Aims: The in vitro antimicrobial activity of three essential oil samples of frankincense (Boswellia rivae, Boswellia neglecta and Boswellia papyrifera) and two essential oil samples of myrrh and sweet myrrh (Commiphora guidotti and Commiphora myrrha), collected from different regions of Ethiopia, was investigated independently and in combination to determine their anti-infective properties. Methods and Results: The microdilution minimum inhibitory concentration (MIC) assay was performed, whereby it was noted that generally Cryptococcus neoformans (MIC values in the range of 0·8–1·4 mg ml⁻¹) and Pseudomonas aeruginosa (MIC values in the range of 0·5–1·3 mg ml⁻¹) often appeared to be the most susceptible micro-organisms against oils of both Boswellia and Commiphora spp. When assayed in various combinations, the frankincense and myrrh oils displayed synergistic, additive and noninteractive properties, with no antagonism noted. When investigating different ratio combinations against Bacillus cereus, the most favourable combination was between B. papyrifera and C. myrrha. The composition of the oils was determined by gas chromatography coupled to mass spectrometry (GC–MS) to document the specific chemotypes used in the study, and the chemical profiles were found to be congruent with previously reported data. Conclusions: The majority of interactions identified synergistic and additive effects, with strong synergism noted between B. papyrifera and C. myrrha. Significance and Impact of the Study: Frankincense and myrrh essential oils have been used in combination since 1500 bc; however, no antimicrobial investigations have been undertaken to confirm their effect in combination. This study validates the enhanced efficacy when used in combination against a selection of pathogens.

The antimicrobial activity ofLavandula angustifoliaessential oil was assessed in combination with 45 other oils to establish possible interactive properties. The composition of the selected essential oils was confirmed using GC-MS with a flame ionization detector. The microdilution minimum inhibitory concentration (MIC) assay was undertaken, whereby the fractional inhibitory concentration (ΣFIC) was calculated for the oil combinations. When lavender oil was assayed in 1 : 1 ratios with other oils, synergistic (26.7%), additive (48.9%), non-interactive (23.7%), and antagonistic (0.7%) interactions were observed. When investigating different ratios of the two oils in combination, the most favourable interactions were whenL. angustifoliawas combined withCinnamomum zeylanicumor withCitrus sinensis,againstC. albicansandS. aureus,respectively. In 1 : 1 ratios, 75.6% of the essential oils investigated showed either synergistic or additive results, lendingin vitrocredibility to the use of essential oil blends in aroma-therapeutic practices. Within the field of aromatherapy, essential oils are commonly employed in mixtures for the treatment of infectious diseases; however, very little evidence exists to support the use in combination. This study lends some credence to the concomitant use of essential oils blended with lavender.

The paper focuses on the in vitro antimicrobial activity of Lavandula angustifolia Mill. (lavender) essential oil in combination with four commercial antimicrobial agents. Stock solutions of chloramphenicol, ciprofloxacin, nystatin, and fusidic acid were tested in combination with L. angustifolia essential oil. The antimicrobial activities of the combinations were investigated against the Gram‐positive bacterial strain Staphylococcus aureus (ATCC 6538) and Gram‐negative Pseudomonas aeruginosa (ATCC 27858) and Candida albicans (ATCC 10231) was selected to represent the yeasts. The antimicrobial effect was performed using the minimum inhibitory concentration (MIC) microdilution assay. Isobolograms were constructed for varying ratios. The most prominent interaction was noted when L. angustifolia essential oil was combined with chloramphenicol and tested against the pathogen P. aeruginosa (ΣFIC of 0.29). Lavendula angustifolia essential oil was shown in most cases to interact synergistically with conventional antimicrobials when combined in ratios where higher volumes of L. angustifolia essential oil were incorporated into the combination.

This study investigated the potential efficacy of 369 commercial essential oil combinations for antimicrobial, anti-toxic and anti-inflammatory activity with the aim of identifying synergy among essential oils commonly used in combination by aromatherapists for respiratory purposes. Essential oil combinations were assessed for their antimicrobial activities using a panel of Gram-positive, Gram-negative, and yeast strains associated with respiratory tract infections. The antimicrobial activity was measured by determining the minimal inhibitory concentration (MIC) of microbial growth. The fractional inhibitory concentration index (ΣFIC) was calculated to determine the antimicrobial interactions between the essential oils in the combination. The toxicity of the essential oil combinations was tested in vitro using the brine shrimp lethality assay, the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay on RAW 264.7 mouse macrophage cells and A549 lung cancer cell lines. In addition, an inflammatory response was evaluated measuring nitric oxide production. The essential oils, when in combination, demonstrated an increased antimicrobial effect, a reduction in toxicity and provided improved anti-inflammatory outcomes. Five distinct combinations [Cupressus sempervirens (cypress) in combination with Melaleuca alternifolia (tea tree), Hyssopus officinalis (hyssop) in combination with Rosmarinus officinalis (rosemary), Origanum marjorana (marjoram) in combination with M. alternifolia, Myrtus communis (myrtle) in combination with M. alternifolia and Origanum vulgare (origanum) in combination with M. alternifolia] were found to be the most promising, demonstrating antimicrobial activity, reduced cytotoxicity and improved anti-inflammatory effects. With the increased prevalence of respiratory tract infections and the growing antimicrobial resistance development associated with antimicrobial treatments, this study provides a promising complementary alternative for the appropriate use of a selection of essential oil combinations for use in the respiratory tract.

Illegible prescriptions are an illegal, frequent, and longstanding problem for pharmacy personnel engaged in dispensing. These contribute to patient safety issues and negatively impact safe dispensing in pharmaceutical delivery. To date, little is documented on measures taken to assess the negative impact posed by illegible prescriptions on South African pharmacy dispensing personnel. Therefore, this pilot study was performed to evaluate the ability of pharmacy personnel to read and interpret illegible prescriptions correctly; and to report on their perceived challenges, views and concerns when presented with an illegible prescription to dispense. A cross-sectional, three-tiered self-administered survey was conducted among pharmacy personnel. A total of 885 measurements were recorded. The ability to read an illegible prescription is not an indicator of competency, as all (100%) participants (novice and experienced) made errors and experienced difficulty evaluating and deciphering the illegible prescription. The medication names and dosages were correctly identified by only 20% and 18% of all participants. The use of digital prescriptions was indicated by 70% of the participants as a probable solution to the problem. Overall, improving the quality of written prescriptions and instructions can potentially assist dispensing pharmacy personnel in reducing illegible prescription-related patient safety issues and dispensing errors.

Background: Antimicrobial stewardship (AMS) is a critical global intervention aimed at optimising antimicrobial use and decreasing antimicrobial resistance (AMR) with pharmacists playing a pivotal role within AMS teams. However, AMS is not comprehensively taught in pharmacy curricula and little is known about the relevance of pharmacists’ training to meet AMS needs in South Africa.Aim: This study aimed to explore the attitudes, knowledge and perceptions of clinical pharmacists towards AMS participation and training in South Africa.Setting: This study was conducted among clinically practicing pharmacists in public and private healthcare sectors in South Africa.Methods: A quantitative exploratory research design was selected for this study. The study was conducted using a self-administered structured survey. Categorical variables were analysed using simple descriptive statistics. Mann–Whitney and Kruskal–Wallis tests were applied to determine differences between variables.Results: Pharmacists demonstrated good attitudes knowledge and perceptions towards AMS (median 4.3). There was statistical significant differences in AMS participation between pharmacists of different years of experience (p = 0.005), sector of employment (p = 0.01), position of employment (p = 0.015) and presence of AMS programmes (p = 0.004). Pharmacists indicated that their Bachelor of Pharmacy undergraduate studies inadequately prepared them for their role in AMS (median 4.3).Conclusion: Pharmacists show positive attitudes, knowledge and perceptions towards AMS. Education and training in AMS principles is obtained through master’s programmes, short courses, Continued Professional Development (CPDs) and workshops and insufficiently incorporated in undergraduate programmes.Contribution: This study confirms that undergraduate pharmacy programmes inadequately prepare pharmacists for their role in AMS.