Staphylococcal and streptococcal species trigger a wide variety of infections involving epithelial tissues. Virginian witch hazel (WH; Hamamelis virginiana L.; family: Hamamelidaceae) is a plant that has been used traditionally by Native Americans to treat a variety of skin conditions. Extracts from the leaves were examined for their inhibitory effects on these bacterial species. Solvents of different polarity (water, methanol, ethyl acetate, hexane and chloroform) were used to prepare extracts from WH leaves, and the aqueous resuspensions were screened for antibacterial activities using disc diffusion and liquid dilution assays. Extract phytochemical profiles and toxicities were also examined, and combinations of extracts with conventional antibiotics were tested against each bacterial strain. The methanolic and aqueous extracts inhibited the growth of S. oralis, S. pyogenes, S. epidermidis and S. aureus, but not S. mutans. The extracts were especially active against staphylococcal species, with MIC values between 200 and 500 μg/ml. Combinations of active extracts with conventional antibiotics failed to yield beneficial interactions, except for two cases where additive interactions were observed (aqueous WH extract combined with chloramphenicol against S. oralis, and methanolic WH extract combined with ciprofloxacin against S. aureus). Phytochemical assays indicated an abundance of tannins, triterpenoids and phenolics in the water and methanol extracts, with trace amounts of these components in the ethyl acetate extract. Phytochemicals were not detected in hexane and chloroform extracts. Thus, phytochemical abundance in extracts was concordant with antibacterial activities. All extracts were found to be non-toxic in Artemia nauplii assays. These findings indicate the potential for WH leaf extracts for clinical use in treating staphylococcal and streptococcal infections, while substantiating their traditional Native American uses.

Virginian witch hazel (WH; Hamamelis virginiana L.; family: Hamamelidaceae) is a North American plant that is used traditionally to treat a variety of ailments, including bacterial infections. Solvents of varying polarity (water, methanol, ethyl acetate, hexane and chloroform) were used to prepare extracts from this plant. Resuspensions of each extract in an aqueous solution were tested for growth-inhibitory activity against a panel of bacteria (including three antibiotic-resistant strains) using agar disc diffusion and broth microdilution assays. The ethyl acetate, hexane and chloroform extracts were completely ineffective. However, the water and methanolic extracts were good inhibitors of E. coli, ESBL E. coli, S. aureus, MRSA, K. pneumoniae and ESBL K. pneumoniae growth, with the methanolic extract generally displaying substantially greater potency than the other extracts. Combining the active extracts with selected conventional antibiotics potentiated the bacterial growth inhibition of some combinations, whilst other combinations remained non-interactive. No synergistic or antagonistic interactions were observed for any WH extracts/antibiotic combinations. Gas chromatography–mass spectrometry analysis of the extracts identified three molecules of interest that may contribute to the activities observed, including phthalane and two 1,3-dioxolane compounds. Putative modes of action of the active WH extracts and these molecules of interest are discussed herein.

Background: Hospital discharge is a vulnerable point in a patient’s journey where increased medication-related errors occur. Despite the importance of discharge summaries as a communication tool at the hospital-community healthcare interface, many factors impede doctors’ ability to prepare accurate and timely discharge summaries and medication lists. Objective: To explore junior doctors’ perceptions of the hospital discharge process. Method: Semi-structured interviews were conducted with purposively selected junior doctors (interns, residents and registrars) from a metropolitan health service between November and December 2022. The interview tool contained prompts to explore opinions and experiences relating to the discharge processes, specifically discharge summaries, medication reconciliation and collaboration between healthcare professionals. Interview transcriptions were thematically analysed. Results: Twenty junior doctors were interviewed. Five interconnected themes emerged: (1) workload and time restraints, (2) perceptions of medication reconciliation, (3) collaboration with pharmacists, (4) communication between healthcare professionals and (5) impact of organisational factors. Significant barriers to preparing discharge summaries included time pressures and high patient turnover. Factors aiding doctors included direct involvement in the patient’s care, designated time to complete discharge summaries, well-documented in-patient progress notes and availability of comprehensive admission medication information recorded by pharmacists. Conclusion : Junior doctors face significant challenges during the hospital discharge process. Under heavy workloads and high patient turnover, continuity of care can be compromised as direct patient care tasks take priority over preparing discharge summaries. Implications for health information management practice: The findings underscore the need for enhanced medicines education and support for junior doctors, alongside improved integration of pharmacist expertise, to facilitate clear, accurate and timely discharge documentation.