Background/Objectives: Neonatal sepsis is a systemic inflammation in neonates caused by bacteria, viruses, or fungi that can progress into severe conditions. In developing countries, neonatal sepsis is a major cause of mortality and a major public health issue with a high prevalence. This study aims to evaluate the antibiotic prescription practice and resistance patterns of bacterial isolates from the neonatal intensive care unit (NICU) at the largest governmental hospital in Amman, Jordan. Methods: This was a retrospective cross-sectional study. The antibiotic prescription practice and resistance patterns of bacterial isolates from the NICU at Al Basheer Government Hospital in Amman, Jordan, were evaluated. The hospital’s microbiology lab database and medical records were the sources of the retrospective data collection. Results: A total of 266 neonates treated with antibiotics were assessed. The findings showed that most neonates had late-onset sepsis (LOS) (65.4%). The penicillin group of antibiotics (ampicillin) was the most highly prescribed first empiric antibiotic for LOS and early-onset sepsis (EOS) (61.7%). Aminoglycosides (60.9%) were the most prescribed antibiotics as a second empiric treatment for EOS and LOS. The culture results showed that resistance to antibiotics was as follows: 15.4% of the culture samples were resistant to penicillin (Micrococcus and Viridans streptococci), 13.9% were resistant to cefotaxime (Klebsiella pneumoniae and Viridans streptococci), 13.2% were resistant to cefoxitin (Klebsiella pneumoniae and Staphylococcus epidermidis), and 12.4% were resistant to oxacillin (Klebsiella pneumoniae and Staphylococcus epidermidis). Conclusions: This retrospective study sheds light on the antibiotic prescription practice and resistance patterns of bacterial isolates from newborns with sepsis. The results highlight the high rates of antibiotic resistance. These findings underline the urgent need for improved antibiotic stewardship and infection control strategies to prevent resistance from spreading further.

Objectives Online purchasing, including drugs, increased dramatically in the last decade especially through the COVID-19 pandemic. The aim of this study was to investigate the frequency and attitudes of consumers concerning online drug purchasing and assess their perceptions regarding the benefits and disadvantages. Design A web-based survey conducted through a self-administered questionnaire that was approved by the Institutional Review Board (IRB) committee, ethical approval number: IRB/Al-Ahliyya Amman University/3/13/2021-2022. Cronbach’s alpha for the attributes of benefits and disadvantages was 0.608 and 0.744, respectively. Primary outcome measures were extent of trust of the public in online drug purchasing using Likert scale. Multivariate linear regression was used to assess predictors of the trust score. Settings Hashemite Kingdom of Jordan. Participants Inclusion criteria; residents of the Hashemite Kingdom of Jordan 18 years or older. The questionnaire was distributed through snowball effect via different social media. Results A total of 428 participants filled the questionnaire, their average age was 29.7±11.2. Almost all participants, 419 (98.6%) use the internet daily but only 79 (18.6%) participants shop online regularly. Fifty participants (11.8%) purchased drugs online and they had higher benefits score of online purchasing compared with those who did not buy drugs online, 12.5±3.7 and 10.9±3.1, respectively, p=0.002. Participant who purchased drugs online had an increase in trust score of 0.847 compared with those who did not purchase drugs online, p<0.001. In the multivariate model, participants with education level of high school or higher than high school, compared with those with education lower than high school had an increase in trust score of 1.336 (p=0.026) and 1.137 (p=0.039), respectively. Conclusion The public recognises the risks in buying drugs online. Awareness campaigns and regulations that control and monitor online drug purchasing should be implemented.

Objectives: The widespread use of proton pump inhibitors (PPIs) raised concerns on the safety of long-term use of these drugs. Community pharmacists have great responsibility of educating patients on these drugs which requires having adequate knowledge. The aim of this study was to assess the practices and knowledge of community pharmacists regarding PPIs. Design: This was a cross-sectional study conducted by filling in a questionnaire. The questionnaire was developed after a comprehensive literature review and assessed knowledge and practices. Settings: Community pharmacists with at least 1 year of experience working in a community pharmacy were enrolled in the study. Participants: Community pharmacists with at least 1 year of experience working in a community pharmacy were enrolled in the study. Primary outcome measures: The knowledge, attitudes, and practices of community pharmacists towards PPIs dispensing. Results: A total of 459 community pharmacists were approached for participation in the study, 451 (98.3%) community pharmacists agreed to be enrolled. The most dispensed PPIs in Jordan were lansoprazole and the most commonly treated medical condition with PPIs was gastric ulcer. PPIs were dispensed by the pharmacists very frequently and one-fourth of the participants did not review instructions with patients to ensure their proper use of PPIs. Participants had an average knowledge of 6.1±1.7 (the highest knowledge score is 12). More than one-third of participants (180, 39.9%) had inadequate knowledge (a score of less than 6). Being a PharmD graduate was the only significant factor that predicted adequate knowledge in the logistic regression model, with an adjusted OR of 5.671, p=0.002. Conclusion: To provide adequate pharmaceutical care services, community pharmacists must possess appropriate knowledge on different aspects of PPIs concerning administration, efficacy and long-term and short-term side effects.

Background: Total knee replacement (TKR) is a major orthopedic surgery that is considered high risk for the development of venous thromboembolism (VTE). Objective: The aim of this study is to evaluate the clinical outcomes that resulted from the use of a new proposed VTE risk stratification protocol for selecting a suitable extended VTE prophylaxis for post TKR surgery patients administered in conjunction with patient education programs. Method: A randomized controlled trial was conducted in two medical centers in Saudi Arabia. A total of 242 patients were enrolled in the study, 121 patients in each group. The experimental group (A) was assessed by using the proposed VTE risk stratification protocol and also took part in patient education programs about TKR and its complications. The control group (B) was assessed by using the 2005 Caprini risk assessment tool and no education programs were given to this group. Both groups were followed for 35 days post operation. Results: The mean age of the participants was 65.86 (SD 8.67) and the majority of them were female 137 (56.6%). The mean body mass index of the study sample was 32.46 (SD 5.51). There were no significant differences between the two groups except for surgery type; the proportion of bilateral TKR in group A was higher than in group B (69/121 (28.5%) vs. 40/121(16.5%), p˂0.05). There were no confirmed pulmonary embolism cases in the study sample and diagnosis of deep-vein thrombosis was confirmed in 12/242 (5.0%) of patients: 1/121 (0.8%) in group A and 11/121 (9.1%) in group B (p˂0.05). The readmission rate for all patients was 2.5% (6/242), all of whom were in group B (p˂0.05). Conclusion: The proposed VTE risk stratification protocol that was applied in conjunction with patient education programs reduced VTE complications and readmission events, post TKR surgery. Trial Registration: ClinicalTrials.gov Identifier: NCT04031859.

Excessive exposure to unprotected sunlight increases the risk of premature skin aging and cancer. University students can be considered a high-risk group for the short- and long-term adverse effects of ultraviolet (UV) radiation, owing to their intensive exposure to the sun. This study aimed to evaluate university students’ knowledge and practice of sunscreen use in Northern Jordan. A cross-sectional study was conducted using a self-administered questionnaire to assess knowledge and practice. The questionnaire was created using Google Forms and was distributed online on different social media platforms. Participants were recruited through convenience sampling and snowball questionnaire distribution. A total of 915 university students participated in this study. The results showed that the students were aware of the different types of skin damage resulting from exposure to sunlight. Female participants and those who took courses on skincare or cosmetics had higher knowledge scores. Participants from faculties unrelated to human health had lower knowledge scores. Most participants used sunscreen (80.1%), and there was a significant association between sunscreen use and sex. Female participants had a higher usage of sunscreen than male participants (90.5% compared to 36.1%, p < 0.001). Participants who used sunscreen continuously had a higher average knowledge score (3.0 ± 1.1) than other participants who used sunscreen frequently (2.9 ± 1.1), sometimes (2.6 ± 1.3), or rarely (2.4 ± 1.2), p < 0.001. Three-quarters of sunscreen users apply it immediately without renewal. Less than half of sunscreen users apply sunscreen indoors. Pharmacies were still the primary providers of sunscreen products, where most participants bought sunscreen agents (80.8%). In conclusion, the knowledge and practice of sunscreen use among students in Northern Jordan were reasonably acceptable. However, there is a need for awareness campaigns focusing on the importance of sunscreen products. Future awareness campaigns should be directed toward informing students of the need for reapplication and protection against both UVA and UVB radiation.

Background and Objectives: The investigation of the psychosomatic symptoms in women residing in developing countries is still emerging. To be precise, the prevalence and correlates of severe fibromyalgia, depression, anxiety, and insomnia are understudied in Arab women, as these symptoms could relate to improper self-medication. This study mainly investigated the association between self-medication with analgesics and fibromyalgia, depression, anxiety, and insomnia symptoms among a community-based cohort of females in Jordan. Materials and Methods: We used a web-based cross-sectional study design. Fibromyalgia, depression, anxiety, and insomnia were assessed using validated scales. The used over-the-counter (OTC) painkillers were recorded. Results: Data were analyzed from 741 women, and fibromyalgia was screened in 16.4%, depression in 37.4%, anxiety in 27.8%, and insomnia in 38.3%. Fibromyalgia was associated with “married” (OR = 1.5, 95% CI = 1.017–2.305), “using OTC acetaminophen” (OR = 1.75, 95% CI = 1.15–2.69), “using herbal remedies” (OR = 2.02, 95% CI = 1.33–3.07), and “using antiseizure medications” (OR = 2.43, 95% CI = 1.38–4.28). Severe depression was significantly associated with “age” (OR = 0.97, 95% CI = 0.96–0.99), “high school education” (OR = 1.90, 95% CI = 1.21–2.98), “smoking” (OR = 1.72, 95% CI = 1.15–2.56), “OTC acetaminophen” (OR = 1.40, 95% CI = 1.02–1.92), “OTC non-steroidal anti-inflammatory drugs” (OR = 1.75, 95% CI = 1.15–2.65), and “antiseizures” (OR = 2.19, 95% CI = 1.30–3.70). Severe anxiety was significantly associated with “smoking” (OR = 2.08, 95% CI = 1.40–3.12), “OTC acetaminophen” (OR = 1.48, 95% CI = 1.06–2.06), and “antiseizure medications” (OR = 2.04, 95% CI = 1.22–3.41). Severe insomnia was significantly associated with “age” (OR = 0.98, 95% CI = 0.96–0.99), “high school education” (OR = 1.58, 95% CI = 1.01–2.47), “smoking” (OR = 1.51, 95% CI = 1.01–2.25), “OTC non-steroidal anti-inflammatory drugs” (OR = 1.74, 95% CI = 1.13–2.64), “antiseizure medications” (OR = 1.84, 95% CI = 1.09–3.11), and “No analgesics” (OR = 0.48, 95% CI = 0.32–0.71). Conclusions: Self-medication with analgesics is associated with a high burden of psychosomatic symptoms in Arab women, and awareness campaigns are required to guide self-medication behavior.