Antimicrobial resistance (AMR) is a global health problem threatening safe, effective healthcare delivery in all countries and settings. The ability of microorganisms to become resistant to the effects of antimicrobials is an inevitable evolutionary process. The misuse and overuse of antimicrobial agents have increased the importance of a global focus on antimicrobial stewardship (AMS). This review provides insight into the current AMS landscape and identifies contemporary actors and initiatives related to AMS projects in eight African countries (Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Uganda, and Zambia), which form a network of countries participating in the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme. We focus on common themes across the eight countries, including the current status of AMR, infection prevention and control, AMR implementation strategies, AMS, antimicrobial surveillance, antimicrobial use, antimicrobial consumption surveillance, a one health approach, digital health, pre-service and in-service AMR and AMS training, access to and supply of medicines, and the impact of COVID-19. Recommendations suitable for adaptation are presented, including the development of a national AMS strategy and incorporation of AMS in pharmacists’ and other healthcare professionals’ curricula for pre-service and in-service training.
Background The incidence of pain and inflammation in West Africa and in fact globally, continues to increase at an alarming rate. This research was conducted to investigate the analgesic and anti-inflammatory activities of leaf extracts of Chasmanthera dependens and Chenopodium ambrosioides ; formulate and evaluate polyherbal gels from their combination in a bid to providing topical therapeutic solutions to pain and inflammation. Methods Pre-formulation studies (phytochemical analysis, in vitro analgesic and anti-inflammatory activities) were conducted on the methanol leaf extracts of Chasmanthera dependens and Chenopodium ambrosioides . Individual and polyherbal gels were prepared using polymer carbopol 940 (1%) at combination ratios of 0:100, 25:75, 50:50, 75:25 and 100:0 Chasmanthera : Chenopodium. These herbal gels were evaluated for physical parameters, pH, viscosity, extrudability and spreadability. Analgesic and anti-inflammatory activities of herbal gels were evaluated by their inhibitory activities (percentage inhibition) against COX-2, TNF-α, IL-10, PGE-2 and compared with commercial diclofenac gel. Results The phytochemicals of the two extracts detected gave varied contents of major classes of secondary metabolites. The pre formulation inhibitory studies of the two extracts exhibited dose dependent inhibitory activities against COX-2, TNF-α, IL-10, PGE-2. The physical appearance, homogeneity, and consistency of the herbal formulations were good. The herbal gels were spreadable with good extrudability. The pH of the herbal gels ranged from 4.5 ± 0.4 to 5.2 ± 0.4. The viscosity of the herbal gels ranged between 4.3 ± 0.2 and 4.7 ± 0.4 Pas. The herbal gels exhibited significant differences in inhibitory activities against COX-2, TNF-α, IL-10, PGE-2 when compared with control commercial diclofenac gel. Conclusion The outcomes, including the inhibition of mediators COX-2, TNF-α, IL-10, PGE-2, confirm the use of the plant extracts under study, the individual and polyherbal gels formulated for the potential topical therapeutic treatment of pain and inflammation.
Purpose Parquetina nigrescens (Pn) extract was evaluated for safety and antidiarrheal activity, formulated into stable suspensions, and characterized. Methods Acute toxicity of the extract based on Organization for Economic Cooperation and Development-423 guidelines was performed. The antidiarrheal effects of the extract on castor oil-induced diarrhea in four groups of Wistar rats were determined. The first and second groups received 5 and 200 mg/kg body weight (bw) of the extract, while the third and fourth groups received normal saline (5 mg/kg bw) and loperamide (5 mg/kg bw) as negative and positive controls, respectively. Pn extract was used at 1.25% w/v to formulate structured vehicle (carboxylmethylcellulose, polyvinylpyrrolidone and tragacanth) suspensions. The suspensions were tested for pharmacological activity and characterized. Results Acute toxicity gave a lethal dose 50 (LD50) that is greater than 300 and less than 2,000 mg/kg bw. A reduction in intestinal transit by 0.14 and 0.15% at 5 and 200 mg/kg of the extract was achieved as compared to an inhibition of 0.12% by 5 mg/kg loperamide. There was a dose-dependent decrease in the frequency of watery stool passed in castor oil-induced rats by 35.29% and 64.70% at 5 and 200 mg/kg, respectively. All the suspensions inhibited diarrhea, exhibiting a dose-dependent pattern and remained stable after 4 weeks. Their pH values ranged from 4.60±2.73 to 4.73±1.91, while viscosity ranged from 3.50±1.23 to 6.75±1.24 Pas at 60 rpm. Conclusion The results suggest that Pn possesses significant antidiarrheal activity. Suspensions of Pn were successfully formulated in structured vehicles and were effective in the control of diarrhea in Wistar rats.
Antimicrobial resistance (AMR) is a global health problem threatening safe, effective healthcare delivery in all countries and settings. The ability of microorganisms to become resistant to the effects of antimicrobials is an inevitable evolutionary process. The misuse and overuse of antimicrobial agents has increased the importance of a global focus on antimicrobial stewardship (AMS). This review provides insight into the current AMS landscape and identifies contemporary actors and initiatives related to AMS projects in eight African countries (Ghana, Kenya, Malawi, Nigeria, Sierra Leone, Tanzania, Uganda, and Zambia), which form a network of countries participating in the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme. We focus on common themes across the eight countries, including the current status of AMR, infection prevention and control, AMR implementation strategies, AMS, antimicrobial surveillance, antimicrobial use, antimicrobial consumption surveillance, a one health approach, digital health, pre-service and in-service AMR & AMS training, access to and supply of medicines, and the impact of COVID-19. Recommendations suitable for adaptation are presented, including the development of a national AMS strategy and incorporation of AMS in pharmacists’ and other healthcare professionals' curricula for pre-service and in-service training.
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