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Cutibacterium acnes, Staphylococcus epidermidis, and Staphylococcus aureus proliferate within accumulated sebum and produce localised inflammation thereby inducing acne vulgaris. Essential oils are one of the leading natural products used for acne and are diluted in fixed oils to reduce irritation and toxicity. This study investigated the in vitro antimicrobial, anti-inflammatory, cytotoxicity, and skin retention properties of Rosa rubiginosa rosehip fixed oil in combination with essential oils having activity against acne vulgaris. The broth microdilution assay was used to determine the minimum inhibitory concentration (MIC), and the sum of the fractional inhibitory concentration index (ΣFIC) was calculated for the interactions. The lipopolysaccharide (LPS) induced inflammatory pathway in RAW 264.7 macrophages was used to assess anti-inflammatory activity. A dual-staining method in A549 epithelial cells was used to assess cytotoxicity. Qualitative Fourier Transform Infrared spectroscopy analysis was used for initial skin retention determination. Rosa rubiginosa oil combined with Cinnamomum zeylanicum essential oil displayed antimicrobial synergy (MIC = 0.42 mg/ mL; ΣFIC = 0.45) against three acne-inducing strains. Rosa rubiginosa fixed oil combined with Styrax benzoin essential oil suppressed LPS-induced nitrite production by 33.80%. Rosa rubiginosa oil combined with Melaleuca quinquenervia essential oil exhibited the lowest cytotoxicity (84.32% cell viability). Rosa rubiginosa oil combined with either C. zeylanicum, Eugenia caryophyllata, Rosa damascena or S. benzoin essential oil was retained within the porcine skin. Rosa rubiginosa fixed oil serves as an ideal carrier oil that can potentiate selected essential oils for the treatment of acne vulgaris. [ABSTRACT FROM AUTHOR]

Fungal infections present a challenge when it comes to topical treatment failure thereby necessitating the need for more effective topical delivery systems. Essential oils have demonstrated noteworthy antifungal activity; however, their volatility limits therapeutic use for skin conditions. This study aimed to investigate the antifungal activity of essential oils alone and in combination. Thereafter, antifungal nanoparticulate formulations were designed using three essential oil combinations against Microsporum canis, Trichophyton mentagrophytes and Candida albicans. The antifungal activity was investigated using the broth microdilution assay to determine the minimum inhibitory concentration (MIC). The formulations were prepared by forming nanoparticles (polymer-based and composite lipid-polymer-based systems), with the preferred formulation encapsulating the essential oil combinations. Characterisation of the formulations was performed with a Zeta-sizer and using attenuated total reflectance-fourier transform infrared spectroscopy (ATR-FTIR). The in vitro antifungal activity of the three nanoparticulate formulations was then determined, where a significant (p = 0.002) increase in the average antidermatophyte activity could be observed for all three formulations. The combination of A. sativum and C. martinii displayed the lowest MIC value across all three reference strains (MIC values 0.06-0.38 mg mL-1) and the formulation maintained the antifungal activity with MIC values ranging 0.08-0.36 mg mL-1. A successful combination of essential oils with antifungal activity was achieved thereby emphasising an effective nanoparticulate formulation. [ABSTRACT FROM AUTHOR]

Aims Antimicrobial resistance continues to be a growing concern, resulting in increased use of drug combinations. Antibiotic adjuvants are an emerging strategy that may potentiate an antibiotics efficacy. Ibuprofen's polypharmacological properties have been investigated for their antimicrobial and host-modulating potential. This study aimed to investigate the potential of a novel multidrug combination involving ibuprofen, essential oil compounds (EOCs), and conventional antimicrobials against skin pathogens. Methods and Results The minimum inhibitory concentrations of ibuprofen, conventional antimicrobials, and EOCs were determined and then combined and tested against 14 (reference and clinical) skin pathogens. The cytotoxicity was analysed using the MTT assay, whilst the anti-inflammatory effects were evaluated using lipopolysaccharide activated RAW264.7 murine macrophages. Four pairwise (Ibuprofen and antibiotic) (ΣFIC 0.33–0.50) and three triple (Ibuprofen and antibiotic with EOC) (ΣFIC 0.44–0.47) synergistic antimicrobial interactions were identified. These combinations demonstrated cell viability of 77.59%–100%. No combination significantly reduced nitric oxide production. Conclusion The results from this study provide insight into the potential of a multidrug combination involving ibuprofen with conventional antimicrobials and EOCs against common skin pathogens. [ABSTRACT FROM AUTHOR]

Essential oil compounds have been identified as alternative antimicrobials; however, their use is limited due to their toxicity on human lymphocytes, skin, and reproduction. Carrier oils can reduce the toxicity of essential oils, which raises the question as to whether such activity would extend to the essential oil compounds. Thus, this study aimed to investigate the antimicrobial and toxicity activity of essential oil compounds in combination with carrier oils. The antimicrobial properties of the essential oil compounds, alone and in combination with carrier oils, were determined using the broth microdilution assay. The toxicity was determined using the brine shrimp lethality assay. Antimicrobial synergy (ΣFIC ≤ 0.50) occurred in 3% of the samples when tested against the ESKAPE pathogens. The compound thymoquinone in combination with the carrier oil Prunus armeniaca demonstrated broad-spectrum synergistic activity and a selectivity index above four, highlighting this combination as the most favorable. The carrier oils reduced the toxicity of several compounds, with Calendula officinalis and P. armeniaca carrier oils being responsible for the majority of the reduced toxicity observed. This study provides insight into the interactions that may occur when adding a carrier oil to essential oil compounds. [ABSTRACT FROM AUTHOR]

The topical use of essential oils requires dilution into a carrier oil; however, scientific evidence regarding the antimicrobial efficacy and cytotoxicity when a carrier oil is combined with an essential oil is lacking. This study sets out to determine the antimicrobial activity and cytotoxicity of 23 essential oils combined with six known carrier oils. Gas chromatography- mass spectrometry/flame ionization detector (GC-MS/FID) was used to characterize the methyl esters of the carrier oils. The antimicrobial activity of the carrier oils alone and in combination with the essential oils was investigated using the broth microdilution assay against 11 skin pathogens and the cytotoxicity was determined using the brine shrimp lethality assay. The interactive profiles of the combinations for both antimicrobial activity and the cytotoxicity were analysed and calculated using the fractional inhibitory concentration index (SFIC). The carrier oils demonstrated no antimicrobial antagonism when combined with the essential oils and the overall cytotoxicity of the majority of the combinations was decreased. The carrier oils that could be identified as enhancing the antimicrobial activity and decreasing the cytotoxicity were Aloe Vera (Aloe vera Mill.) and Jojoba (Simmondsia chinensis C.K. Schneid) oil, with an overall reduction in essential oil cytotoxicity of 87.5% at 24 hrs and 85% at 48 hrs by Aloe Vera. Five of the essential oils (when diluted in Aloe Vera and Jojoba carrier oils) demonstrated enhanced antimicrobial activity against pathogens such as Brevibacterium epidermidis, B. linens, and P. aeruginosa with MIC values ranging from 0.09 to 0.50 mg/mL (and SFIC 0.14-0.39). The study could conclude that the carrier oils are complementary to essential oil formulations, mostly reducing cytotoxicity and in some cases enhancing the antimicrobial activity. [ABSTRACT FROM AUTHOR]

Non-communicable diseases, including cardiovascular disease (CVD), are some of the leading causes of mortality worldwide. Despite the effectiveness of early diagnostic and treatment options, patient screening, disease detection and disease progression remain a challenge, resulting in suboptimal outcomes. Consequently, cardiovascular diseases remain underdiagnosed and undertreated, particularly in developing countries. Several barriers, including paucity of recommended cardiovascular health information and low literacy levels, lead to a poor understanding of the importance of intervention in terms of modifiable risk factors as well as treatment adherence. This narrative review focuses on cardiovascular patients' understanding of their disease, and the need for compliance with their medication and lifestyle modifications. Low levels of perception and insufficient knowledge of CVDs among patients continue to be indispensably important factors in health behaviour. Increased awareness of these issues has the potential to improve the effectiveness of the multidisciplinary cardiovascular team and ultimately improve the care provided to these patients.

Background: Dyslipidaemia is defined as elevated total or low-density lipoprotein (LDL) levels or low levels of high-density lipoprotein (HDL). Patients may often make use of natural cholesterol lowering supplements (NCLSs) available at the pharmacy; however, limited information on these supplements is readily available. Pharmacists should be knowledgeable about NCLSs to ensure that the use of these supplements is supported by evidence and to provide appropriate advice to patients for desirable therapeutic outcomes., Aim: This study aimed to identify the NCLSs being sold in South African pharmacies and review the scientific evidence for each of the ingredients in these NCLSs., Methods: Seventeen NCLS products were identified, and the Joanna Briggs Institute (JBI) scoping review methodology was used to conduct a literature review of NCLSs., Results: From the ingredients reviewed it is evident that co-enzyme Q10, probiotics and sterols have sufficient evidence supporting their use. However, there is still limited scientific evidence available to validate the remaining ingredients., Conclusion: Further research on NCLSs will provide practising pharmacists and practitioners with a guide of the evidence available on the various ingredients in NCLSs., Contribution: This study provides a review of the available literature on the NCLSs being sold in the pharmacies across South Africa to provide pharmacists with a collated document of the evidence behind these popular supplements to assist them in making evidence based informed decision regarding natural products for cholesterol., Competing Interests: The authors have declared that no competing interest exists., (© 2024. The Authors.)

Background: Vaccination falls within the scope of practice of a pharmacist and the coronavirus disease 2019 pandemic has seen an increase in pharmacies providing vaccination services. These vaccines are not without risk of allergic reactions and anaphylaxis. The available guidelines for the management of anaphylaxis include the administration of intravenous (IV) fluids. However, IV administration does not fall within the scope of practice of a pharmacist. A gap was identified in the availability of guidelines for the management of anaphylaxis without the use of IV fluid administration., Aim: This review aimed to address this gap by describing the mechanisms of allergic reactions and anaphylaxis and developing an algorithm to assist pharmacy personnel to manage these within the scope of practice., Methods: The authors used the recommendations for developing guidelines., Results: The availability of anaphylaxis guidelines and clinical studies catering for anaphylaxis and allergy management by pharmacists was deficient, thus the review modified the available management guidelines to align the management of allergy and anaphylaxis within the scope of a pharmacist. The items required for the management were also identified and listed as items that form part of the emergency tray in the pharmacy., Conclusion: The review designed algorithms based on the available literature to assist pharmacy personnel to manage allergy and anaphylaxis within the relevant scope of practice. The review also lists the equipment needed for an emergency tray., Contribution: This review serves to offer guidance for the management of allergy and anaphylaxis in a pharmacy setting., Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article., (© 2022. The Authors.)