Five-membered heterocycles are essential structural components in various antibacterial drugs; the physicochemical properties of a five-membered heterocycle can play a crucial role in determining the biological activity of an antibacterial drug. These properties can affect the drug’s activity spectrum, potency, and pharmacokinetic and toxicological properties. Using scientific databases, we identified and discussed the antibacterials used in therapy, containing five-membered heterocycles in their molecular structure. The identified five-membered heterocycles used in antibacterial design contain one to four heteroatoms (nitrogen, oxygen, and sulfur). Antibacterials containing five-membered heterocycles were discussed, highlighting the biological properties imprinted by the targeted heterocycle. In some antibacterials, heterocycles with five atoms are pharmacophores responsible for their specific antibacterial activity. As pharmacophores, these heterocycles help design new medicinal molecules, improving their potency and selectivity and comprehending the structure-activity relationship of antibiotics. Unfortunately, particular heterocycles can also affect the drug’s potential toxicity. The review extensively presents the most successful five-atom heterocycles used to design antibacterial essential medicines. Understanding and optimizing the intrinsic characteristics of a five-membered heterocycle can help the development of antibacterial drugs with improved activity, pharmacokinetic profile, and safety.

Background/Objectives: Fluoroquinolones (FQNs) are widely prescribed broad-spectrum antibiotics but are associated with central and peripheral nervous system adverse reactions (ARs). Regulatory agencies have issued multiple safety warnings regarding their neuropsychiatric effects; however, large-scale, comparative evaluations across individual FQNs remain limited. This study aimed to comprehensively characterise and compare neuropsychiatric profiles associated with Ciprofloxacin, Levofloxacin, and Moxifloxacin using pharmacovigilance data. Methods: A retrospective pharmacovigilance study was conducted using reports from the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS) between 2010 and 2025. Neuropsychiatric ARs were identified using MedDRA terms, including neurological and psychiatric manifestations. Reporting trends, demographic characteristics, and event frequencies were descriptively analysed. Signal detection was performed using the Information Component (IC), Proportional Reporting Ratio (PRR), and Reporting Odds Ratio (ROR). Results: A total of 95,968 individual case safety reports involving neuropsychiatric ARs were included. Levofloxacin accounted for the highest number of reported events, followed by Ciprofloxacin and Moxifloxacin. Disproportionality analyses identified peripheral neuropathy as the strongest neurological signal for Levofloxacin and Moxifloxacin, while Ciprofloxacin showed stronger central nervous system associations. Psychiatric ARs were drug-specific, with anxiety predominating for Ciprofloxacin and Moxifloxacin, and insomnia for Levofloxacin. All major signals were statistically robust (IC025 > 0), confirming distinct compound-specific neuropsychiatric risk profiles. Conclusions: The large-scale 16-year analysis demonstrates distinct, drug-specific neuropsychiatric risk profiles. The available evidence supports a non-interchangeable safety profile among FQNs and emphasises the importance of drug-specific risk–benefit assessment in clinical practice.

Background: The modern pharmacist is no longer just a person who prepares medicines, but has become an important health care provider involved in public health, including pharmaceutical care, prevention, chronic disease management and digital health. Such a transition requires the need for professional independence, supported by effective regulation. Deontological codes guarantee this independence and duties but variability in legal frameworks across Europe limits consistent innovation in pharmaceutical care. Objectives: The study analyses the deontological framework for pharmacist professional independence across 30 European jurisdictions and evaluates how effectively each national framework protects independence as a precondition for the development of pharmaceutical care, taking into account professional mobility and changes in healthcare system requirements. Methods: A comparative analysis examined deontological codes and professional ethics from 27 EU countries, the UK, Norway, and Switzerland. Data were collected using a 14-criterion protocol on topics like legal status, professional independence, conscientious objection, confidentiality, advertising, inter-professional relations, competition, errors, telepharmacy, digitalization, continuity of care, professional development, salary regulation, pharmaceutical services, and incompatibilities. These criteria were organized into five thematic clusters for comparison. Results: Three regulation models were identified regarding the legal status of deontological codes: (a) incorporation into primary health legislation, (b) delegation to professional bodies to establish binding corporatist codes, and (c) implementation of soft-law professional standards. While all models share an ethical focus, emphasizing patient priority and confidentiality, they differ considerably in terms of legal bindingness, sanctions, and structural safeguards of professional independence—such as pharmacists’ salaries, ownership rights, and incompatibilities. Telepharmacy is governed by different regulatory frameworks, whereas the application of AI in pharmacy practice has not yet been incorporated into existing deontological codes. Conclusions: The current deontological framework affirms professional independence but offers uneven protection; its effectiveness relies more on the legal structure, enforceability, and safeguards than on explicitly enshrined independence. EU-wide harmonization is neither legally feasible nor essential; instead, a shared minimum standard advocated by professional organizations could facilitate European coordination. The digital and AI gap is the most urgent area for deontological updates.

Antimicrobial resistance is a major public health concern associated with inappropriate antibiotic use and self-medication. This exploratory study described antibiotic self-medication practices in a convenience sample of adults in Romania by assessing antibiotic-related knowledge, attitudes, and behaviours, identifying sources of antibiotic acquisition, and exploring associations with sociodemographic factors. Data were collected through an online survey (June 2024–September 2025; N = 465). Respondents generally demonstrated good awareness of antimicrobial resistance, although misconceptions about appropriate antibiotic use remained common. Overall, 59.4% correctly recognised that antibiotics are effective only against bacterial infections, while 86.7% were aware that bacteria can become resistant to antibiotics. Antibiotics were predominantly obtained through prescription-based channels, with 97.2% reporting pharmacy dispensing upon presentation of a medical prescription. However, 7.7% reported obtaining antibiotics without a prescription, and 7.1% reported using leftover antibiotics from previous treatments. Among respondents who had used antibiotics during the previous year (n = 298), self-medication prevalence was 22.1% (95% CI: 17.8–27.2%), or 14.2% of the total sample (66/465). Exploratory sociodemographic associations were weak and item-specific. Age was associated with antibiotic treatment frequency and keeping antibiotics at home, whereas educational attainment and gender were associated only with treatment frequency. The results support responsible antibiotic use and control of antibiotic dispensing.

Antimicrobial resistance is a major global health challenge that has created an urgent need for new antibacterial agents capable of overcoming emerging resistance mechanisms. Among nitrogen-containing heterocycles, pyrrolidine has been widely investigated in medicinal chemistry due to its structural versatility, favourable physicochemical properties, and ability to enhance interactions with biological targets. This review provides a comprehensive and critical overview of pyrrolidine-based compounds investigated for antibacterial applications. Relevant studies describing clinically approved antibiotics, natural products, synthetic derivatives, hybrid molecules, and antibacterial adjuvants containing a pyrrolidine scaffold were collected, classified, and critically evaluated, with particular emphasis on structural features, antibacterial activity, and structure–activity relationships. The reviewed evidence demonstrates that the pyrrolidine moiety is present in several antibacterial drug classes, including carbapenems, cephalosporins, fluoroquinolones, lincosamides, streptogramins, and tetracyclines, where it contributes to improved target affinity, antibacterial potency, and pharmacokinetic behaviour. Numerous recently reported pyrrolidine derivatives have shown promising activity against clinically relevant, multidrug-resistant bacterial pathogens. The pyrrolidine scaffold is valuable for the design of next-generation antibacterial agents and resistance-modifying compounds, though further in vivo studies and pharmacological evaluation are required to support their clinical development.