TY - JOUR A1 - Kirkpatrick, Charles James A1 - Rangoonwala, Ramzan A1 - Reshetnykov, Mykhaylo A1 - Barbeck, Mike A1 - Ghanaati, Shahram Michael T1 - Non-equivalence of antibiotic generic drugs and risk for intensive care patients T2 - Pharmaceutical Regulatory Affairs N2 - Background: The underlying axiom in applying generic drugs is the equivalence of their active ingredient with the (usually more expensive) innovator product, an all-embracing statement with the insidious result that physicians assume that the generic products have been subjected to the same rigorous testing regimens as the brand-name products. The present paper presents novel experimental data on an investigator-blinded comparison between the innovator imipenem antibiotic, and a number of its generics. Methods: Particulate matter contamination of each group was visualized by means of a membrane filter method. Functional studies in an animal model–the dorsal skinfold chamber technique in mice-designed to simulate the state of microcirculatory dysfunction in intensive care patients was performed, in order to assess the influence of the particulate matter of each group on the functional capillary density of the striated skin muscle, after their intravenous injection. Results: The results showed massive particulate contamination of the generics, in a size range relevant for impacting the microcirculation. The particulate contamination contributed in some generic groups to a significant shutdown of tissue perfusion. Conclusion: The presented data underscore the need to raise the regulatory barriers for the entry of generics to the market, well beyond the simplistic proof of “bioequivalence”, which in no measure deals with the essential questions of quality and patient safety. If generics are used, they should be tested by a filter technique and optical microscopy, to ensure the absence especially of small particulate contaminants and their purity. KW - Antibiotic generic drugs KW - Generic drugs Y1 - 2013 UR - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/31697 UR - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-316976 SN - 2167-7689 N1 - Copyright: © 2013 Kirkpatrick CJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. VL - 2 IS - 1 1000109 SP - 1 EP - 7 PB - OMICS Publishing Group CY - Sunnyvale, Calif. ER -