<p><strong>Introduction. </strong>Antibiotic resistance is a major threat to public health globally. The aim was to examine the impact of the COVID-19 pandemic on the distribution and antimicrobial resistance of pathogenic microorganisms isolated from samples&nbsp;<br />obtained during standard hospital care in one hospital center. &nbsp;<br /><strong>Methods.</strong> Data were obtained retrospectively from a database of the hospital microbiology laboratory. Study sample consisted of 3012 samples tested before the pandemic in 2019 and 3130 samples from the pandemic period in 2021.&nbsp;<br /><strong>Results.</strong> There was no statistically significant difference in the occurrence of agents that were resistant to all antibiotics between the observed years, but there was the difference in the occurrence of those agents between departments, with the highest frequency in the intensive care unit and the COVID-19 department (p&lt;0.001). Isolation of Acinetobacter bacteria increased 2.7 times, and Clostridioides difficile 6.4 times during 2021 compared to 2019. Statistically significant differences were registered in resistance to: imipenem, piperacillin-tazobactam, ceftayidime, cefepime, glycopeptides, aminoglycosides, levofloxacin and ciprofloxacin in 2021 compared to 2019.&nbsp;<br /><strong>Conclusion. </strong>Our results suggest possible influence of COVID-19 on antimicrobial resistance and input a need for a new larger study addressing this issue.</p>

Background: Nasal decongestants are drugs that are used to prevent excessive nasal secretions, and to facilitate breathing in case of a cold, allergy or other disorders of the upper respiratory tract. They are most often used locally in the form of sprays, nasal drops or inhalation products, but they can also be used oraly in the form of tablets or capsules, alone or in combination with other medicines. Monitoring the consumption of medicines is important for the analysis and improvement of its rational use, and the aim of this paper is to analyze the outpatient consumption of nasal decongestants for local administration, in the Republic of Srpska during the period from 2020 to 2022. Methods and Objectives: The data were obtained from the Annually Drug Consumption Report of the Public Health Institute of the Republic of Srpska, and are expressed in defined daily doses per 1000 inhabitants per day (DID), in accordance with the recommendations and classifications of the World Health Organization. Results: Among the drugs for the treatment of the respiratory tract, nasal preparations (drugs for the treatment of diseases of the nasal mucosa) are in second place, right after the drugs for the treatment of obstructive lung diseases. Among the nasal preparations, the sympathomimetics xylometazoline and oxymetazoline, and the combination of xylometazoline with dexpanthenol, are used the most, similarly to other countries in the region. Conclusions: During the observed period, a slight increase in the consumption of nasal preparations was observed, and it is necessary to continue monitoring the trend of consumption and work on improving cooperation between doctors, pharmacists and patients in order to rationalize therapy and raise knowledge and awareness about the correct use of nasal decongestants in accordance with modern therapeutic guidelines.

Background: Patulin (4-hydroxy-4H-furo[3,2-c]pyran-2(6H)-one; CAS Number 149-29-1) patulin as a secondary metabolite of certain types of molds, primarily Penicillium, Aspergillus and Byssochlamys, belongs to the group of mycotoxins. Patulin is a well-known toxicant in food, with adverse immunological, neurological and gastrointestinal outcomes associated with chronic intake. Patulin is an enteropathogenic mycotoxin and has the ability to alter the function of the intestine. Methods and Objectives: The method for determining patulin using liquid chromatography is described in AOAC method 995.10, by which patulin is extracted three times with ethyl acetate, followed by purification using sodium carbonate solution, evaporation of the organic solvent, and determination of patulin on a C-18 reverse phase column, with a UV detector. 24 samples of baby food containing apple were analyzed. All samples were imported. Results: In the group of products for infants and small children, patulin was detected in juices and porridges, in average concentrations below 10mg/kg. The maximum determined content of patulin was 3.3 and 2.7 mg/kg in juices and porridges, respectively. In none of the 24 samples of food for infants and young children tested in this research, the patulin content was not over 10 mg/kg, from which it follows that all tested samples in terms of patulin content meet the legal requirements. Conclusions: The safety rating of the tested samples was given on the basis of a comparison of the obtained results with the relevant maximum permitted levels defined by the legislation in the Republic of Srpska. In order to preserve public health, it is necessary to monitor and control the population's exposure to patulin.

<p><strong>Introduction.</strong> Vitamin D is a liposoluble vitamin that has many important roles in the human body. Daily requirements for vitamin D are met through intake of food and exposure to sunlight. The high frequency of vitamin D deficiency is a public health problem that can be corrected using food supplements (FS), which is why its consumption is increasing. The quality of FS, including the content of active components, depends on the good manufacturing practice which is not strictly regulated for the production of FS, as well as the formulation, packaging and storage. Because of that, the quality of FS can be variable. The aim of our pilot study was to examine the conformity of the actual determined content of vitamin D and the declared content in 49 FS, in the form of tablets and capsules, present on the market in Republic of Srpska. <strong>Method.</strong> Determination of vitamin D content was performed by high-performance liquid chromatography (HPLC). <strong>Results.</strong> The range of the determined content of vitamin D in relation to the declared content, expressed as a percentage, was from 64,4% to 188,8%, whereby the deviation is not statistically significant (mean: 100.50%; Cl 95% -0.54 to 0.17; p=0.313 tablets; mean: 98.02%; Cl 95% -3.00 to 0.42; p=0.127 capsules). When measurement uncertainty is taken into account, only one sample (2.0%) was outside the legally allowed range (88.8% more than labeled). <strong>Conclusion.</strong> Therefore, it has been shown that most of the examined products are of satisfactory quality in terms of vitamin D content, but it is necessary to continuously monitor the food supplements that are on the market.</p>

Water is one of the most frequently used raw materials in pharmaceutical industry. Water for pharmaceutical purposes includes the two primary water types: purified water and water for injection. Drinking water used for obtaining purified water is not official in pharmacopoeia. Depending on quality prescribed for a certain product preparation, various water types and procedures have been used to prepare pharmaceutical industry water. Possible ways to obtain water for pharmaceutical purposes are: reverse osmosis, demineralization, electrodeionization, ultrafiltration, distillation. Reasons for the widespread use of water lie in the facts that it is capable of dissolving a great number of therapeutic substances, compatible with a large number of substances, appropriate to be used from a physiological aspect given that it is an integral part of the cell and the major component of body fluids and whenever the drug is administered in the form of an aqueous solution, reabsorption is rapid and complete, it also has suitable physical-chemical properties. In this study, analysis results of 15 samples of water were obtained using pharmacopoeial methods for pharmaceutical purposes. Results showed that 86.6% of water samples were accurate and 13.3% did not have appropriate calcium content, magnesium content and total hardness values.

Abstract Introduction: Antibiotics are indispensable to maintaining human health; however, their overuse has resulted in resistant organisms, increasing morbidity, mortality and costs. Increasing antimicrobial resistance (AMR) is a major public health threat, resulting in multiple campaigns across countries to improve appropriate antimicrobial use. This includes addressing the overuse of antimicrobials for self-limiting infections, such as upper respiratory tract infections (URTIs), particularly in lower- and middle-income countries (LMICs) where there is the greatest inappropriate use and where antibiotic utilization has increased the most in recent years. Consequently, there is a need to document current practices and successful initiatives in LMICs to improve future antimicrobial use. Methodology: Documentation of current epidemiology and management of URTIs, particularly in LMICs, as well as campaigns to improve future antimicrobial use and their influence where known. Results: Much concern remains regarding the prescribing and dispensing of antibiotics for URTIs among LMICs. This includes considerable self-purchasing, up to 100% of pharmacies in some LMICs. However, multiple activities are now ongoing to improve future use. These incorporate educational initiatives among all key stakeholder groups, as well as legislation and other activities to reduce self-purchasing as part of National Action Plans (NAPs). Further activities are still needed however. These include increased physician and pharmacist education, starting in medical and pharmacy schools; greater monitoring of prescribing and dispensing practices, including the development of pertinent quality indicators; and targeted patient information and health education campaigns. It is recognized that such activities are more challenging in LMICs given more limited resources and a lack of healthcare professionals. Conclusion: Initiatives will grow across LMICs to reduce inappropriate prescribing and dispensing of antimicrobials for URTIs as part of NAPs and other activities, and these will be monitored.

Introduction. Arsenic exists in various forms in nature and living organisms. Toxic elements, including arsenic, which are present in some plants, can severely damage haemopoietic, immune, nervous and reproductive systems. For this reason, a content of heavy metals is one of the criteria for the assessment of the safe use of plant material in the production of traditional medicines and herbal infusions. This instigates the need for constant and organized safety control of plants that are used as raw materials in pharmaceutical industry. The aim of this study is to determine the arsenic content in selected teas which are available on the market of the Republic of Srpska. Methods. The 10 g samples of 13 herbal and 3 fruit teas were mineralized by dry ashing and arsenic contents were determined by the atomic absorption spectrophotometer Agilent Technologies Series 200 with an air-acetylene burner and D2 background correction. Results. Mean arsenic concentrations in the herbal tea samples ranged from 0.009 to 0.145 mg/kg. The lowest arsenic concentration in a single sample of 0.007 mg/kg was found in Chamomile tea and Uva ursi collected as a wild plant at elevation above 1200 m. The highest arsenic concentration was found in the sample of Sambucus nigra tea (0.145 mg/kg). In fruit teas, the arsenic concentration ranged from 0.014 mg/kg (Cranberry) to 0.027 mg/kg (Fruit mix). Conclusion. Arsenic content in all analyzed tea samples is below the value stipulated by the national legislation.

Background: Monitoring and measuring of the medicine utilisation enables to assess the quality of use of medicines, providing the evidence-based data for the improvement of the prescribing practice and a more rational use of medicines. The aim of this study was to analyse utilisation patterns of medicines and to compare the results with other countries. Methods: A retrospective, observational study to analyse outpatient medicines utilisation in the Republic of Srpska between 2009 and 2017. Data of medicines utilisation were retrieved from the national database in the Public Health Institute of the Republic of Srpska and calculated and analysed by using the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) methodology. The results were expressed as Defined Daily Doses (DDDs) per 1,000 inhabitants per day. Results: Total medicines utilisation increased, from 448 DDDs in 2009 to 1,036 DDDs in 2017. Cardiovascular medicines (group C) were the most used medicines, and their share in the total utilisation increased from 36.6% in 2009 to 44.4% in 2017. Among them, the most frequently used were angiotensin-converting enzyme inhibitors, plain and in combinations with diuretics, namely enalapril. The share of medicines used in diabetes in the total utilisation increased from 3.9% in 2009 to 5.1% in 2017. Metformin and glimepiride accounted for about 83% of the blood glucose lowering medicines group (A10B). Among the antithrombotic medicines, the most frequently used were platelet aggregation inhibitors (B01AC), mainly acetylsalicylic acid whose use tripled since 2009. Diclofenac was the most frequently used non-steroidal anti-inflammatory and antirheumatic drug (M01). Conclusion: The trend of increased medicines utilisation was observed in this study. This finding is comparable with other countries. Variations between countries in the preferred medicines within a class as well as the extent of medicines use were observed. These differences were probably consistent, but not solely attributable, to differences in local guidelines and reimbursement policies.