Annals of Mechnikov's Institute

Multidrug-resistant pathogens in crisis-affected hospitals

2026-04-06T12:49:08+03:00

Aim. This study aims to evaluate the prevalence, species distribution, and antimicrobial resistance profiles of multidrug-resistant organisms (MDROs) in hospitals affected by ongoing conflict in Kharkiv, Ukraine, during 2024–2025. The goal is to generate data to support infection control and antimicrobial stewardship in resource-limited, crisis-affected settings. Materials and Methods. An observational study was conducted across five Kharkiv hospitals from January 2024 to December 2025. Clinical isolates were collected from patients with suspected healthcare-associated infections, including bloodstream, urinary, respiratory, and surgical site infections. Bacterial identification was performed using conventional culture methods, and antimicrobial susceptibility testing was performed in accordance with EUCAST standards. Patient demographic and clinical data were analyzed to assess resistance patterns and prevalence. Results. A total of 1313 MDRO isolates were collected, mainly from wound exudates, bronchoalveolar lavage, and urine samples. The most common species were Klebsiella pneumoniae (44.4%), Acinetobacter baumannii (19.9%), and Pseudomonas aeruginosa (13.6%). Resistance to multiple antibiotic classes was widespread, especially among Gram-negative bacteria. The isolates affected a broad age range (1 month to 88 years), with males accounting for 69%. The findings highlight the significant burden of resistant bacteria in conflict-affected hospitals, driven by healthcare disruptions, increased antibiotic use, and compromised infection control. Conclusions. The study demonstrates a high prevalence of MDROs, predominantly Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa. Wound, respiratory, and urinary tracts are major reservoirs. These results emphasize the urgent need for enhanced infection prevention, antimicrobial stewardship, and ongoing microbiological surveillance to limit the spread of resistant pathogens. The data provide a crucial baseline for developing policies to combat antimicrobial resistance in conflict-affected healthcare environments. There is an imperative to enhance the capacity of the epidemiological surveillance system by integrating advanced diagnostic technologies and comprehensive information management platforms to facilitate timely detection, reporting, and response to antimicrobial resistance threats in these vulnerable settings.

Surgical clinic for the treatment of tuberculous exudative pleurisy: availability of anti-tuberculosis medicines

2026-04-04T18:05:16+03:00

Introduction. Tuberculous exudative pleurisy remains a difficult clinical problem for surgical practice, especially in wartime conditions, with disruptions in organization and limited access to medicines. The peculiarities of the disease course, the difficulties of diagnosis, and the need for invasive verification methods lead to delays in establishing a diagnosis and initiating treatment. The effectiveness of pharmacotherapy depends not only on the pharmacological properties of anti-tuberculosis drugs but also on the stability of their availability in the pharmaceutical market. Objective. To assess the availability of anti-tuberculosis drugs in the pharmaceutical market of Ukraine using clinical content analysis to ensure continuous pharmacotherapy for patients with tuberculous exudative pleurisy in surgical clinics. Materials and methods. The study was conducted in 2022–2026. The object of the study was anti-tuberculosis drugs in circulation in Ukraine. The clinical content analysis technology was used, based on the principles of evidence-based medicine, evidence-based pharmacy, and clinical-pharmacological analysis. Regulatory documents, clinical guidelines, instructions for medical use, and data from the State Register of Medicines of Ukraine were analyzed. Methods of grouping by manufacturer, statistical data processing (Sturges' formula), and regulatory, documentary, marketing, and graphic research methods were applied. Results. The presence of 41 names of anti-tuberculosis drugs on the pharmaceutical market of Ukraine was established. 4 groups of manufacturers were distinguished by the breadth of their assortment and the stability of their supply. It was found that most drugs have confirmed production quality (GMP) and bioequivalence; however, there are gaps in the availability of fixed combinations and pediatric formulations. It has been shown that the continuity of pharmacotherapy depends on the availability of alternative manufacturers, the diversity of dosage forms, and the stability of supply. Discussion. Content analysis, as an innovative tool, allows for the systematization of information about medicines and its linking to clinical needs. The results emphasize the importance of organizational support for treatment, including formulary development, procurement planning, and continuity of therapy. Attention should be paid to the risk of pharmacokinetic alterations associated with pleural localization, which may affect treatment effectiveness. Conclusions. Clinical content analysis technology is an effective tool for assessing the availability of anti-tuberculosis medicines and optimizing pharmacotherapy of tuberculous exudative pleurisy. The need to provide at least two alternative manufacturers for each active substance, and the availability of fixed combinations to increase treatment adherence and prevent therapy interruption, have been identified. The results of the study can be used to inform the development of local protocols, formularies, and procurement planning in healthcare institutions.

Pharmacotechnical and structural-mechanical characterization of hydrogels with thienoflogin

2026-03-22T18:16:56+02:00

The aim of this study was to investigate the organoleptic, pharmacotechnical, and structural-mechanical properties of Thienoflogin-containing hydrogels, as well as the effect of excipients on their rheological characteristics. Materials and Methods. The objects of the study were experimental hydrogel samples with different concentrations of Aristoflex AVC, containing either a dispersion of Thienoflogin in vaseline oil with the addition of polysorbate 80 or a dispersion of Thienoflogin in dimethyl sulfoxide. The appearance and homogeneity of the experimental samples were evaluated; colloidal stability and thermostability were assessed, and the pH of the model samples was measured. Based on measurements of structural and mechanical parameters (shear stress and dynamic viscosity), flow rheograms were constructed, and the dependence of structural viscosity on shear stress was investigated. Results. The rational combination of Thienoflogin with the gel formulation is supported by previous studies on release kinetics using the diffusion method across a semipermeable membrane. Hydrogels using excipients of different natures and properties were studied, and the optimal hydrogel composition with the best Thienoflogin release and its subsequent effective application was determined. The results of the research indicate that all experimental samples have homogeneous consistency, and their pH ranges from 5.4 to 6.1. The samples are thermostable and colloidally stable. Based on the study of the structural and mechanical properties of the experimental samples, graphs of the dependence of dynamic viscosity on shear rate were constructed. It was established that the dynamic viscosity decreases with increasing shear rate, indicating pseudoplastic behavior of the experimental samples and the disruption of the hydrogel’s internal structure under applied stress. The presence of hysteresis loops on the flow rheograms indicates sufficient thixotropy of the studied samples, allowing the gel structure to gradually recover after disruption. Experimental samples were selected that showed good consumer properties: they spread evenly on the skin surface and did not leave marks on clothing. Conclusions. The organoleptic and rheological properties of hydrogels containing Thienoflogin were studied. It was established that the developed samples exhibit non-Newtonian flow behavior and moderate thixotropic properties. It was found that the Thienoflogin hydrogel based on the gelling agent Aristoflex AVC at a concentration of 1.5 % demonstrates satisfactory quality parameters and consumer characteristics.

Medical Technologies. Pharmaceutical Cosmetology, Cosmeceuticals Based on Herbal Medicines: Modern Trends and Regulatory Approaches

2026-04-09T18:10:31+03:00

Introduction. Modern cosmetology is characterized by the integration of medical technologies, pharmaceutical and cosmetic approaches, which led to the formation of cosmeceuticals as a separate direction. A special place in cosmeceuticals is occupied by phytopreparations that contain biologically active substances (flavonoids, carotenoids, triterpenoids) and provide a complex effect on the skin. Purpose of the study. To analyze the role of herbal remedies in cosmeceuticals on the example of Calendula officinalis L. (calendula extract), to conduct a comparative analysis with the requirements of Deutsches Arzneibuch (DAB), as well as to perform a SWOT (Strengths, Weaknesses, Opportunities, Threats)- and PESTEL (Political, Economic, Social, Technological, Environmental, Legal) analysis of the development of phytocosmeceuticals. Materials and methods. Documentary analysis of scientific sources and regulatory documentation, comparative analysis of pharmacopoeia requirements, pharmacological analysis of biologically active substances (quercetin, β-carotene, oleanolic acid derivatives), as well as SWOT and PESTEL analysis were used. Cosmeceutical preparations, in particular Calendula ointment (International Nonproprietary Name: Calendula extract) and dexpanthenol agents (chemical name: (R)-2,4-dihydroxy-N-(3-hydroxypropyl)-3,3-dimethylbutanamide) were studied. Results. It has been established that herbal remedies provide anti-inflammatory, antiseptic, antioxidant, and regenerative effects due to their multicomponent composition. Calendula extract has been shown to be effective in the treatment of inflammatory and degenerative skin conditions. It has been found that the requirements of DAB are more stringent and provide for standardization according to marker compounds and the use of chromatographic methods (TLC - (Thin-Layer Chromatography), HPLC (High-Performance Liquid Chromatography). SWOT analysis demonstrated the strengths of phytocosmeceuticals (naturalness, biocompatibility) and limitations (composition variability), while PESTEL analysis confirmed the significant impact of macroeconomic and regulatory factors on the development of the industry. Conclusions. Herbal remedies are a promising area of cosmeceuticals that combines effectiveness and safety. Calendula officinalis L. is one of the key ingredients in modern cosmeceuticals. It is necessary to improve the standardization system in accordance with European requirements and introduce innovative technologies to improve the quality of products.

Determination of CD4+ cell count and viral load in hiv-positive patients as possible indicators of art effectiveness

2026-03-26T16:46:09+02:00

The introduction of antiretroviral therapy (ART) among patients formerly naïve to treatment leads to suppression of HIV replication and CD4+ cell count recovery. The global response to end Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) by 2030 is critically dependent on effective viral load (VL) monitoring and management cluster of differentiation 4 (CD4+) cell count recovery after initiation of ART is a potential indicator of HIV patient’s clinical outcome and an increase in CD4+ cell count indicates a favourable outcome related with both AIDS and non–AIDS-related conditions and the improvement in life expectancy. Early initiation of antiretroviral therapy (ART) is essential for suppressing viral replication, enhancing immune function, and reducing morbidity and mortality rates. In conclusion, CD4+ cell count failed to recover in a substantial proportion of patients initiating ART in this resource-limited setting. Therefore, novel therapeutic approaches, with good access to CD4+ cell count monitoring and a focus on those at greatest risk, are needed to maximize CD4+ cell count recovery and improve outcomes during therapy. VL suppression was low among the patients. Health promotion activities are needed for people who have been suppressed to maintain and achieve a lifetime undetectable VL, targeting the younger age group.

Integrative Transcriptomic Immune Scoring and Network Topology Reveal ME13-Driven Spatial Heterogeneity in Glioblastoma

2026-04-07T21:46:12+03:00

Glioblastoma (GBM) is one of the most aggressive and heterogeneous variants of brain cancer; it is associated with intricate connections between pathways of proliferative signaling and modulation of the immune system. The paper shall clarify how to explain immune-relevant transcriptional programs in GBM by an integrative gene co-expression network analysis. Powered by normalized expression data of 17,362 genes in the GSE16011 dataset, Weighted Gene Co-expression Network Analysis (WGCNA) was used to build functional coherent modules, and ME13 turned out to be the one most significant to the infiltration of immune cells (r = 0.82, p < 0.001). The gene-gene interaction network identified five crucial central hub genes, including GIMAP4, CD84, KRT23, KLF9, and RCBTB2, which are correlated with FOXP3 and CD8A expression, suggesting their possible regulatory roles in the dynamic processes of cytotoxic T cells and Tregs. To put the pattern of spatial activation into context, overlaying and GSVA scoring of Grad-CAM revealed a wide variety in the immune landscape within glioblastoma tissues. This multimodal combination illustrated the presence of ME13 in IL-17 and the p53 signaling pathway, as well as its value for immune stratification. The results not only provide the molecular framework for interpreting immune heterogeneity in GBM but also reveal the potential of hub genes as therapeutic targets and for future diagnostic profiling. Although some constraints will emerge due to the absence of experimental verification, the study paves the way for translation through multi-omics platforms and spatial immunogenomics.

Determination of some numerical indicators of different types of plant raw materials of Onopordum acanthium L.

2026-04-04T11:40:04+03:00

Introduction. Today, the popularity of phytochemical research has been steadily increasing. Plants of the Asteraceae family have attracted considerable attention. The genus Onopordum of the Asteraceae family includes over 50 species, which are widespread in Eurasia, northern Africa and are invasive in North America. The chemical composition and biological properties of the plant raw material of Onopordum acanthium have been most extensively studied. Plant raw material of Onopordum acanthium contains soluble sugars, inulin, proteins, fatty oil, saponins, sesquiterpene lactones, triterpenes, sterols, phenolic compounds (phenolcarboxylic acids, coumarins, flavonoids, tannins) and alkaloids. Extracts from plant raw material have traditionally been used as a bactericidal, cardiotonic, hemostatic and diuretic agent, for the treatment of nervousness, as an antitumor agent, and for the treatment of inflammation of the bladder, respiratory and urinary systems. We conducted marketing research on domestic producers of Onopordum acanthium plant raw materials (grass, flowers and fruits are available) and dietary supplements with extracts from this plant. The aim is to determine the quantitative content of total polyphenols, total hydroxycinnamic acids and total flavonoids in Onopordum acanthium plant raw materials of different phenological phases of harvesting. Materials and methods. Plant raw materials were harvested in the corresponding phases of vegetation from wild specimens of Onopordum acanthium in the summer of 2025 in the village of Velyka Babka, Chuhuyiv district, Kharkiv region (series 1), the village of Trybusivka, Tulchyn district, Vinnytsia region (series 2) and on the outskirts of Nizhyn, Chernihiv region (series 3). Leaves and stem before the beginning of flowering in the vegetative phase (May), stem leaves and stem in the mass flowering phase (June), fruits in the mass fruiting phase (July) with subsequent air-shade drying. The quantitative content of total polyphenols in terms of pyrogallol, of total hydroxycinnamic acids in terms of chlorogenic acid and of total flavonoids in terms of hyperoside was determined according to the method of the State Pharmacopoeia of Ukraine (SPhU) 2.0. Results and discussion. The obtained results of determining the quantitative content of each of the BAS groups are comparable for each of the plant raw material series. For all types of plant raw materials and all series, the following pattern is observed: the content of total polyphenols>the content of total flavonoids>the content of total hydroxycinnamic acids. The highest content of BAS is observed in the leaves in the mass flowering phase: the content of total polyphenols in terms of pyrogallol is the highest of the determined groups of compounds and ranges from 7.14 ± 0.02 % (series 3) to 7.85 ± 0.02 % (series 2); the content of total hydroxycinnamic acids in terms of chlorogenic acid is 1.04 ± 0.01 % (series 3) – 1.54 ± 0.01 % (series 2). The content of total flavonoids in terms of hyperoside ranges from 4.13 ± 0.02 % (series 1) to 5.02 ± 0.02 % (series 2). Conclusions. For the first time in domestic series of a number of types of plant raw materials of Onopordum acanthium from different places of collection, the quantitative content of total polyphenols, total hydroxycinnamic acids and total flavonoids was determined. The dynamics of the accumulation of each group of BAS was traced depending on the vegetation phase and place of growth. The lower limits of the quantitative content of each group of BAS in each type of plant raw material were also established. The most attractive in this regard are leaves in the mass flowering phase, for which the content of total polyphenols was not lower than 7.1 %, total hydroxycinnamic acids was not lower than 0.54 %, total flavonoids – not lower than 4.15 %.

The role of the Herpesviridae family in the development of Long COVID

2026-03-09T17:30:28+02:00

The aim of this study was to investigate the activity of viruses from the Herpesviridae family in the leukocytes of patients with long COVID. Materials and Methods. Following a case-control design, the study included 52 patients with long COVID (Group 1). These patients were matched with "pairs" from those who had contracted COVID-19 and fully recovered within 3 months of disease onset (Group 2). The diagnosis of long COVID was established based on WHO criteria. Detection of Herpesviridae family antigens was performed by immunofluorescence using specific monoclonal mouse antibodies (MyBiosource, USA). Results. The Groups were comparable in terms of gender (32 women and 20 men in each Group) and age (52,6 ± 21,3 years vs 50,2 ± 20,6 years), p = 0,56. HSV 1, 2: there were 42 (80,8 %) patients with medium or high viral loads in Group 1 vs 16 (30,8 %) in Group 2, р < 0,0001. VZV: evaluation showed similar trends: 15 (28,8 %) patients had medium or high viral loads in Group 1 vs 4 (7,7 %) in Group 2, р = 0,006. EBV: fifteen (28,8 %) patients in Group 1 had medium or high viral loads vs 2 (3,8 %) in Group 2, р = 0,0006. CMV: twenty-five (48,1 %) patients in Group 1 had medium or high viral loads vs 3 (5,8 %) in Group 2, р < 0,0001. HHV 6: 25 (48,1 %) patients in Group 1 had medium or high viral loads vs 11 (11.5%) in Group 2, р < 0,0001. Conclusions. Our study provides valuable insights into the complex relationship between COVID-19 and Herpesviridae infections, offering a scientific basis for developing public health policies and interventions. Collectively, these findings suggest that latent viral infections should be considered a causative factor for the long COVID condition. Screening and prevention programs for these conditions may be considered.

Lesion of the Urinary Bladder Microbiome in Neurogenic Dysfunction after Spinal Cord Injury

2026-04-28T12:17:18+03:00

Introduction. Spinal cord injury is one of the most severe forms of neurological damage. It almost always leads to neurogenic bladder dysfunction. This, in turn, leads to a high incidence of recurrent urinary tract infections, which are linked to disturbances in the urobiome. The aim of the study is to summarize current scientific data on bladder microbiome disorders in neurogenic dysfunction after spinal cord injury and to assess the impact of drainage methods, antibiotic therapy, and microbiome-oriented interventions on the course of urinary tract infections. Materials and methods. The study was conducted in a systematic review format in accordance with PRISMA recommendations. Clinical, experimental, and randomized studies were analyzed, followed by qualitative and quantitative data synthesis. It was established that neurogenic dysfunction after spinal cord injury is associated with persistent urobiome dysbiosis, characterized by decreased alpha diversity and a reduction in Lactobacillus spp., with the dominance of Enterobacteriaceae and Pseudomonadaceae. Intermittent self-catheterization is associated with a lower incidence of urinary tract infections and greater microbiome diversity than indwelling catheterization. A high level of antimicrobial resistance was identified, including ESBL-producing strains and carbapenem-resistant Pseudomonas aeruginosa, which sustains a vicious cycle of «dysbiosis – infection – antibiotic therapy». The potential effectiveness of probiotic and immunotropic strategies has been demonstrated, with reductions in infection recurrence rates of 21–32%. The practical value of the results lies in the systematization of data on the disruption of the uromicrobiome, a key element in the pathogenesis of neurogenic dysfunction after spinal cord injury. It is substantiated that microbiome-oriented approaches, early monitoring, and catheterization optimization can significantly improve infection prevention and rehabilitation outcomes. Conclusions. Spinal trauma leads to deep dysbiosis of the uromicrobiome. It is seen as a decrease in the alpha-diversity index and in Lactobacillus spp. Less than 5 % and predominance of E. coli (38–45 %), K. pneumoniae (18–24 %) і P. aeruginosa (12–17 %). Draining of the urinary bladder really influences the microbiological profile. Interruptable catheterization is associated with the lowest frequency of symptomatic urinary tract infections and the highest microbial diversity index. Constant urethral catheterization leads to the formation of stable polymicrobial biofilms and a threefold increase in microbiota abundance. Antimicrobial resistance in neurogenic dysfunction after spinal trauma remains critically high. ESBL-production revealed in 34–58 % of isolates, whereas carbapenem-resistance of P. aeruginosa was found in 15–22 % cases. Тривале та нераціональне використання антибіотиків є незалежним чинником поглиблення дисбіозу (OR = 2,4; 95 % ДІ: 1,7–3,4), підтримуючи порочне коло та вимагаючи принципово нових терапевтичних підходів. Microbiome-oriented correction strategies show clinically important efficacy. Intravesical introduction of L. rhamnosus GG decreases frequency of recurrent urinary infections in 32 % (95 % DІ: 18–46 %), usage of Uro-Vaxom на 21 % (95 % DІ: 8–34 %). Transplantation of fecal microflora has shown promise in animal models. Early microbiological monitoring with molecular typing, application of interruptible self-catheterization, are priorities of preventive medicine in spinal trauma. Perspectives of future investigations are connected with randomized clinical examinations of fecal microflora transplantation, elaboration of personal uromicrobial profiling on the basis of new generation sequencing.

Features of Local Treatment of Onychomycosis

2026-05-04T08:24:33+03:00

Recently, the incidence of onychomycosis has been increasing. This is facilitated by poor nutrition, poor personal hygiene, decreased immunity, and changes in the body’s immune reactivity. Systemic therapy carries a risk of adverse and toxic effects. Local therapy has several advantages, the main one being minimal side effects. The antifungal agent is applied directly to the affected nail plates and is rapidly absorbed. The concentration of the antifungal agent in the lesion is sufficient to suppress the activity of pathogenic fungi. The use of topical drugs during and after systemic therapy can reduce its duration and prevent recurrence. Topical treatment begins with mechanical removal of the affected portion of the nail plate and the use of keratolytic agents (e.g., urea and salicylic acid). Local antifungal drugs include azole derivatives. They disrupt ergosterol biosynthesis by inhibiting the conversion of lanosterol to ergosterol through inactivation of the enzyme 14α-demethylase, resulting in a fungistatic effect. Allylamines inhibit squalene epoxidation and its conversion to lanosterol by inactivating the enzyme squalene epoxidase. This leads to ergosterol deficiency in the cell membrane and accumulation of the toxic substance squalene in fungal cells, causing their death. Antifungal nail lacquers include terbinafine, amorolfine and ciclopirox. Amorolfine inhibits two fungal enzymes – delta-14-reductase and delta-7-8-isomerase – involved in ergosterol biosynthesis. This results in the accumulation of toxic metabolites such as squalene and desmethylsterol, leading to fungal cell death. Ciclopirox accumulates in fungal cells at high concentrations, damages the fungal cell wall, disrupts the functions of mitochondria and ribosomes, and blocks the transport of potassium ions, phosphates, and amino acids, ultimately leading to fungal death. Despite the long duration of treatment, local therapy for onychomycosis remains a safe and affordable approach to treating fungal nail infection. Timely initiation of treatment and regular procedures significantly increase the chances of complete recovery of the nail plate and prevention of reinfection.

Analysis of the National Market of Herbal Medicinal Products Used in the Treatment of Hepatobiliary Disorders

2026-05-04T09:33:38+03:00

Introduction: Chronic liver diseases are a significant medical and social issue, characterized by high prevalence and a tendency toward chronicity. Herbal medicines play an important role in the pharmacotherapy of hepatobiliary disorders due to their multifaceted pharmacological effects and favorable safety profile. Analyzing the structure of the pharmaceutical market for these products is relevant to assessing the market's characteristics and identifying development prospects. Objective: To investigate the structure of the domestic market of herbal medicines for hepatobiliary disorders and to substantiate the feasibility of developing a novel oral gel formulation based on dry extracts of Silybum marianum and Scutellaria baicalensis. Materials and Methods: Data from the State Register of Medicines of Ukraine as of 01.02.2026, WHO ATC classification, and publicly available pharmacy catalogs were analyzed. Structural analysis classified medicines by ATC subgroups, dosage forms, and composition (mono- or multicomponent). Logical and comparative analyses were conducted to assess the shares of domestic and foreign manufacturers and to compare the Ukrainian market structure with those of Poland and Germany. Graphical analysis was used to visualize the results in tables and figures. Results and Discussion: The analysis revealed that a substantial number of medicines for hepatobiliary disorders are registered in Ukraine (ATC group A05). Domestic products dominate the A05AX-10 subgroup (83.7%), while Ukrainian manufacturers account for 57.1% of the silymarin segment (A05BA03). Solid oral dosage forms predominate (~60%), with liquid forms and herbal raw materials underrepresented. A comparative analysis of the Polish and German markets demonstrated the successful application of oral gels in related gastroenterological categories (antacids, enterosorbents), supporting their potential introduction in hepatology. Conclusions: The pharmaceutical market for hepatobiliary medicines is characterized by a high share of domestic herbal products and predominance of solid dosage forms. The development of oral gels based on herbal raw materials is feasible to enhance therapeutic efficacy.

Resistance of Klebsiella pneumoniae and Escherichia coli to β-lactam antibiotics: prevalence and mechanisms of rapid spread

2026-04-22T17:08:13+03:00

The growth of antibiotic resistance (ABR) in common bacterial pathogens is a global threat to public health and healthcare systems worldwide. The problem has been widely recognized as highly significant, prompting rigorous surveillance and comprehensive studies of the molecular mechanisms underlying ABR development and spread. This publication aimed to review current data concerning beta-lactam antibiotic (BLA) resistance in major nosocomial pathogens, Escherichia coli and Klebsiella pneumoniae. Materials and methods. Review of relevant articles retrieved by a search of the PubMed, Cochrane Library databases, and WHO published data. Results and discussion. In 2017, the WHO, for the first time, published a list of 12 families of antibiotic-resistant pathogens (Bacterial Priority Pathogens List (BPPL)) posing the greatest threat to human health. Escherichia coli and Klebsiella pneumoniae were classified in the critical priority category. The updated 2024 version of BPPL comprises three additional families and continues to categorize carbapenem-resistant Enterobacterales as a critical priority. Infections caused by Gram-negative enteric bacilli have been treated with BLA for a long time. This prompted the evolution of various bacterial resistance mechanisms, particularly numerous types of β-lactamases (β-lactam-degrading enzymes), including extended-spectrum β-lactamases (ESBLs). This trend is also observed in Ukraine: in 2014-2020, the average rate of BLA resistance among Enterobacterales strains isolated from surgical site infections was 60,0-65,0%, reaching 85,0-100,0% in the ICU. Unfortunately, the current national research infrastructure fails to generate sufficient genomic data, hindering reliable assessment of the local spread of ESBL. The review highlights the diversity and quick molecular evolution of multiple BLA-resistance mechanisms in Escherichia coli and Klebsiella spp., as well as the role of horizontal gene transfer in their spreading. Monitoring this process in hospital settings is crucial for developing a reasonable strategy to overcome ABR and requires implementing genomic surveillance of antimicrobial resistance.

Cost of migraine attack control: comparative characteristics of rizatriptan preparations on the pharmaceutical market of Ukraine

2026-03-12T12:08:37+02:00

The aim of the study was to conduct a marketing and pharmacoeconomic study of rizatriptan drugs circulation in Ukraine for abortive migraine therapy, analyzing availability and treatment cost. Materials and Methods. The study was observational, retrospective-prospective. Objects included data from the State Register of Medicines of Ukraine (December 2024–2025), pharmacy network data, and official instructions. Webometric method, comparative analysis, and pharmacoeconomic cost minimization analysis were applied. The cost of migraine attack control (VCP) was calculated considering dosage, frequency, and packaging in six regional centers: Dnipro, Kyiv, Lutsk, Lviv, Odesa, Kharkiv. Results. Positive market dynamics were established: registered trade positions increased by 40% (from 5 to 7). Manufacturer geography expanded due to the Indian company "MacLeods" (28.6% share). The 10 mg dosage is more cost-effective than 5 mg, as the latter requires two tablets, increasing cost by 4.5 UAH. The most beneficial drug is "RIZAMIGREN 10 mg No. 3" by LLC "Pharmaceutical Company Health" (VCP 53.99–56.50 UAH). The most expensive is "RIZOPTAN® 10 mg No. 3" (up to 80.16 UAH). Treatment cost varies by location: minimum in Lutsk, maximum in Odesa. Larger packaging reduces single dose cost by almost 20%. Conclusions. The rizatriptan market in Ukraine is evolving, attracting new manufacturers. For patients, the optimal choice is "RIZAMIGREN 10 mg No. 3". There is significant cost variability between regions and trade names, amounting to overpayment up to 48%. As of 2025, rizatriptan is absent from the reimbursement program, but growing competition and domestic manufacturers create prerequisites for its possible inclusion in the "Affordable Medicines" program soon.

Solubilizer choice justification of the antiviral ointment composition

2026-03-02T14:35:11+02:00

Introduction. Modern pharmacy aims to create highly effective dosage forms with an improved safety profile. The rise in mixed viral-bacterial infections, particularly herpesvirus lesions, necessitates the development of combination drugs with synergistic effects. Optimization of the solubility of hydrophobic APIs is a critical stage in the pharmaceutical development of soft dosage forms. Increasing the degree of dispersion and solubility of active substances in an ointment base ensures the formation of a thermodynamically stable system, thereby guaranteeing dosage uniformity, improving release kinetics, and increasing the drug's bioavailability. The use of solubilizers, optimization of viscoelastic properties, and control of temperature parameters in the technological process provide a significant increase in the efficiency of the transport of active substances into the skin and in their pharmacological activity. The aim: experimental justification of the choice of solubilizer and its concentration to ensure optimal dispersion of acyclovir in the composition of a combined ointment with antiviral and antimicrobial action. Materials and methods. The work used APIs of acyclovir and miramistin. Cetyl stearyl alcohol and glycerol monostearate, at concentrations of 1.0% to 5.0%, were studied as solubilizers. The study of the dispersion of acyclovir particles was conducted using optical microscopy with a Granum R-40 microscope and morphometric analysis software. Results and discussion. It was established that the introduction of solubilizers significantly affects the size of acyclovir particles in the ointment base. The best results were demonstrated by cetyl stearyl alcohol at a concentration of 3.0%. It was shown that increasing the preparation temperature from 65 °C to 75 °C does not significantly affect particle dissolution, allowing the 65 °C mode to be chosen as energy-efficient and safe for component stability. Conclusions. To ensure a high degree of dispersion of acyclovir in the composition of the ointment, the use of the solubilizer SCS at a concentration of 3.0% at a manufacturing temperature of 65 °C is justified.

Study of the elemental composition of Hieracium pilosella

2026-05-04T09:44:28+03:00

Introduction. Minerals are essential nutrients that play a critical role in maintaining human health by regulating a wide range of physiological functions. These include, in particular, bone formation, enzyme activity, nerve impulse transmission, and immune response. Both mineral deficiency and excess may have significant health consequences. Therefore, the search for natural sources of elements – such as medicinal plants – is well justified as part of a comprehensive approach to the prevention and treatment of various diseases. In this context, our attention was drawn to a native plant species—Hieracium pilosella—which is widely distributed across Ukraine and has a sufficient supply of raw material. Hieracium pilosella L. (mouse-ear hawkweed) is a common and highly invasive weed belonging to the Asteraceae family. It is a perennial plant with a basal rosette of leaves, the underside of which is covered with whitish hairs. The flowering stem usually reaches up to 30 cm in height and bears a single pale-yellow inflorescence, with marginal ligulate flowers showing a reddish tint on the underside. Herba Pilosellae is well known in European ethnomedicine and is used to treat urinary tract inflammation and skin diseases due to its diuretic, astringent, antiseptic, and anti-inflammatory properties. Hieracium pilosella may also be used in the phytotherapy of hypertension and obesity due to its pronounced diuretic effect. This medicinal plant is not described in the European Pharmacopeia, but it has a monograph in the French Pharmacopeia. Preparations from Hieracium pilosella have been known and used for centuries in Polish folk medicine to treat cystitis, nephritis, urolithiasis, as well as cough and inflammatory respiratory conditions, and associated bleeding. For external use, plant extracts are applied to treat infected wounds. In Le Livre des Plantes Médicinales et Vénéneuses de France (Fournier, 1948), the following properties of the plant are described: diuretic action, as well as aperitive and depurative effects, astringent, wound-healing (vulnerary), and bactericidal activities. In Ressources Médicinales de la Flore Française (Garnier et al., 1961), Hieracium pilosella is characterized as a dechlorinating and azoturic diuretic. Its use is reported for influenza, brucellosis (as an infusion), and to enhance diuresis. The plant has also been used in combination with other herbs for rheumatism, gout, and urolithiasis. In Précis de Matière Médicale (Paris and Moyse, 1971), Hieracium pilosella is noted for its pronounced diuretic activity; the whole plant is used as infusions or decoctions and is considered useful in brucellosis. According to the British Herbal Pharmacopeia (1979), Pilosella herba exhibits the following therapeutic effects: when administered orally, spasmolytic, expectorant, anticatarrhal, diuretic, and sialogogue; when applied topically, wound healing. Indications include bronchitis, bronchial asthma, whooping cough, hemoptysis, and edema. Externally, it is used for hernias and fractures as lotions or compresses. Specific indications include whooping cough, pulmonary diseases with excessive sputum production, chest pain, and hemoptysis. Aim of the study. To investigate the qualitative composition and quantitative content of macro- and microelements in Hieracium pilosella herb in order to expand knowledge about its chemical composition and assess the prospects for its further use. Materials and Methods. The study used plant material of the Hieracium pilosella herb (supplier: LLC “Greenmilya”, Kharkiv). Elemental composition was determined using atomic emission spectrography, which is based on the evaporation of plant ash in an electric arc discharge, photographic recording of the emitted spectrum, and measurement of the intensity of spectral lines of individual elements. Results and Discussion. The content of 15 macro- and microelements was determined in the Hieracium pilosella herb. The levels of heavy metals in the studied raw material, determined by atomic emission spectrography, were within the permissible limits established for food products and plant materials. Based on the experimental data, the total ash content of the herb was 12.27 ± 0.12%. Among macronutrients, the dominant elements were: potassium (3900 µg/100 g), silicon (1100 µg/100 g), and calcium (920 µg/100 g). These accounted for 55%, 16%, and 13% of the total elemental content, respectively. Among trace elements, the predominant ones were: aluminum (245 µg/100 g), iron (185 µg/100 g), zinc (86 µg/100 g), and manganese (21 µg/100 g). The general pattern of quantitative distribution of elements was as follows: macroelements: K > Si > Ca > Mg > P > Na, microelements: Al > Fe > Zn > Mn > Ni > Mo. Conclusions. Using atomic emission spectroscopy, the content of macro- and microelements in the Hieracium pilosella herb was determined. A total of 15 elements were identified in the raw material studied. Among macronutrients, potassium (3900 µg/100 g), silicon (1100 µg/100 g), and calcium (920 µg/100 g) predominated; among trace elements, aluminum (245 µg/100 g), iron (185 µg/100 g), zinc (86 µg/100 g), and manganese (21 µg/100 g).

Study of the composition of fatty and amino acids in the common pear leaves of lisova krasunya variety

2026-02-19T13:02:06+02:00

Introduction. One of the most common groups of biologically active substances formed in plants is amino acids, which are found in plant proteins. They are known to be necessary for the synthesis and metabolism of specific tissue proteins, nucleic acids, bile acids, antibodies, complex carbohydrates, enzymes, fats, hormones, antibiotics, and other amino acids, and for the normal functioning of organs and systems of the human body. In medicine, they are widely used for parenteral nutrition (especially during resuscitation), treatment of diseases of the digestive system, anemia, burns, stomach ulcers, neuropsychiatric and epileptic seizures, for pharmacotherapeutic correction of disorders of the hepatobiliary system, and cancer. Medicines containing amino acids are used for premature aging, congenital and acquired metabolic disorders, the negative effects of ionizing radiation on the body, and acute and chronic poisoning with various substances. They have a positive effect on human cardiovascular and brain activity, promote the restoration of liver and kidney function, improve absorption, prolong the therapeutic effect, and potentiate the action of the main biologically active compounds of plant origin. Plants are the largest source of amino acids (almost 30%), which are found in a free or bound state. Therefore, the use of amino acids in the prevention and treatment of many diseases is becoming increasingly important in many countries, and research in this area is revealing new functions of amino acids and their specific effects on the human body. Essential polyunsaturated fatty acids, in particular ω-6 and ω-3, are no less important for human health. They affect metabolism and nervous system function, participate in fat metabolism, help lower cholesterol levels, prevent the development of atherosclerosis, lower blood pressure, improve blood circulation, reduce the risk of anemia, and prevent inflammation. Moreover, these compounds improve cellular and tissue trophism, stimulate the immune system, serve as precursors of prostaglandins, and positively affect the growth and normal development of the child's body. It is known that omega-3 polyunsaturated fatty acids increase the fluidity of cell membranes, increase the number of receptors and the affinity of insulin for them, and increase the number of glucose transporters, which may represent a promising direction in the treatment of diabetes mellitus. Therefore, the search for promising plant sources of polyunsaturated fatty acids and amino acids is a relevant direction in pharmaceutical science, aimed at developing effective domestic medicines and dietary supplements based on them. The aim of the study was to investigate the qualitative composition and quantitative content of amino and fatty acids in the leaves of the common pear variety Lisova Krasunya, which is widely cultivated in Ukraine. Materials and methods. We selected leaves of the common pear variety Lisova Krasunya, harvested in June 2025 in the Kharkiv region, as the object of our study. The fatty acid composition was studied using a gas chromatograph (Agilent Technologies 7890B) with a mass spectrometric detector (5977 B). The amino acid composition was studied using ion-exchange liquid column chromatography on an AAA T-339M automatic amino acid analyzer manufactured by Microtechn (Czech Republic) and equipped with a recording photocell. Results and discussion. Seven fatty acids were found in the leaves of the common pear variety Lisova Krasunya: four saturated and three unsaturated. Among the identified saturated acids, a significant content was found for palmitic acid – 8.76 ± 0.23%. The predominant unsaturated fatty acids were α-linolenic (46.51 ± 0.42%) and linoleic (42.38 ± 0.37%). The lowest content among saturated acids was stearic acid (0.19 ± 0.05%), and among unsaturated acids, palmitoleic acid (0.23 ± 0.06%). It should be noted that unsaturated fatty acids significantly prevailed in the total content of the leaves of the common pear variety Lisova Krasunya – 89.12%. Sixteen amino acids were found in the leaves of the common pear variety Lisova Krasunya: 7 essential, 5 conditionally essential, and 4 replaceable. The raw material studied contained significant amounts of glutamic and aspartic acids, leucine, and slightly lower levels of lysine, isoleucine, phenylalanine, arginine, and valine. Cysteine and tyrosine were identified in minor amounts. It should be noted that, in terms of total content in the leaves of the common pear variety Lisova Krasunya, replaceable amino acids slightly prevailed – 56.49%. Among the essential amino acids, which are of greatest interest to the human body, leucine (4.98 ± 0.10%), lysine (3.28 ± 0.07%), and phenylalanine (3.13 ± 0.06%) predominated in terms of content. They accounted for about 25% of the total amino acid content. It should be noted that the content of some essential amino acids (leucine, isoleucine, lysine, phenylalanine + tyrosine, threonine, valine, and histidine) slightly exceeds the FAO/WHO level (for adults). Conclusions. The fatty acid composition of leaves of the common pear variety Lisova Krasunya was studied using chromatography-mass spectrometry. Seven fatty acids were identified, of which four were saturated (palmitic, stearic, arachidonic, and heneicosanoic acids) and three were unsaturated (α-linolenic, linoleic, and palmitoleic acids). Among the unsaturated fatty acids, α-linolenic acid dominated, and among the saturated fatty acids, palmitic acid dominated. The amino acid composition of the leaves of the common pear variety Lisova Krasunya was studied using ion-exchange liquid chromatography. Sixteen amino acids were identified, among which glutamic, aspartic acids, and leucine dominated. The studies confirm the promise of further phytochemical research on the leaves of the common pear variety Lisova Krasunya and the possibility of using the plant's raw materials as a source of amino and fatty acids.

Blastocystosis: principles and methods of treatment (Information letter)

2026-04-23T13:58:43+03:00

Blastocystosis is a common protozoan intestinal disease in humans, caused by unicellular, anaerobic eukaryotic parasites of the genus Blastocystis, which primarily colonize the large intestine, leading to functional and pathomorphological disorders in the digestive system and other organs and tissues. All patients with blastocystosis (both immunocompromised and immunocompetent) require complex treatment, an important component of which is etiotropic therapy. Since there are still no generally accepted guidelines for the etiotropic therapy of blastocystosis, the modern approach to the selection and dosing of antiprotozoal agents is based on data on the sensitivity of regional clinical strains of Blastocystis sp. to these agents, which is most often determined by in vitro tests. Based on the results of an in vitro study of the susceptibility of 15 Blastocystis sp. strains isolated in Ukraine from patients with blastocystosis to the action of predictive bioequivalent concentrations (PBCs) of a group of antiparasitic drugs, it was established that all parasite isolates were most sensitive to nitazoxanide (NTZ), paramomycin (PAR), metronidazole (MTZ), and moderately sensitive to co-trimoxazole (COT; trimethoprim/sulfamethoxazole). Taking into account the experimental data and actual circumstances, when NTZ and PAR are not yet registered in Ukraine, it is proposed to use MTZ as a first-line drug for the etiotropic therapy of patients with blastocystosis, and COT as an alternative second-line drug. To increase the effectiveness of blastocystosis treatment, it is recommended to follow these dosage rules for these medications. MTZ dosage: 500 mg, three times a day (every 8 hours), for a course of 7–10 days. COT dosage: 1920 mg (320 mg trimethoprim/1600 mg sulfamethoxazole), twice daily (every 12 hours), for a course of 7–10 days. The performance of blastocystosis treatment is assessed using clinical and parasitological efficacy criteria.

Method of treating proctology diseases (Information letter)

2026-04-23T13:23:51+03:00

A method for treating proctological diseases using suppositories containing hop essential oil in combination with diclofenac sodium is proposed. The use of this method will increase the effectiveness of treating proctological diseases due to the complex effect of the developed composition on the course of the diseases.

Assessment of benefit-risk ratio of antibiotics in pharmacovigilance: systematic analysis of international databases

2026-05-04T08:52:27+03:00

Introduction. To conduct a systematic analysis of benefit-risk profiles of commonly used antibiotics based on international pharmacovigilance databases for the period 2021–2026. Materials and methods. Data were analyzed from VigiBase, FDA Adverse Event Reporting System (FAERS), EudraVigilance, and the National Register of Adverse Drug Reactions of Ukraine. The benefit-risk assessment included frequency and severity of adverse events, clinical efficacy from randomized controlled trials, and population characteristics. Statistical analysis used proportional reporting ratios and relative risk calculations. Results and discussion. Analysis of over 20 million adverse event reports showed that antibiotic-related adverse events increased from 2.8 million cases in 2021 to 3.4 million in 2025 (21.4% increase). Gastrointestinal disorders (28.3%), allergic reactions (19.5%), and hepatotoxicity (12.4%) were most frequently reported. Penicillins demonstrated the best benefit-to-risk ratio (8.5:1), followed by third-generation cephalosporins (6.2–6.8:1). Macrolides and fluoroquinolones showed moderate ratios (2.8–3.5:1), while aminoglycosides had the poorest ratios (1.8–2.0:1). In Ukraine, 2,456 antibiotic-related adverse events were reported (18.3% of all adverse drug reactions), with medication dosing errors in 34.2% of antibiotic-treated patients. Conclusions. Penicillins and third-generation cephalosporins are first-line antibiotics with superior benefit-to-risk profiles suitable for most clinical situations. Macrolides and fluoroquinolones require cautious use with monitoring. Aminoglycosides should be reserved for limited situations, with mandatory monitoring of renal and hearing function. Ukraine requires improvements in adverse event reporting systems and enhanced physician awareness regarding antibiotic safety.