Children’s preferences among six novel moxifloxacin and linezolid-dispersible tablet formulations

BACKGROUND: Moxifloxacin (MFX) and linezolid (LZD) are key components of rifampicin-resistant TB treatment regimens. Currently, available dispersible tablet formulations of both drugs have poor palatability in children. We evaluated children’s preferences for more child-friendly formulations from tw...

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Main Authors: G. Hoddinott, H.R. Draper, N. Vanqa, S. Myeni, S. Staples, T. Sachs, M. Raffique, N. Tshethu, M. Palmer, L. Viljoen, K. Inabathina, R. Taneja, A.C. Hesseling, A.J. Garcia-Prats
Format: Article
Language:English
Published: International Union Against Tuberculosis and Lung Disease (The Union) 2025-04-01
Series:IJTLD Open
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Online Access:https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2025/00000002/00000004/art00004
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author G. Hoddinott
H.R. Draper
N. Vanqa
S. Myeni
S. Staples
T. Sachs
M. Raffique
N. Tshethu
M. Palmer
L. Viljoen
K. Inabathina
R. Taneja
A.C. Hesseling
A.J. Garcia-Prats
author_facet G. Hoddinott
H.R. Draper
N. Vanqa
S. Myeni
S. Staples
T. Sachs
M. Raffique
N. Tshethu
M. Palmer
L. Viljoen
K. Inabathina
R. Taneja
A.C. Hesseling
A.J. Garcia-Prats
author_sort G. Hoddinott
collection DOAJ
description BACKGROUND: Moxifloxacin (MFX) and linezolid (LZD) are key components of rifampicin-resistant TB treatment regimens. Currently, available dispersible tablet formulations of both drugs have poor palatability in children. We evaluated children’s preferences for more child-friendly formulations from two generic manufacturers. METHODS: This was a randomised, cross-sectional ‘swish-and-spit’ taste panel study at two sites in South Africa. Each manufacturer created three flavour-blend variants for each drug. Healthy child volunteers 5–17 years old were sampled stratified by age, sex, and ethnic group and completed a preference rank-ordering and five acceptability 5-point Likert scales. We explored the blends’ acceptability using summary, comparative, and ranking statistics. RESULTS: Ninety-seven and 96 children contributed data for the MFX and LZD drug blends, respectively. For both manufacturers’ MFX blends, the Friedman test showed children had a statistically significant preference for novel options over the Existing blend (Q(2) = 24,937; P < 0.001, and Q(2) = 21.213; P < 0.001, respectively). Even the most preferred MFX blend had sub-optimal acceptability, especially for one manufacturer. Children did not have a clear preference for both manufacturers’ LZD blends. These findings were not influenced by age, sex, or ethnic group. CONCLUSION: Children across a broad age spectrum can provide meaningful input on the palatability preferences of TB drug formulations. Novel MFX formulation blends were recommended for development, but acceptability remains suboptimal.
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spelling doaj-art-861ef8dbd37140caa3fb1cb2ad22ace12025-08-20T02:09:21ZengInternational Union Against Tuberculosis and Lung Disease (The Union)IJTLD Open3005-75902025-04-012420821610.5588/ijtldopen.24.05464Children’s preferences among six novel moxifloxacin and linezolid-dispersible tablet formulationsG. Hoddinott0H.R. Draper1N. Vanqa2S. Myeni3S. Staples4T. Sachs5M. Raffique6N. Tshethu7M. Palmer8L. Viljoen9K. Inabathina10R. Taneja11A.C. Hesseling12A.J. Garcia-Prats13Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;THINK Tuberculosis and HIV Investigative Network (RF) NPC, Durban, South Africa;THINK Tuberculosis and HIV Investigative Network (RF) NPC, Durban, South Africa;Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;Global Alliance for TB Drug Development (TB Alliance), New York, NY, USA;Global Alliance for TB Drug Development (TB Alliance), New York, NY, USA;Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa;BACKGROUND: Moxifloxacin (MFX) and linezolid (LZD) are key components of rifampicin-resistant TB treatment regimens. Currently, available dispersible tablet formulations of both drugs have poor palatability in children. We evaluated children’s preferences for more child-friendly formulations from two generic manufacturers. METHODS: This was a randomised, cross-sectional ‘swish-and-spit’ taste panel study at two sites in South Africa. Each manufacturer created three flavour-blend variants for each drug. Healthy child volunteers 5–17 years old were sampled stratified by age, sex, and ethnic group and completed a preference rank-ordering and five acceptability 5-point Likert scales. We explored the blends’ acceptability using summary, comparative, and ranking statistics. RESULTS: Ninety-seven and 96 children contributed data for the MFX and LZD drug blends, respectively. For both manufacturers’ MFX blends, the Friedman test showed children had a statistically significant preference for novel options over the Existing blend (Q(2) = 24,937; P < 0.001, and Q(2) = 21.213; P < 0.001, respectively). Even the most preferred MFX blend had sub-optimal acceptability, especially for one manufacturer. Children did not have a clear preference for both manufacturers’ LZD blends. These findings were not influenced by age, sex, or ethnic group. CONCLUSION: Children across a broad age spectrum can provide meaningful input on the palatability preferences of TB drug formulations. Novel MFX formulation blends were recommended for development, but acceptability remains suboptimal.https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2025/00000002/00000004/art00004rifampicin-resistantmoxifloxacinlinezolidacceptabilitypalatabilitychildren
spellingShingle G. Hoddinott
H.R. Draper
N. Vanqa
S. Myeni
S. Staples
T. Sachs
M. Raffique
N. Tshethu
M. Palmer
L. Viljoen
K. Inabathina
R. Taneja
A.C. Hesseling
A.J. Garcia-Prats
Children’s preferences among six novel moxifloxacin and linezolid-dispersible tablet formulations
IJTLD Open
rifampicin-resistant
moxifloxacin
linezolid
acceptability
palatability
children
title Children’s preferences among six novel moxifloxacin and linezolid-dispersible tablet formulations
title_full Children’s preferences among six novel moxifloxacin and linezolid-dispersible tablet formulations
title_fullStr Children’s preferences among six novel moxifloxacin and linezolid-dispersible tablet formulations
title_full_unstemmed Children’s preferences among six novel moxifloxacin and linezolid-dispersible tablet formulations
title_short Children’s preferences among six novel moxifloxacin and linezolid-dispersible tablet formulations
title_sort children s preferences among six novel moxifloxacin and linezolid dispersible tablet formulations
topic rifampicin-resistant
moxifloxacin
linezolid
acceptability
palatability
children
url https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2025/00000002/00000004/art00004
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