersensitivity & manufacturing facility of penicillin in the pharmaceutical industry. We will also discuss other beta-lactam ring antibiotics. But before going into details of the manufacturing facility, first, have a brief look over penicillin and beta-lactam.
What Is Penicillin?
Penicillins are a group of natural or semisynthetic antibiotics containing beta-lactam rings with 6 APA or 6 aminopenicillanic acid and are effective against bacteria.
Who Discovered Penicillin?
Penicillin was discovered by Alexander Fleming in 1928 from the fungus Penicillium. The discovery of penicillin brought huge changes in the field of medicine and it is also known as the “wonder drug” or queen of drugs.
What is a Beta-Lactam Ring?
Beta-lactam is a 4 membered lactam & lactam is an amide in the form of cyclic amide.
This lactam is called beta-lactam because nitrogen is attached to the beta-carbon.
Beta-lactam is part of many important antibiotics and these antibiotics work by inhibiting the synthesis of the cell wall of bacteria.
Note
- As we discussed in the above section, the beta-lactam ring is not only present in penicillin but also present in other antibiotics as well so all these antibiotics containing beta-lactam ring are known as beta-lactam antibiotics.
Name of Antibiotics Containing Beta-Lactam Ring
Some common classes of antibiotics which contain beta-lactam ring are as follows,
- Penicillin
- Cephalosporin
- Penams
- Carbapenem
- Monobactams
What Is Common In All Beta Lactam?
The similarity between all the above-mentioned classes of beta-lactam antibiotics is that all contain 4 membered lactam ring having 3 carbon & 1 nitrogen cyclic amide.
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How Does the Beta-lactam Antibiotic Class differ?
The difference between the activity or reactivity of different classes of beta-lactam antibiotics is due to the difference in the attachment of the side chains or different groups attachment by a peptide bond.
Explanation
The difference is explained as,
Penicillins
- Penicillins have 6 APA or 6 aminopenicillanic acids.
Cephalosporins
- Cephalosporins have 7 aminocephalosporanic acids.
Penams
- In penams, the beta-lactam ring is fused to a saturated 5-membered ring which has 1 sulfur atom.
Carbapenem
- Here carbon is substituted by sulfur.
Monobactams
- Alone beta-lactam ring, not fused to another ring.
Hypersensitivity To Penicillin
Apart from giving many useful results in treating infections, penicillin is also harmful to those individuals who are allergic or sensitive to penicillin and produce minor skin rashes to life-taking anaphylactic shocks.
The hypersensitivity reactions of penicillin may include the following,
- Skin Rashes
- Hay Fever
- Asthma
- Hives
- Itching Eyes
- Swelling Of Tongue
- Swelling of face
- Difficulty in breathing
- Runny nose
- Fever
- Anaphylaxis
Anaphylaxis is a life-threatening effect and it may contain many symptoms which are as follows,
- Tightening of airways resulting in difficulty of breathing,
- Nausea
- Vomiting
- Abdominal Cramps
- Fainting
- Fast or slow pulse rate
- Reduction in B.P
Penicillin allergy is observed in patients sensitive to penicillin because the immune system recognizes the penicillin drug as a bacteria or virus and starts fighting against the drug.
Differences in 6 aminopenicillanic acid side chains may cause allergic reactions.
Skin Test
The ratio of individuals who are allergic to penicillin is very small; only 10 out of 100 may be allergic to penicillin but as a preventive measure before using penicillin a skin test or sensitizing dose is used.
If the amount of IgE is increased after the skin test it indicates that the individual is sensitive to penicillin.
Individuals who are sensitive to penicillin may also be sensitive to other beta-lactam antibiotics so care should be taken.
Why Does Penicillin Manufacturing Require a Separate Facility?
As we discussed in the above portion, penicillins are sensitizing agents and may trigger hypersensitivity reactions, although the ratio is as low as 10% but US-FDA and other regulatory bodies demand to manufacture these antibiotics in separate facilities to prevent cross-contamination.
So a common question isÂ
“What does a separate manufacturing facility mean?
The answer is very simple:
A separate manufacturing facility is a design that has,Â
- Separate manufacturing area from the main plant for manufacturing of other products.
- Separate HVAC System
- Separate Equipment
- Separate WorkForce
- Separate Laundry
- Separate Canteen
- Separate Washrooms
Now let’s explain why the above-mentioned precautions are done for penicillin manufacturing,
Separate Manufacturing Area
To prevent cross-contamination of penicillin with non-penicillin beta-lactam antibiotics or with other general products the manufacturing plant of penicillin antibiotics is dedicated and built separately where only penicillin beta-lactam antibiotics are manufactured.
Separate HVAC
The separate plant built for penicillin is installed with its heating, ventilation, and air conditioning system which has no connection with any other facility.
It is to prevent cross-contamination and as we know air may also result in cross-contamination so a suitable distance is maintained between penicillin and other products manufacturing plants.
The common confusing question that is asked about distance is that
How much distance should we maintain between the penicillin manufacturing plant & other products plant?
A rough estimation is that a distance of 75 meters or more than 75 meters should be maintained between plant to plant.
Separate Equipment
In penicillin plants dedicated equipment and machines are used. Never shift or transfer any machine or part from the penicillin plant to another plant because any traces left may result in triggering hypersensitive reactions.
Separate Work Force
All the staff including pharmacists, workers, and engineering staff are separately hired for the penicillin plant.
Personnel movement from the penicillin plant to the non-penicillin beta-lactam plant is not allowed because it may result in cross-contamination.
One important point to remember is that top-level management like director production, director compliance, etc should also be separated to ensure strict control.
Separate Laundry, Canteen & Washrooms
For washing uniforms, the laundry of penicillin is built separately. For tea, lunch & dinner the staff must have a separate canteen and in the same, we have a separate washroom facility.
Important Points
Like penicillin for all other sensitizing non-penicillin beta-lactam antibiotic classes, the FDA recommends separate manufacturing facilities and strict controls.
The penicillin sensitivity or hypersensitivity due to penicillin may be so severe that the invisible traces of penicillin on documents like BMRs can start hypersensitivity reactions.
Sometimes it may be the case where a plant is not manufacturing the penicillin or other non-penicillin beta-lactam antibiotics but the adjacent or nearby plant is producing the above-mentioned.
So preventive measures will have to be taken by the plant of non-penicillin to prevent penicillin hypersensitivity.
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