Perceptions towards the prescribing of antibiotics by pharmacists and the use of antibiotics in primary care in South Africa

Introduction: Antibiotics deserve their place a powerful pillar in modern medical care, but the development of antibiotic resistance is emerging faster than the availability of new antibiotics. This poses a major threat to public health. The primary aim was to determine the perceptions towards the prescribing of antibiotics by pharmacists and the use of antibiotics in primary care in Nelson Mandela Bay, South Africa. Methodology: A questionnaire survey was conducted under community pharmacists during 2014. Purposive sampling was used. Results: Eighty percent of pharmacists were of the opinion that antibiotics are overprescribed. Amoxicillin, or the combination of amoxicillin with clavulanic acid, was indicated by 87.5% of respondents as the most often dispensed in their pharmacies, with ciprofloxacin, clarithromycin and azithromycin also commonly dispensed. One specific trade name product was mentioned by 43.8% of respondents as the antibiotic product they most often dispense. The most common diagnoses for which antibiotics were dispensed were upper respiratory tract infections and sinusitis. On average, more females (60.0%) were dispensed antibiotics. Most antibiotics were dispensed to adults (44.4%) and children (23.1%). On the question whether respondents were of the opinion that pharmacists should prescribe antibiotics, 50.0% indicated that they do not agree and 31.3% agreed. The main reason was because pharmacists are not qualified to diagnose. However, with further training they should be able to diagnose minor ailments and counsel patients. Conclusions: Pharmacists had mixed opinions on whether they should be able to prescribe antibiotics. Most pharmacists were of the opinion that antibiotics are overprescribed.

The effect of supportive E. coli mastitis treatment on PMN chemiluminescence and subpopulations of T lymphocytes

The aim of this field study was to assess the impact of a single i.m. injection of lysozyme dimer and flunixin meglumine in combination with intramammary and systemic antibiotic on chemiluminescence of PMN (polymorphonuclear leucocytes) and subpopulations of lymphocyte T in blood of cows with E. coli mastitis. Examinations were performed on 30 dairy cows affected with naturally occurring acute form of E. coli mastitis. Cows were randomly divided into three groups according to the method of treatment. The first group was treated with approved intramammary antibiotic product, the same antibiotic in i.m. injection and one injection of flunixin meglumine on the first day of therapy. Next group was treated with the same antibiotic and additionally one injection of lysozyme dimer on the first day of therapy. The third one was treated only with an antibiotic and served as a control group. Blood samples were taken before treatment and on days 3 and 7. In samples haematology indices were determined, spontaneous and opsonised zymosan stimulated CL and PMA measurements were performed and the subpopulations of T lymphocyte (CD2+, CD4+, CD8+) were assayed in whole blood. There was no effect of the applied supportive treatment on the value of morphological blood indices. A significant influence of the time of sample collection on the level of CL and dynamics of lymphocytes T subpopulation was demonstrated. A single injection of flunixin meglumine or lysozyme dimer on the day of the beginning of treatment of E. coli mastitis, does not affect the level of neutrophil chemiluminescence and the percentage of T lymphocytes in the blood of mastitic cows in the analysed period of time.

2-n-Pentyl-4-Quinolinol Produced by a Marine Alteromonas sp. and Its Potential Ecological and Biogeochemical Roles

ABSTRACT Bacterium-bacterium interactions occur at intimate spatial scales on the order of micrometers, but our knowledge of interactions at this level is rudimentary. Antagonism is a potential interaction in such microenvironments. To study the ecological role of antibiosis, we developed a model system involving an antibiotic-producing isolate (SWAT5) derived from a marine particle and its dominant antibiotic product, 2-n-pentyl-4-quinolinol (PQ). This system was used to address questions about the significance of this antibiotic for microbial ecology and carbon cycling on particles. We characterized the chemical and inhibitory properties of PQ in relation to the mechanisms used by particle-associated bacteria in interacting with particles and with other attached bacteria. PQ was produced by SWAT5 only on surfaces. When SWAT5 was grown in polysaccharide matrices, PQ diffused within the matrices but not into the surrounding seawater. SWAT5 might thus be able to generate a localized zone of high antibiotic concentration on particles suspended or sinking through seawater. Target bacterial respiration was most sensitive to PQ (75 nM), while inhibition of DNA synthesis, protein synthesis, and bacterial motility required higher (micromolar) PQ levels. The presence of PQ altered the composition of the bacterial community that colonized and developed in a model particle system. PQ also inhibited Synechococcus and phytoplankton growth. Our results suggest that antibiosis may significantly influence community composition and activities of attached bacterial and thus regulate the biogeochemical fate of particulate organic matter in the ocean.

ADP-Ribosylation as an Intermediate Step in Inactivation of Rifampin by a Mycobacterial Gene

ABSTRACT Mycobacterium smegmatis DSM43756 inactivates rifampin, and the inactivated antibiotic product recovered from culture medium was ribosylated on the 23-OH group. To study this process, the gene responsible for the inactivation was expressed at high levels by thelac promoter in Escherichia coli conferring resistance to >500 μg of antibiotic per ml. Cell homogenates generated a novel derivative designated RIP-TAs; in this study, we determined that RIP-TAs is 23-(O-ADP-ribosyl)rifampin. Our results indicated that RIP-TAs is an intermediate in the pathway leading to ribosylated rifampin and that the previously characterized gene encodes a mono(ADP-ribosyl)transferase which, however, shows no sequence similarity to other enzymes of this class.