FACULTY OF PHARMACY

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450 Barriers and enablers to medication deprescribing among older patients attending a geriatric clinic in southwestern nigeria: a cross-sectional study
(2023) Akande-Sholabi W.; Ajilore C. O.; Olowookere O.O; Adebusoye L.A
Introduction: Polypharmacy is an increasing health problem, leading to rise in morbidity and mortality, especially among older patients. De prescribing has been recommended for managing polypharmacy, but deprescribing medication in older patients is still uncommon (1). Safe deprescribing interventions can reduce exposure to inappropriate polypharmacy among older patients. However, few empirical data exist on the barriers and enablers to medication deprescribing among older patients in sub-Saharan African countries. Aim: This study aimed to assess the barriers and enablers of medication deprescribing among older patients. Methods: A cross-sectional study of 415 older patients aged ≥60 years, selected consecutively at the geriatric clinic in a Tertiary Hospital was carried out between May and July 2022. An interviewer-administered semi-structured questionnaire was used to obtain information on their socio-demographic characteristics, and barriers and enablers
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(2019-05) Valantine
A preliminary investigation of prevalence of extended spectrum beta lactamases among enterobacteriaceae isolated from poultry farms in Ibadan, Nigeria
(Nigeria Association of Pharmacists in Academia (NAPA), 2015) Ayeni, F. A.; Olujobi, O. F.; Alabi, O. S.
Background: -Antibiotic resistance and extended spectrum beta–lactamase (ESBL) producing enterobacteriaceae are global health concerns and major problems for the treatment of different infections caused by enterobacteriaceae. Objective: -This study was carried out to determine the prevalence of phenotypically identified ESBL producers in enterobacteriaceae strains isolated from poultry farms in Ibadan. Material and Methods: Enterobacteriaceae were isolated from faecal samples of 45 chickens from 3 farms in Ibadan, Nigeria. The E. coli strains in the isolates were identified by biochemical methods. The susceptibility of all enterobacteriaceae strains to selected β lactam antibiotics were tested by disc diffusion method. ESBL production was tested by double disk synergy test and MIC determination (8–512 μg/ml) Results: - A total of 40 Enterobacteriaceae strains were isolated and 20 of the strains were identified as E. coli while 20 were tagged other Enterobacteriaceae strains. The E. coli strains were generally susceptible to tested antibiotics while other Enterobacteriaceae were relatively resistant. All the tested Enterobacteriacea were susceptible to cefepine. 15% of E.coli isolates were resistant to amoxicillin/clavulaniz and 38.9% of other Enterobacteriaceace isolates were resistant to cefoxitin. 5% of E. coli strains and 25% of other Enterobacteriaceae produced ESBL with concentration range of ˂8 μg/ml and >512μg/ml for antibiotics used singly and in combination with clavulanic acid respectively. Conclusions: - This study showed low occurrence of ESBL in E. coli strains but relatively high occurrence in other Enterobacteriaceae in poultries in Ibadan, Nigeria.. Therefore, there is need to control the use of antibiotics in poultry feeds and livestock production.
Acetylated starch of ofada rice as a sustained release polymer in microsphere formulations of repaglinide
(Pharmaceutical Society of Nigeria, 2015) Okunlola, A.; Ogunkoya, T. O.
Background: Acetylated starches with degrees of substitution (DS) of > 2 have been found suitable for sustained release applications because of their hydrophobic nature and thermoplasticity. The short half-life and high dosing frequency of repaglinide make it an ideal candidate for sustained release. Objectives: To formulate and evaluate repaglinide microspheres using acetylated starch of the indigenous rice species Oryza glaberrima Steud (Ofada) as polymer. Materials and Methods: Ofada rice starch was acetylated with acetic anhydride in pyridine (DS 2.68) and characterized for morphology (Scanning electron microscope, SEM), Crystallinity (Fourier Transform Infra-Red spectroscopy, FTIR, and X-ray diffraction crystallography, XRD), density and swelling. Microspheres of repaglinide were prepared by emulsification solvent-evaporation method, varying the drug-polymer ratio (1:2, 1:4, 1:8 and 1:10) and polymer type (ethyl cellulose as standard). Microspheres were characterized for particle size, wall thickness, swelling, entrapment efficiency, time taken for 80% drug release (t80) and permeability. Data obtained from in-vitro drug release studies were fitted to various kinetic models. Results: Repaglinide microspheres were near spherical, discrete and of size range 23.45 ± 4.25 to 44.55±3.85 μm. FTIR spectra revealed the absence of drug–polymer interaction and complete drug entrapment. Particle size, swelling, entrapment and wall thickness increased with drug: polymer ratio and were generally higher in microspheres containing acetylated Ofada rice starch while t80 (195±6.60 - 395± 24.75 min) was lower. Drug release fitted the Hixson-Crowell kinetic model. Conclusions: The acetylated starch of Ofada rice was found suitable as a polymer to sustain the release of repaglinide in microsphere formulations.
ANTI-DIABETIC AND ANTI-OXIDANT EVALUATION OF ANTHOCLEISTA DJALONENSIS A. CHEV AND ANTHOCLEISTA VOGELII PLANCH
(2014-12) OLUBOMEHIN, O. O.
Diabetes a major degenerative disease of global concern accounts for about 3.2 million deaths annually. Alpha-amylase inhibitors from plants are effective in managing postprandial hyperglycaemia which is significant in Type 2 diabetes. Search for natural anti-oxidants has increased recently because free radicals production has been linked to a number of diseases including diabetes. Anthocleista djalonensis and Anthocleista vogelii are used traditionally in Nigeria and parts of Africa to treat diabetes. This study was aimed at evaluating the α-amylase inhibition, anti-oxidant and anti-diabetic effects of extracts and compounds of both plants to verify their traditional use. The leaves, stem bark and roots of both plants were collected along Ijebu-Ode – Benin road and authenticated at the Herbarium of the Forestry Research Institute of Nigeria, Ibadan. The plant samples were macerated in 80% aqueous methanol for 72 h. Each crude extract, suspended in water: methanol (4:1) was partitioned into ethyl acetate. The crude extracts and ethyl acetate fractions of the leaves and stem bark of both plants were subjected to in vitro α-amylase inhibition assay with acarbose as positive control. The anti-oxidant activity was evaluated using 2, 2’-diphenyl-1-picrylhydrazyl with α-tocopherol as control, while anti-diabetic properties of the crude extracts were studied in vivo using 45 albino wistar rats (150-200 g) of both sexes. The rats were made diabetic with 80 mg/kg of alloxan and treated with the extracts (1 g/kg) for seven days; glibenclamide 2.5 mg/kg was used as reference. Blood glucose levels (BGL) were monitored daily. Bioassay-guided fractionation and chromatographic methods were used to isolate active compounds from the ethyl acetate fractions of both plants. Structures of the isolated compounds were elucidated using spectroscopic techniques: infra-red, mass spectrometry, nuclear magnetic resonance (one-dimensional and two-dimensional). Data were analysed statistically using ANOVA at p<0.001. Anthocleista djalonensis leaf and stem bark crude extracts gave highest α-amylase inhibition of 42.8% and 41% with their ethyl acetate fractions also producing the highest α-amylase inhibition of 50.0% and 36.6% at 1.0 mg/mL while acarbose gave 54.9%. The crude extract and ethyl acetate fraction of A. vogelii leaf gave 80.7% and 87.4% inhibitions at 1.0 mg/mL in the anti-oxidant assay while α-tocopherol gave 89.5%. Peak reduction in BGL was observed for A. djalonensis stem bark and leaf crude extracts at 72.6% and 45.7% on day-6 of treatment while the stem bark and leaf extracts of A. vogelii gave 68.9% and 60.4%, respectively on day-7. The root extracts of both plants also caused peak reduction in BGL at 48.5% on day-7 while glibenclamide had 57.4%. Bioassay-guided fractionation furnished djalonenol, a monoterpene diol with a significant α-amylase inhibition of 53.7% from fraction 11 of the stem bark of A. djalonensis and decussatin, a xanthone with significant inhibition of 78.0% from fraction 5 of the leaves and stem bark of A .vogelii. The presence of α-amylase inhibitors, djalonenol and decussatin from both plants makes them important in the treatment of type 2 diabetes and could be responsible for their anti-diabetic effect. Anthocleista vogelii could be a source of anti-oxidant compounds.
Anti-Inflamatory and analgesic activities of securidaca longepedunculata fers (Polygalaceae) leaf and stem bark methanolic extract
(2014-09) Alafe, A. O.; Elufioye, T. O.; Faborode, O. S; Moody, J. O.
Securidaca longepedunculata Fers (Polygalaceae) is commonly used in many parts of Africa for the treatment of rheumatic conditions, fever, headache and various other inflammatory based diseases. The present study was carried out to evaluate the anti-inflammatory and analgesic activity of Securidaca longepedunculata leaf and stem bark methanol extracts using animal model. The anti-inflammatory activity of the methanolic extracts were evaluated using carrageenan induced paw edema in rats while the analgesic activity was determined using acetic acid induced writhing in mice. Both the leaf and stem methanol extracts exhibited anti-inflammatory activity greater than 70% at all doses tested. This activity was dose dependent with the highest being at 800 mg/kg Po and significant at P< 0.05. The analgesic activity of both extract was however below 50%, though comparable with that of aspirin used as the standard. This study has justified the inclusion of Securidaca longepedunculata in remedies used for the management of inflammatory based diseases traditionally.
Antibiotic resistance profile and phenotypic detection of betaLactamase-producers among gram-negative bacteria isolated from
(Nigeria Association of Pharmacists in Academia (NAPA), 2016) Adejumo, A. E.; Alabi, O. S.; Adeleke, O. E.
Background: Cockroaches are carriers of numerous microorganisms. However, there is paucity of information on their role as potential reservoir for beta-lactamase producers. Objectives: This research determined the antibiotics susceptibility profile of Beta-lactamase producing Gramnegative bacteria isolated from the gut of household cockroaches in selected locations in and around University of Ibadan, Oyo state. Materials and Methods: Thirty Cockroaches from different locations in and around University of Ibadan were collected between June 2015 and March, 2016, and their intestinal homogenates cultured on different selective media for the isolation of bacteria. The isolates were identified using a combination of biochemical tests and 16S rRNA sequencing. Antibiotic susceptibility testing was done using the disc-diffusion technique and phenotypic detection of extended-spectrum beta-lactamase (ESBL), AmpC-beta-lactamase (AmpC) and Metallo-beta-lactamase (MBL) production was done using double-disc synergy, cefoxitin/cloxacillin and imipenem/EDTA double-disc methods respectively. Results: A total number of 58 bacteria belonging to nine genera; Pseudomonas, Proteus, Klebsiella, Salmonella, Enterobacter, Escherichia, Serratia, Shigella and Raoultella were isolated. Higher percentage of the isolates exhibited resistance to erythromycin (90%), azithromycin (87.5%), amoxicillin (84.5%), ampicillin (74.1%), amoxicillin-clavulanic acid (74.1%), cefoxitin (67.2%) and chloramphenicol (54%), while lower percentage showed resistance to aztreonam (25%), ertapenem (13%), cefotaxime (8.6%), ceftazidime (10.3%), cefepime (5.2%), ciprofloxacin (3.5%), gentamicin (5.2%) and imipenem (0%). MDR phenotype was recorded among 82% of the isolates, 17.2% were positive for ESBL, 12% for AmpC and 13.8% for MBL production. Conclusion: This study identified household cockroaches Periplaneta americana, as a potential reservoir for MDR and beta-lactamase-producing isolates. Keywords: Susceptibility testing, ESBL, AmpC, MBL, Beta-Lactamase, MDR, Household cockroaches Cockroaches are insects of the order Blattodea some of which are associated with human environment (Beccaloni, 2014). One of the two species of cockroaches that has been reported by different authors to be widely distributed in Nigeria is the American cockroaches namely Periplaneta americana (Ajero et al., 2011; Etim et al., 2012; Akinjogunla et al., 2012; Tilahun et al., 2012). The incidence of Cockroach infestation in restaurants, hospitals, warehouses, offices and within households, particularly the kitchen, have been reported to be very high in Nigeria (Omudu and Akosu, 2013; Braimah et al., 2015). The insects being nocturnal in nature are found in dark places within the households during the day hiding in opened and cracked sections of the wall, furniture, inside wardrobes and cupboards (Omudu and Akosu, 2013; Billah et al., 2015; Braimah et al., 2015). Sometimes they enter into cooking pots and other kitchen utensils if left opened. They feed on leftover food, cooked and uncooked food materials contaminating them with microorganisms on their body and in their faecal droppings especially those ready to eat food that do not require further processing before eating them (Xue et al., 2009). They are also found in other parts of the house including bedrooms (Etim et al., 2013). Cockroaches are also found in garbage and sewage tanks, particularly in homes with pit latrine (Craczyk et al., 2005; Pai et al., 2005) making them a potential vector for pathogenic and non-pathogenic microorganisms from human origin (Graczyk et al., 2005; Pai et al., 2005; Vazirianzadeh et al. 2014). Studies have shown that most of the disease-causing bacteria of human origin can survive within the body system of cockroaches (Imamura et al., 2003), hence their presence in sewage and garbage elucidate their role as potential carriers of these human diseasecausing agents (Vazirianzadeh et al., 2014). Several authors have incriminated cockroaches as reservoir and transmitters of disease-causing microorganisms like Enterobacter spp., Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Shigella spp., Campylobacter spp. and Salmonella spp., especially those in the hospital environment (Craczyk et al., 2005; Tatfeng et al., 2005; Ukay et al., 2009; Tilahun et al., 2012; Vazirianzadeh et al., 2014). In addition, cockroaches have also been reported to carry microbial agents of leprosy, urinary tract infection (Enterococcus spp.), MATERIALS AND METHODS Study Area The study was carried out in University of Ibadan metropolis, Oyo state. The areas of choice were kitchen and toilets in residential apartments in and around the University of Ibadan. Specimen Collection and Preparation for bacteria isolation A total of 30 cockroaches, identified to be Periplaneta americana, through online file (Beccaloni, 2014), were collected from residential cholecystitis (Helicobacter hepaticus), plague (Yersinia pestis) and bacteremia, septic arthritis and peritonitis (Oligella urethralis) (Pat, 2006; Falsafi and Mahboubi, 2013). Antibiotic resistance and its spread among bacterial isolates is a global problem and has been reported among bacterial isolates in both clinical and community settings (WHO, 2014). Cockroaches have been reported to harbour pathogenic and opportunistic pathogens that exhibited high level resistance to antibiotics, especially those used in lifethreatening disease cases such as the cephalosporins and carbapenems (Fathpour et al., 2003; Bouamama et al., 2010; Wannigama et al., 2014). Bacterial isolates exhibiting multidrug resistance phenotype have also been reported in cockroaches (Devi and Murray, 1991; Tetteh-Quarcoo et al., 2013). Resistance to beta-lactam antibiotics are known to be mediated mostly by beta-lactamase enzymes. The initial variants of these enzymes were active only on the penicillin class but the discovery of the third generation cephalosporin class help to overcome their destructive action (Paterson and Bonomo, 2005). The advent of extended-spectrum beta-lactamase, and metallo beta-lactamase enzymes among others which are known in addition to the penicillin class, to hydrolyze the third generation cephalosporins (Ceftazidime, cefotaxime, ceftriaxone) and the carbapenems (imipenem, ertapenem) respectively, created a serious problem for clinicians in the management of life-threatening infections caused by such bacteria habouring the enzymes (Paterson and Bonomo, 2005). Currently, there is paucity of information on the various resistant determinants harboured by bacteria isolated from household cockroaches. This study therefore, aimed at using phenotypic techniques to determine multidrug resistance phenotype and the presence of common beta-lactamase enzymes among bacterial isolates from the gut of house-hold cockroaches in selected locations in and around University of Ibadan. apartments using sticky rods and direct collection with sterile hand-gloves (Paul et al., 1992). They were introduced into separate sterile wide-mouth bottles aseptically and transported to the laboratory of the Department of Pharmaceutical Microbiology, University of Ibadan for freezing at 0oC for 10- 15min to anaesthetize them. Intestinal gut of each cockroach was prepared into samples using the method highlighted by Tetteh-Quarcoo et al. (2013)
Antibiotic susceptibility profiles of lactic and acetic acid bacteria isolated from ogi, yoghurt and human vagina in Nigeria
(Faculty of Pharmaceutical Sciences, Ahmadu Bello University (ABU), Zaria, Nigeria, 2018-03) Murtala, M.; Alabi, O. S.; Ayeni, F. A .
The beneficial effects of lactic and acetic acid bacteria in human foods are well documented, however, there are increasing safety concerns associated with the exposure of humans to live microbes including transferable antibiotic resistance determinant. Therefore this study determines the antibiotic susceptibility and resistance profiles of lactic and acetic acid bacteria previously isolated from fermented foods and human vagina and the presence of plasmids in the strains. The antibiotic susceptibility and resistance of the bacterial strains was determined by disc diffusion method and the MIC for resistant strains by VITEK 2 compact system. Plasmid extraction was evaluated by ZyppyTM Plasmid Miniprep Kit while the resistant strains were cured using ethidium bromide as mutagen. All the isolates showed varying levels of antibiotic susceptibility/resistance. All the isolates were susceptible to gentamicin and resistant to vancomycin followed by ciprofloxacin. In MIC determination, only the vagina isolates showed 25% resistance to gentamicin and 75% resistance to erythromycin. Overall, only one plasmid was detected from Acetobacter pasterianus which was isolated from yoghurt with size greater than 1kb. Microbial resistance to four antibiotics (Tetracycline, Ampicillin, Sulphamethoxazole/ Trimethoprim and Neomycin) in Lactobacillus plantarum and Acetobacter pasterianus were cured. The studied isolates exhibited high degree of susceptibility to the antibiotics and the curing of the four antibiotic resistant strains indicated that the resistance may be plasmid mediated which can be transferable. Therefore the bacteria strains with cured resistance are not safe for probiotic purpose.
Antifungal capacity of lactic acid bacteria isolated from salad vegetables
(2011-05) Adeniyi, B.; Damsa, I.
This study explores the use of lactic acid bacteria from fresh salad vegetables to inhibit fungal growth. The antifungal assay was done using the agar well diffusion method as reported by Schillinger and Lucke (1989). The largest zone of inhibition (25mm) was recorded by the antagonistic activity of the isolate identified to Lactobacillus plantarum against Candida albicans ATCC 90029. No activity was recorded against Candida parapsilosis ATCC 22019, C. valida UCH 1508, C. pseudotropicalis UCH1408, C. tropicalis UCH 1308 and Trichophyton interdigitalis UCH1708. The cell free supernatant (CFS) of the isolate described to be Lactobacillus brevis was exceptional as it was the only CFS that inhibited the growth of Epidermophyton floccosum UCH 1908. The results show that LAB isolated from salad vegetables can inhibit some fungi pathogens by developing zones around agar well that contain LAB metabolites and can probably be a feasible option for the chemotherapy of fungal infections given the drug resistance exhibited to antifungal agents currently in use.
Antimicrobial activity of garcinia kola (Heckel) seed extracts and isolated constituents against caries-causing microorganisms
(2014-09) Ajayi, T. O.; Moody, J. O.; Fukushi, Y.; Adeyemi, T. A.; Fakeye, T. O.
Garcinia kola Heckel (Guttiferae) seed, has found use in folkloric medicine of Southern Nigeria for the treatment of toothache and prevention of dental caries. The crude ethanolic extract, chromatographic fractions and isolated constituents of Garcinia kola seed against clinical strains of dental-caries-causing and related microorganisms is being evaluated. Antimicrobial evaluations were done by testing different concentrations of the crude extract, vacuum liquid chromatographic (VLC) fractions and pure isolates against Streptococcus mutans, Streptococcus viridans and Staphylococcus aureus in already set blood agar with gentamicin as the reference standard. The zones of inhibition and minimum inhibitory concentrations (MIC) were determined as appropriate. Fraction N, eluted with (hexane: ethyl acetate 70: 30), exhibited the highest activity with MIC’s of 1.50 mgml⁻¹ and 0.33 mgml⁻¹ while the pure isolates 1 (cycloartenol) and 2 (24-methylenecycloartanol) gave MIC’s of 0.17 mgml⁻¹ and 0.38 mgml⁻¹ against Streptococcus mutans and Streptococcus viridans respectively. Isolate 3 (garcinianin) gave MIC of 1.0 mgml⁻¹ against Streptococcus mutans but there was no significant activity against Streptococcus viridans and Staphylococcus aureus. The results provide justifications for the folkloric use of Garcinia kola Heckel (Guttiferae) for dental caries-related health problems while the isolated compounds may also serve as templates for future antimicrobial drug development.
Antimicrobial and pharmaceutical properties of the seed oil of leucaena leucocephala (Lam.) de wit (Leguminosae)
(2011-01) Aderibigbe, S. A.; Adetunji, O. A.; Odeniyi, M. A.
The seed oil of Leuconia leucocephala was investigated for its antimicrobial activity and the pharmaceutical properties of its lotion formulation determined. The oil was extracted from the pulverised dried seeds of the Leuconia leucocephala plant by cold maceration in n-hexane. The oil was tested against four bacteria (Staphylococcus aureus, Esherichia coli, Bacillus subtilis and Pseudomonas aeruginosa) and four fungi (Aspergilus niger, Rhizopus stolon, Penicillum notatum and Candida albicans) isolates. Gentamycin and tioconazole were the reference drugs respectively. The oil was later formulated as a lotion and the pharmaceutical properties of the formulation determined.The oil was found to have a concentration-dependent activity against both Gram-positive and Gram-negative bacteria, while showing no activity against the fungi tested. The lotion formulation of the oil containing oleic acid had good pharmaceutical properties and was stable over the test period. Leucaena leucocephala seed oil extract had a concentration-dependent activity against both Gram-positive and Gram-negative bacteria and the lotion formulation had good pharmaceutical properties.
Antimicrobial evaluation of microencapsulated ciprofloxacin+Irvinga gabonensis gum against klebsiella SPECIES FROM PATients in a teaching hospital in Benin
(African Scientific Research and Innovation Council (AU-ASRIC), 2023) Onyenwel, N. E.; Nnamani, N. D.; Nwafor, C. N.; Onojob, V. O .; Alabi, S. O .; Obun-Nnadi, C.; Adeboye, O. O.
Klebsiella species causes nosocomial infections and other diseases. The use of Ciprofloxacin formulations has been adopted for skin and systemic infections, hence Irvingia gabonensis a specie of African trees in the genus Irvingia, was used for the microencapsulation of ciprofloxacin and used against sequenced disease causing Klebsiella species. Adopting the non-solvent addition of microencapsulation, drug-excipient compatibility test, batches of encapsulated ciprofloxacin + Irvinga gabonenesis, gelatin gum with the pure active ciprofloxacin were prepared from formula X. The FT-IR absorbance at different wavelength was recorded. The resultant microncapsulated drugs were screened for antimicrobial activity using the single disc agar diffusion against K. quasipneumoniae, K. aerogenes, and K. pneumoniae isolates. There were no difference in wavelength of FT-IR spectra of Irvinga gabonensis, pure active ciprofloxacin, and ciprofloxacin blend+Irvinga gabonensis gum. The pure active ciprofloxacin was very effective at the concentration of 8.3µg/mL(IC5o:1.02µg/ml) and 4.15(IC5o:0.08µg/ml) against all the Klebsiella species. The ciprofloxacin + Irvinga gabonenesis at 7.12 µg/mL (IC5o:0.90µg/mL) had significant zone of inhibition when compared to the pure active ciprofloxacin drug alone (IC5o:0.80µg/mL) at a concentration of 4.12µg/ml active ciprofloxacin. Based on the 95% mean inhibition concentration, ciprofloxacin + Irvinga gabonenesis gum (IC5o:0.90µg/mL) is a better excipient than ciprofloxacin + Gelatin gum (IC5o:1.38µg/mL). Ciprofloxacin + Irvinga gabonensis gum exerts effective antimicrobial activities and compatibility in terms of effective drug release.
Antimicrobial screening and GC-MS analysis of bioactive compounds from strains of pseudomonas aeruginosa isolated from poultry fecal littered soil in Ibadan, Nigeria.
(Faculty of Physical Sciences and Faculty of Life Sciences,University of Ilorin, 2019) Alabi, O. S.; Koleoso, O. B.; Abiala, A. M.
The emergence of pathogens exhibiting multiple antibiotic resistance (MDR) is bringing a thwart to available chemotherapeutic agents thus the urgency in the search for bioactive agents that will be effective against the MDR pathogens. This study screened isolates of Pseudomonas aeruginosa from poultry fecal littered soil in two selected locations in northern Ibadan, southwest Nigeria (University of Ibadan Teaching Research Farm and Ayede community) for production of bioactive compounds, evaluated their activities against selected MDR bacteria pathogens and analyzed the crude ethylacetate extract using GC-MS. A total of 178 strains of P. aeruginosa were isolated on cetrimide agar and identified presumptively by standard biochemical test. Primary and secondary screening of the whole cell and cell free supernatant ethylacetate extracts were done by perpendicular streaking and agar-well diffusion methods respectively against selected clinical MDR bacteria pathogens. Five out of the 178 strains of the presumptive P.aeruginosa with excellent antibacterial activity were further confirmed by 16S rRNA amplification and sequencing. Cell free supernatant ethylacetate extracts of two most active strains among the five (denoted with code APC2-1 and APC2-14) were subjected to GC-MS analysis of the metabolites. The five P. aeruginosa strains were identified as P. aeruginosa MR24 strains 1, 2, 3, Pseudomonas sp SD12 and P. aeruginosa Kasamber 1 which were closely related phylogenetically. The bioactive compounds produced by the isolates that were studied had greater activity on Gram positive than Gram negative pathogens. GC-MS analysis revealed a total of 19 different compounds (1-heptadecanamine; 2ethyl-1-hexanamine; 3-butyn-1-ol; Pent-3-enylamine; Pent-4-enylamine; Propane; Acetaldehyde; Ethylene oxide; hydroxyacetonitrile; Bromo-acetonitrile; Azetidine; 2-methyl-Azetidine; Aminocaproic acid; 18nonadecen-1-amine; 5-aminovaleric acid; 2,2-dimethyl-1,3-propanediamine; 1-octadecanamine; 1-octanamine and 2-(3-butynyloxy)tetrahydro-2H-pyran) among which are antibacterial, anticancer, antifibrinolytic, and antimalarial compounds. This study therefore revealed the potentials of Pseudomonas aeruginosa as producers of secondary metabolites of medical and industrial importance. Multidrug resistance is currently on the increase, globally threatening public health and decreasing the efficacy of the antibiotics available currently (WHO, 2017). This therefore, has precipitated the search for novel compounds from natural sources like the environment, beneficial microorganisms, animals and plants from both aquatic and terrestrial habitats with potentials to produce potent antimicrobial agents against the resistant pathogens (Wolfender et al., 2015; Dias et al., 2016). Microbial genome mining is an important tool in the discovery of unculturable organisms and screening of isolates with potential secondary metabolites (Bachmann et al., 2014; Ziemert et al., 2016). With the availability of certain technologies like Ultra-High Performance Liquid Chromatography (UHPLC) and Gas Chromatography and Mass Spectrometry Analysis (GC-MS), an effective separation and identification of different bioactive metabolites from natural products is achievable. Some microorganisms such as bacteria and fungi from ages produce antimicrobials and other bioactive compounds (Butler and Bus, 2006). Pseudomonas spp. are group of Gram-negative bacilli with polar flagella, Gammaproteobacteria and family, Pseudomonadaceae. The species of this genus have a wide array of metabolic diversities capable of colonizing different ecological niches requiring non-specific nutritional requirement for their growth (Meyer et al., 2002). Pseudomonas spp. are known producers of bioactive metabolites such as Phenazine compounds, volatile organic compounds, thioquinolobactin etc. Some of these metabolites have been reported to possess antimicrobial activity, anticancer property, biosurfactant, bio-controlling, bio-pesticide/ bioinsecticide and bioremediation effects, hence its application in pharmaceutical, agricultural, cosmetic, industrial and environmental sector is important (Meyer et al., 2002; Kumar et al., 2016; Gionco et al., 2017). Despite the numerous antibiotics produced from microorganisms most especially the actinomycetes, resistance has taken a
Antimicrobial stewardship: Assessment of knowledge, awareness of antimicrobial resistance and appropriate antibiotic use among healthcare students in a Nigerian University
(Springer Nature, 2021) Akande-Sholabi, W.; Ajamu, A. T.
Background: Inappropriate use of antibiotics is a major cause of antimicrobial resistance (AMR). Inadequate knowledge about AMR among healthcare students could affect their practice of antimicrobial stewardship as future healthcare professionals. This study aims to assess the use of antibiotics and knowledge of AMR among future healthcare professionals of a Nigerian University. Methods: Respondents’ knowledge of antimicrobial resistance, use of antibiotics, and source of antibiotics in the past 12 months was explored using a self-administered questionnaire. Multivariate analyses were used to evaluate the relationship between specific variables and respondents’ knowledge. Results: Of the 939 questionnaires administered to the students, 866 were filled given a response rate of 92.2 %. A total of (765; 88.3 %) of the respondents were aware that antimicrobial resistance makes it harder to eliminate the infection from the body as existing drugs become less effective. In all 824, (95.2 %) of the respondents had use antibiotics in the past 12 months. The use of antibiotics to treat malaria was self-reported by (175; 21.2 %). About half (432; 52.4 %) purchased the antibiotics from community pharmacies, while others obtained their antibiotics from the hospitals (192; 23.3 %), patent medicine stores (150; 18.2 %), and friends and family (50; 6.1 %) in the last 12 months. In all 506, (58.4 %) had good knowledge of antimicrobial resistance. Logistic regression shows that students in 3rd to 6th year 9.29 [AOR = 9.29, 95 % CI: (3.7–22.96)], had greater knowledge of antimicrobial resistance. Conclusions: The healthcare students demonstrated a moderate knowledge of AMR. This underscores the need to adopt several educational tactics to introduce the concepts of AMR to the students and ensure there are strict policies to regulate the flow of antibiotics.
Assessment of Attitude, Practice and Barriers to Pharmaceutical Care Among Community Pharmacists in Ibadan
(2022) Akande-Sholabi, W.; AKINBITAN, A.A.
Background: Pharmaceutical care (PC) is a professional responsibility of a pharmacist that involves medication management with the overall goal of improving the quality of life of patient. Objectives: To evaluate the attitude, practice, and barriers to PC among community pharmacists in Ibadan. Method: A cross-sectional survey was conducted among community pharmacists between May and July 2021, with the aid of a self-administered questionnaires, information on socio-demographic characteristics, practice, attitudes, and barriers to PC was obtained. A consecutive sampling technique was used for participants’ enrolment. Participating pharmacists must have had a minimum of one-year practice experience in a community pharmacy. Pharmacy students, interns, non-pharmacist attendants, and community pharmacists who were absent from their pharmacies during the study were excluded. Data were summarized with descriptive statistics. Results: Over 12 weeks, 120 survey were collected (90.9% response rate). About (115; 95.8%) of respondents had good practice of PC and reported that pharmaceutical care is a timely innovation to pharmacy practice. However, only (62; 52.0%) had positive attitude and (117; 97.5%) believed more pharmaceutical care could be provided. Regarding their practice, most respondents (118; 98.3%) stated pharmaceutical care involves monitoring improvement in patient response to treatment and adherence to treatment regime and counselling patients with drug therapy problems. The top detected barriers for PC provision included insufficient time (71; 59.2%), and inadequate collaboration with other healthcare professionals (56; 46.7%). Conclusion: Community pharmacists in Ibadan demonstrated good practice and positive attitudes towards PC provision. However, further work should emphasise on improving PC understanding, better collaboration among other healthcare professionals and overcoming system-related barriers.
Assessment of compliance to treatment among ambulatory asthmatic patients in a secondary health care facility in nigeria
(2012) Obasan A.A.; Showande S.J.; Fakeye T.O.
This study assessed the level of compliance using three different methods: pill count, self report and peak expiratory flow rate, in asthmatic patients attending a secondary health care facility. Self report (using a pre-tested structured questionnaire), peak expiratory flow rate and pill count were used to assess patient’s compliance and identify the factors which may be responsible for non compliance. Measurement of peak expiratory flow rate and the pill count were done at two different occasions. The data obtained was analysed using descriptive statistics. The study showed that the patients were prescribed a range of one to four drugs: 54% (3 drugs), 32% (2 drugs), 8% (4 drugs) and 2% (1 drug). The levels of compliance were 86.57% for self report and 83.56% for pill count (p > 0.05). Reasons given for non compliance were: apparent wellness (33.31%), forgetfulness (26.67%), cost of drugs (6.67%), dysphagia (6.67%), presence of non-disturbing symptoms (6.67%), side effects (6.67%), ignorance/fear of addiction (6.67%), perceived lack of benefit from treatment (6.67%), and lethargy towards chronic medication (6.67%). However, there was a significant difference in the readings of the peak expiratory flow rate measured at two different occasions (p < 0.05). The study showed no significant difference in the methods used to assess the level of compliance. Non compliance can be overcome by proper education of patients on the importance of complying with the administration of medication and proper usage of metered dose devices.
Assessment of knowledge and reasons for medication non-adherence in ambulatory elderly patients with hypertension and diabetes mellitus in a geriatric centre in nigeria
(2021) Akande-Sholabi W.; Ogini D.E; Adebusoye L .; Fakeye T
Assessment of the knowledge of community pharmacists regarding common phytopharmaceuticals sold in South Western Nigeria
(Pharmacotherapy Group, 2006-12) Adisa, R.; Fakeye, T.
Purpose: The study was carried out to assess the knowledge of community pharmacists who sell herbal/phytopharmaceutical formulations in pharmacy retail outlets. Method: Questionnaires were administered to the pharmacists to gather information on phytopharmaceuticals regarding their use, side effects, potential drug-herb interactions and contraindications of the phytopharmaceuticals sold in their retail outlets. Opinions on regulation, safety and efficacy of herbal remedies were also obtained. Descriptive statistical tests and median scores were used to evaluate the distribution of responses, opinions and perception of the pharmacists on their level of knowledge of the phytopharmaceuticals, and effects of demographic data on the pharmacists’ knowledge of the herbal remedies. Results: The study revealed that 31 (62%) sold imported herbal remedies and nutritional supplements. Seventy-two (72) % had received no postgraduate training on herbal medications. Most of the community pharmacists agreed that they did not possess adequate knowledge of potential interaction profiles and side effects of the herbal remedies sold. The training in pharmacy schools on herbal drugs and sale of phytopharmaceuticals in their outlets also had no influence (p>0.05) on desired knowledge. Community pharmacists with less than 10 years of experience in the practice however possessed better knowledge than pharmacists with more than ten years of professional practice (p=0.05) Conclusions: There was gross inadequacy in the pharmacists’ knowledge of the phytopharmaceuticals sold in pharmacies indicating an urgent need for intensive training in order to render better services to their clients.
Associated With Hospitalisation of Hypertensive in-patients in a Tertiary Hospital, Southwestern Nigeria
(2023-05) Ipingbemi, E . L; Erhun, W . O; Rasaq, A.
The study aimed at estimating the cost of hospitalisation associated with medication non-adherence (MNA) among hypertensive in-patients in a tertiary healthcare facility in southwestern Nigeria. It involved a cross-sectional retrospective review of 322 medical records of hypertensive in-patients at the University College Hospital between 2013 and 2015. Physician’s documentation of MNA in the patients’ medical records prior to admission determined the eligibility into the study. Direct medical costs mainly consultation, medications, laboratory costs for individual patients during hospitalisation were calculated using out-of-pocket payer’s perspective approach. Data were summarised with descriptive statistics, Pearson’s product moment correlation coefficient was used to determine relationship between length of stay in hospital, cost of management and number of comorbidities at p < 0.05 considered statistically significant. Of the 322 medical records of hypertensive in-patients evaluated within the 3-year study period, 230 (71.4%) had a documentation of MNA. The average age was 55.9 ± 15.7 years old. Artisans/self-employed (n = 82; 35.7%) and petty traders (n = 61; 26.5%) made up the majority of the patients. The total cost of hospitalisation for the period studied was USD100,461.40 for all the patients, with an average of USD52.00 ± 28.10/patient/day, more than a quarter of which was spent on pharmaceuticals. Similarly, the costs of management also increased with increase in length of hospitalisation (Pearson’s product moment correlation r = 0.539, p = 0.000). The number of comorbid diseases increased the length of hospitalisation (r = 0.133, p = 0.044). Cost associated with hospitalisation in relation to MNA is high among the studied participants. There is a need to develop strategies to enhance medication adherence among patients with hypertension.
Attitude and opinion of nigerian community pharmacists to self medication practices
(2012) Fakeye T. O.; Adisa R.; Showande S. J. S.
This study evaluated the attitude and opinion of Nigerian community pharmacists on self medication practices with respect to the definition, advantages and disadvantages of self medication, ailments for which self medication should be allowed, as well as measures that may be instituted to ensure appropriate self medication practices. Pretested structured questionnaires were administered to licensed community pharmacists practicing in Southwestern Nigeria between December, 2009 and July, 2010. Descriptive statistics were used to summarize the data. Mann Whitney U and Kruskal Wallis tests were used to evaluate the respondents’ opinions in ordinal variables with p < 0.05 considered statistically significant. Respondents with postgraduate qualification (p < 0.05) believed that self medication solely done by patients without guidance of a health care professional may lead to mismanagement or subtherapeutic management of diseases (66; 91.66%), medication errors and likelihood of disease complications (68; 93.15%). Years of practice had a significant effect on community pharmacists’ perception of advantages of self medication (p < 0.05). Rigorous monitoring of drug advertisement in the media might help in controlling the practice of self medication (63, 86.30%). Respondents believed that keeping the identity of the medications (29; 39.73%) and diagnosis details (19; 27.14%) unknown to patients is unethical. Self medication may be acceptable for fever (53; 74.65%), diarrhea (46; 67.65%) and cough (39; 53.62%), but with specific time limits, for patients on chronic medication who have stable clinical conditions, including asthma (46; 66.67%), hypertension (36; 51.43%) and diabetes (37; 52.86%). Community pharmacists in Southwestern Nigeria possess a good understanding of the concept of self medication, believed the practice should not be discouraged in totality, but should be practiced under controlled conditions, and that public enlightenment may help to ensure safe self medication practices.