Pharmacy Reports

Evaluation of prescribing rationality for rheumatoid arthritis patients at a regional hospital in Indonesia

2026-01-18T12:44:27+00:00

Rheumatoid arthritis requires long-term pharmacotherapy with disease-modifying antirheumatic drugs, corticosteroids, and non-steroidal anti-inflammatory drugs. Irrational prescribing can lead to treatment failure, adverse effects, and increased healthcare costs. This study evaluated prescribing rationality for rheumatoid arthritis patients at RSUD Al Ihsan, Bandung, Indonesia, during 2023. A retrospective cross-sectional design was employed, analyzing medical records of 81 outpatients using five rationality criteria: appropriate indication, appropriate drug, appropriate dose, appropriate patient, and appropriate dosing interval. Results showed complete compliance for appropriate indication (100%) and appropriate drug selection (100%). However, deficiencies were identified in dose appropriateness (81.82%), patient appropriateness (97%), and dosing interval appropriateness (81.82%). Dose-related errors involved diclofenac sodium prescribed below therapeutic range and etoricoxib exceeding recommended doses. Patient-related inappropriateness included diclofenac sodium use in four elderly patients over 65 years without documented gastroprotection. Interval-related errors involved etoricoxib and meloxicam prescribed more frequently than recommended. Overall prescribing rationality was 92.1%, indicating generally appropriate practices with specific areas requiring improvement through clinical decision support systems, prescriber education, and regular prescribing audits.

Photoprotective efficacy and physicochemical stability of sunscreen gel containing Averrhoa bilimbi L. leaf extract

2026-01-18T12:44:28+00:00

Chronic UV-B exposure causes significant skin damage, necessitating effective photoprotective strategies. This study developed and evaluated sunscreen gel formulations containing ethanolic extracts of Averrhoa bilimbi leaves at varying concentrations. Extraction was performed using ultrasonic-assisted extraction (UAE), while sun protection factor (SPF) determination employed the Mansur spectrophotometric method. Four gel formulations were prepared: F0 (0%, control), F1 (0.2%), F2 (1%), and F3 (5% extract). Physicochemical characterization revealed that all formulations exhibited acceptable organoleptic properties, homogeneity, pH (4.5 to 7.0), viscosity (2,000 to 50,000 cps), spreadability (5 to 7 cm), and adhesiveness (>1 second). Accelerated stability testing demonstrated stable pH, viscosity, spreadability, and SPF values, although adhesiveness showed statistical variation while remaining within acceptable limits. SPF analysis revealed concentration-dependent photoprotective efficacy: F1 achieved maximum protection, while F2 and F3 demonstrated ultra protection, with F3 exhibiting the highest SPF value of 36.9. These findings confirm that increased A. bilimbi extract concentration correlates with enhanced photoprotective activity, establishing the potential of this natural ingredient for sunscreen applications.

Concentration-dependent antibacterial activity of Ruellia tuberosa L. leaf extract against Propionibacterium acnes

2026-01-18T12:44:28+00:00

Acne vulgaris, primarily caused by Propionibacterium acnes, affects millions globally, yet current antibiotic treatments face increasing resistance. This study evaluated the antibacterial activity of Ruellia tuberosa L. leaf ethanol extract against P. acnes ATCC 6919 using the disc diffusion method. Phytochemical screening confirmed the presence of alkaloids, flavonoids, tannins, saponins, and terpenoids. Five extract concentrations (15%, 20%, 25%, 30%, and 35% w/v) were tested alongside negative control (distilled water) and positive control (0.1% clindamycin) in quadruplicate. Results demonstrated concentration-dependent antibacterial activity, with inhibition zones increasing from 5.00 ± 1.30 mm (15%, weak) to 11.81 ± 0.84 mm (35%, strong), compared to 22.05 ± 0.27 mm for clindamycin. One-way ANOVA revealed significant differences among groups (p < 0.001), with Tukey post-hoc analysis confirming progressive activity increases from 15% to 30%, but no significant difference between 30% and 35% (p > 0.05). These findings provide preliminary evidence that Ruellia tuberosa leaf extract possesses antibacterial potential against P. acnes, warranting further investigation for botanical anti-acne formulation development.