ST Combination Tablets with Jellification for Pediatric Use: Masking Bitter Taste and Formulation Properties

Abstract

In pediatric pharmacotherapy, the bitterness of the medication often hinders effective treatment. Sulfamethoxazole-trimethoprim (ST) combination drugs are commonly used to prevent infections in immunocompromised patients but are very bitter, making them difficult for children to consume. To address this issue, we developed a jelly formulation from crushed ST tablets that can be prepared at hospital pharmacies. We evaluated the bitterness masking effect 24 hours after preparation using a sensory test with a Visual Analogue Scale (VAS) in healthy adults. The test compared “water,” “ST tablet suspension,” “150-fold diluted suspension,” and “jelly formulation containing ST tablets.” In the bitterness test, the bitterness VAS score of the “jelly formulation containing ST tablet” was significantly suppressed compared to the “ST tablet suspension,” indicating that jellification reduced the bitterness of the ST tablet. In addition, we prepared the jelly and measured its hardness over time using a creep meter. The jelly formulation containing the ST tablet could be packaged in portion cups within 30 minutes after preparation (approximately 2000 Pa), and after 1 day, the jelly strength was sufficient to be easily scooped up with a spoon (approximately 13000 Pa). The jelly formulation we developed is easy to handle at hospitals and pharmacies and reduces bitterness. By switching from tablets to jelly formulations, bitterness was reduced, making it more child-friendly and easier to consume, thereby expanding the possibility of options for medication for pediatric patients.