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Oral pediatric antibiotics and antimalarials are usually formulated as powders that must be correctly reconstituted and administered for effective therapy. We conducted this study, first of its kind in Ghana, to assess the knowledge and practices of caregivers/parents regarding reconstitution, storage, and administration of these products at Ho Teaching Hospital. Participants (N = 78) completed a semi-structured questionnaire, after which their reconstitution and dose measurement skills were evaluated by having them mix provided powders with water and measure 5 mL of the resulting mixture. Most participants knew of antibiotics (78.2 %) and antimalarials (59.0 %); however, 25.6 % of them never read reconstitution directions, and among those who read, only 55.2 % understand them. Additionally, majority seek advice on unclear directions from nurses (52.6 %), use overdiluted medications (70.5 %), shake reconstituted drugs before use (89.7 %), and read storage instructions (61.5 %). Reconstitution challenges listed by participants included uneven mixing, adding the required volume of diluent to reach a level mark, and powder clumping. Sachet (51.3 %), bottled (30.8 %), and tap (7.7 %) water were the main diluents indicated. Dosing times were incorrectly estimated by some respondents (21.8 %). Measuring cup (75.6 %) and medicine cabinet (55.1 %) were the most common dosing device and storage place for the medicines, respectively. Most respondents fully dispersed the given powder in water (97.4 %) and accurately measured 5 mL of their mixtures (82.0 %). Our findings indicate good caregiver knowledge of oral pediatric antimalarials and antibiotics. Educational background significantly influenced reconstitution skills and the reading and understanding of reconstitution and storage instructions, highlighting the need to use pharmacist-led teach-back methods during dispensing to ensure proper information uptake. Manufacturers must also use excipients with good reconstitution properties in such products and indicate instructions in caregiver-friendly language.

The antifungal activity of the 70% ethanol stem bark extract of Erythrina senegalensis (ESB) against different strains and drug resistant clinical isolates of Candida albicans and Candida glabrata were evaluated in the study. The effect of ESB on biofilms as well as its activity in combination with fluconazole, nystatin or caspofungin against the Candida strains were also evaluated. We then evaluated the antifungal activity of a microemulsion formulation of ESB against planktonic and biofilms of the Candida species. UPLC-QTOF-MS2 analysis was then undertaken to identify the phytoconstituents of the extract and UPLC fingerprints developed for the routine authentication as part of quality control measures. ESB exerted strong antifungal activities against C. albicans ATCC 10231 and SC5314 strains, and C. glabrata ATCC 2001 strain with minimum inhibitory concentration (MIC) values from 3.91 to 31.25 μg/mL and minimum fungicidal concentrations (MFCs) that ranged from 62.5 to 250 μg/mL. It also exhibited potent antifungal activities (MIC = 4–64 μg/mL) against a collection of C. albicans and C. glabrata clinical isolates that were resistant to either nystatin or azole antifungals. The formulated ESB demonstrated higher antifungal potency against the C. albicans and C. glabrata strains with MIC values of 3.91–31.25 μg/mL which was the same as the MFC values. The extract and its microemulsion formulation were active against biofilms of the strains of the Candida species inhibiting their biofilm formations (SMIC50 = 16–64 μg/mL) and their preformed biofilms (SMIC50 = 128 –>512 μg/mL). ESB also exhibited synergistic antifungal action with fluconazole and nystatin against C. albicans ATCC 10231 and C. glabrata ATCC 2001 strains in the checkerboard assay. Chemical characterization of the extract revealed the presence of phenolic compounds such as flavonoids and their prenylated derivatives, anthracene glycosides and alkaloids. UPLC Fingerprints of the extract was also developed and validated for routine identification and authentication of the stem bark of E. senegalensis. The study findings have demonstrated that the stem bark of E. senegalensis is as a potential source of bioactive compounds that could be developed as novel antifungal agents.

A library of six compounds with new hybrids in a single molecule triazole ring attached to the phosphonium salts was synthesized. Click chemistry was, however, used to synthesize the 1-, 2-, and 3-triazole intermediates as a tether for the hybrid phosphonium salts. Their antibacterial activity against Gram-positive bacteria (Staphylococcus aureus and Enterococcus faecalis), Gram-negative bacteria (Escherichia coli and Pseudomonas aeruginosa), and Mycobacterium smegmatis mc2155 was determined using the HT-SPOTi assay. Compound 2 showed the most effective antimicrobial activity as it inhibited the growth of Pseudomonas aeruginosa and Staphylococcus aureus at 0.0125 µg/mL and 31.25 µg/mL, respectively. From the FICI data, compounds 2ET-TOL (2) and RABYL-TOL (4) successfully modulated the activities of amoxicillin against Pseudomonas aeruginosa and Staphylococcus aureus. All the test compounds exhibited a concentration-dependent biofilm formation inhibition against S. aureus, except P-Z (compound 6). Compounds P-MEOXY (1) and 2ET-TOL (2) exhibited mild activity against P. aeruginosa with compound 4 showing antimycobacterial activity at 500 µg/mL.

Introduction. Administering the right dose of medications is essential in avoiding potentially life-threatening adverse drug reactions. Industry guidelines for manufacturers of oral, over-the-counter, and liquid medications recommend including dose-delivery devices with packaging to limit dosing inaccuracy. This study describes the prevalence and accuracy of dosing devices packaged with oral liquid medications in the Ho municipality of Ghana. Methods. Dosing device accuracy was determined after deviation of the measured volume from the expected volume was evaluated using the United States Pharmacopoeia criteria. Results. A total of 78.6% of the oral liquid medications were packaged with a dosing device. The most common dosing devices were cups (83.6%), followed by spoons (14.3%), droppers (1.4%), and syringes (0.7%). The volumes measured with cups (5.14 ± 0.52 mL, p=0.006) and spoons (5.3 ± 0.67 mL, p0.999). Further, the measured volumes for 38.6% and 72.2% of the cups and spoons, respectively, deviated by more than 15% of 5 mL. Conclusion. Dosing cups and spoons are associated with significant inaccuracy. Yet, manufacturers continually favour them over syringes in packaging for oral liquid medications. This is unacceptable and of considerable concern due to the risk of variations in therapeutic outcomes. Therefore, strict regulatory directives on the inclusion of accurate dosing devices in the packaging of oral liquid medicines are needed to reduce the possibility of medication errors.

Antacids are over-the-counter medications that neutralize stomach acid and inhibit pepsin activity. They are used to relieve symptoms associated with some upper gastrointestinal disorders. Several antacids are available in Ghana; therefore, comparative data on dose volume, efficacy, and cost are needed. This study investigated the properties of antacid suspensions sold in Ghana. Fourteen antacid suspensions (A−N) were randomly selected from community pharmacies in the Ho Municipality of Ghana and visually inspected. Density, pH, flow time, viscosity, sedimentation rate over 12 days, and acid-neutralizing capacity (ANC) were determined. The minimum adult dose range for the products was 5−15 mL. The samples were produced in Italy (7.1%), the United Kingdom (14.3%), India (28.6%), and Ghana (50.0%). Five samples (36%) lacked dosing devices. The pH, relative density, flow time, viscosity, and sedimentation volume and rate ranges were 7.77 ± 0.03−10.78 ± 0.00, 1.05−1.21, 6.09 ± 0.15−131.00 ± 6.04 seconds, 36.33 ± 1.15−971.67 ± 0.58 cPs, 0.40−1, and 0.00−1.10 mL/day, respectively. Sediments were formed in magnesium trisilicate mixtures. No sediment was formed in four products (29%). ANCs ranged from 12.42 ± 0.33 mEq (product E) to 38.82 ± 2.46 mEq (product J). H and J contained the same active ingredients; however, H had an ANC of 38.25 ± 0.67 mEq at a lower volume and cost per dose, and contained more doses. Product E (imported) was the most expensive antacid (GH¢ 42.00/150 mL), whereas samples K, L, M, and N (locally manufactured) were the least expensive (GH¢ 3.00/200 mL). All ANCs were greater than the minimum recommended value. Product F had the best value for money. There was no link between ANC and product cost or origin. Expensive products were not necessarily better in the tests performed. Therefore, there is no justification for selecting expensive/imported liquid antacids over locally produced/cheaper ones.