There has been no review on the prevalence, possible causes, and clinical outcomes of self-medication with antibiotics (SMA) in the Middle East. Databases were searched (January 2000 through June 2016) for articles on SMA among adults aged ≥18 years living in the Middle East. A hand search for relevant citations and key journals was also performed. Twenty-two studies were found. The prevalence of SMA ranged from 19% to 82%. Age, sex, and educational and income levels were the main determinants of SMA. Socio-cultural, economic, and regulatory factors were the most commonly cited reasons for SMA. Penicillins were the antibiotics most commonly used; the antibiotics were obtained mainly via stored leftover drugs, pharmacies without prescriptions, and friends/relatives. SMA was mainly for upper respiratory tract problems. The primary sources of drug information included relatives/friends and previous successful experience. Inappropriate drug use such as wrong indication, short and long duration of treatment, sharing of antibiotics, and storing antibiotics at home for use at a later time were reported. Negative and positive outcomes of SMA were identified. It is important to understand the links between different factors promoting SMA and to assess the changing trends in order to derive strategies aimed at reducing drug-related health risks.

The sale of antibiotics without a prescription poses a global public health concern. Antibiotics dispensed without a prescription are largely recognised as a cause of antibiotic misuse and overuse which may result in antibiotic resistance, recurrent infection, increased cost and adverse effects of treatment. There have been no qualitative studies to explore the reasons for over-the-counter (OTC) sale of antibiotics, despite the fact that non-prescription sale of antibiotics are increasing in Saudi Arabia. Qualitative interviews were conducted with community pharmacists living in the Eastern Province of Saudi Arabia using face-to-face, open-ended questions. Interviews were audio-recorded and transcribed verbatim. The interview transcripts were analysed using thematic analysis and NVivo 10 software. All participants declared that antibiotics were frequently sold without a medical prescription on an OTC basis. The main reasons for OTC sale of antibiotics were found to be related to the ease of access to community pharmacies compared to other healthcare services, expertise and knowledge of pharmacists and patients’ trust, misconceptions and inappropriate practices of the public towards antibiotic use, customer pressure, pharmacists’ need to ensure business survival and weak regulatory enforcement mechanism. These are presented in more detail below by using illustrative quotes from participants’ transcripts. The non-prescribed sale of antibiotics is still a common practice in Saudi Arabia, despite being a problem. The results of this study highlight the need to design interventions to promote rational use of antibiotics.

In recent decades, the Kingdom of Saudi Arabia has seen an exponentially growing antibiotic resistance, which is exacerbated by the use of antibiotics without a prescription and other various factors. However, no published data are available on factors influencing non-prescription use of antibiotics among the general public in Saudi Arabia using an in-depth interview technique. Semi-structured interviews were carried out with 40 Saudi participants from the Eastern Province of Saudi Arabia, selected via snowball sampling technique. Participants were enrolled based on the following inclusion criteria: 18 years of age or older and had self-medicated themselves with antibiotics in the past two years. Data collection was continued until data saturation was attained. Interviews were audiotaped, transcribed verbatim and analysed using NVivo 10 software. Participants (80% female) had a mean (SD) age of 30 years (10.2). Self-medication with antibiotics was associated with various inappropriate antibiotic use behaviours and negative outcomes such as antibiotic resistance, treatment failures and adverse events. Interviews revealed that different reasons contribute to the rise of self-medication with antibiotics, ranging from difficulty accessing healthcare services, participant’s cultural beliefs and practices, lack of knowledge about antibiotics and antibiotic resistance, and weak regulatory enforcement. The findings of the present study will aid in generating data that may provide an insight when designing future interventions to promote public health awareness regarding safe and effective use of antibiotics.

Objectives: Medication waste has a negative environmental and economic impact. From avoiding unnecessary supply to recycling medicines that are no longer needed, pharmacists are placed in an advantageous position to minimise medication waste. Thus, the aim of this study was to detect waste-minimising activities undertaken by pharmacists to limit medication waste and to evaluate their importance for medication waste minimisation and feasibility for implementation. Methods: A cross-sectional survey of 277 participants, conveniently selected from six Gulf countries. The eligibility criteria were pharmacists or pharmacy technicians, Arabic- or English-speaking individuals, aged ≥18 years, and living in the Gulf countries. An online self-administered survey was distributed during December 2019 and February 2020, via e-mail and social networks; it included the purpose of the study with a link to the webpage that hosted the questionnaire. Data were collected through the online survey site QuestionPro.com. All analyses were performed in SPSS Version 23 and Microsoft Excel. Results: The majority of participants were female (175/277; 63%), hospital pharmacists (206/277; 74%), and had more than 10 years of work experience (100/277; 36%). This study indicates that most of the suggested activities (14/21) were implemented by the majority of pharmacists for minimising medication waste, except four activities in the dispensing stage and three activities in the leftover stage. Activities performed at the prescribing, dispensing and leftover stages were considered very important or important for reducing medication waste and very feasible or feasible for implementation in practice. Conclusions: Many waste-minimising activities were undertaken by pharmacists in the prescribing, dispensing, and leftover stages. However, although waste-minimising activities were perceived as important for reducing waste and feasible for implementation in practice, not all activities were implemented in daily practice.

Background: Workplace violence (WPV) threatens the safety and well-being of healthcare providers and leads to significant organizational consequences, including staff burnout, reduced productivity, and high turnover rates. At the societal level, it reduces the quality of care, increases medical errors, and imposes a substantial economic burden on healthcare systems and communities. Despite the global attention to WPV, systematic reviews specifically addressing WPV across all three professions—physicians, pharmacists, and nurses—and in various healthcare settings in Saudi Arabia are lacking. This review examines the prevalence, contributing factors, types, sources, potential causes, reactions, and impact of WPV against HCPs in Saudi Arabia. Methods: We conducted a systematic search of electronic databases from January 2010 to November 2024 and reviewed reference lists of included studies focusing on WPV against physicians, pharmacists, and nurses in Saudi Arabia. Two researchers independently screened studies for inclusion, resolved discrepancies through discussion, and extracted data in duplicate. The quality of included studies was assessed using critical appraisal tools for cross-sectional studies. Results: A total of 42 studies were reviewed using the AXIS tool for cross-sectional studies. The prevalence of WPV against HCPs ranged from 26% to 90.7%. This range reflects overall WPV prevalence across various studies, encompassing different healthcare settings and professional groups. Verbal violence was the most reported type (19.7– 98.2%), followed by threats (12– 74.4%), physical violence (3– 79%), and sexual violence (1.9– 76.5%). Perpetrators were predominantly male, with patients (7.1– 99.3%) and their relatives or friends (6.6– 91%) as the primary sources. Contributing factors of WPV included gender, age, profession, workload, shift patterns, nationality, experience, and inadequate training. Causes included staff shortages, overcrowding, long waiting times, miscommunication, unmet patient demands, insufficient penalties, and inadequate security measures. Responses to WPV varied, with some HCPs reporting incidents and others taking no action. The impact on HCPs included psychological distress, reduced work quality, and occasional job resignation. Conclusion: The high prevalence of WPV against HCPs in Saudi Arabia highlights the urgent need for enhanced protective measures, increased awareness of WPV policies, and improved reporting systems. Understanding the factors contributing to WPV can inform targeted intervention programs to foster safer healthcare environments.