244 treatment packs of the broad spectrum antibiotic ciprofloxacin were sampled from a stratified sample of 61 web pharmacies. Each sample was analyzed for active pharmaceutical ingredient content (API) and 11 (4.5%) were found to be grossly (less than 80%) under content. Most of the 11 came from non-certified sites, but two came from certified sites. None of the failures appeared to be a falsified medicine (packaging appeared correct and contained over 50% API). All failures were made by Asian manufacturers (7 Indian and 4 Chinese). All the failures regardless of source are a risk to patient health, and could accelerate population level resistance to this crucial antibiotic.
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A new paper from the SMC team is published this week PDF
in the peer review journal Internal Medicine Review. It shows that when our previous research has underestimated the amount of substandard medicines on the market in emerging nations. We therefore hope that nations take the problem more seriously than previously.