Background: Globally, community pharmacists worldwide have prescribed more over-the-counter systemic antibiotics, posing significant issues for international organizations tackling antibiotic-resistant bacteria, a major global threat, due to the accessibility in pharmacies. Objectives: This study aimed to examine the Jordanian pharmacists’ antibiotic selection and over-the-counter antibiotic prescriptions. Methods: A total of 244 community pharmacists participated in an online standardized survey, which examined five essential domains including sources and trust of pharmacy antibiotic prescription information, category and frequency of permitted antimicrobials, prescription-free antimicrobials, interactions, antimicrobial prescription issues for pharmacists, and pharmacy staff’s knowledge of non-prescription antimicrobial questions and answers. Results: This study found that 1—pharmacists are confident in prescribing antibiotics and they use various tools to improve their skills. 2—Antibiotics were the most sought antimicrobials without a prescription, followed by antifungals and antivirals. 3—Throat, urinary tract, chest, and otitis media are the most common infections that require antibiotics. Pharmacists prescribe penicillin for 75% of throat infections, Fluoroquinolones for 48.2% of urinary tract infections, and cephalosporins for 35.9%. Macrolides are the most prevalent otitis media treatment (43.2%). 4—Some people obtain antimicrobial prescriptions without a valid reason or diagnosis. 5—Many pharmacists (171/244, 70%) agree or strongly believe that antibiotic prescription information is difficult to obtain. 6—Many pharmacists (183/200, 91.5%) aimed to educate patients on the risks and correct use of antimicrobials without prescriptions. Conclusions: These results show that Jordanian community pharmacists follow clinical antibiotic prescribing guidelines and conduct antimicrobial stewardship, yet they demand antimicrobials without prescriptions and lack decision support tools. Antibiotic classes address most diseases, and pharmacists emphasize antimicrobial misuse.

Background: Antimicrobial resistance (AMR) is one of the most significant current public health issues, which is driven crucially by the misuse and overuse of antibiotics. Antibiotics are still available without a prescription in many underdeveloped countries, including Jordan, allowing for self-medication and incorrect usage, which contributes to the establishment and spread of resistant bacteria. This cross-sectional study aimed to evaluate antibiotic-use practices and assess knowledge and awareness of antimicrobial resistance among the Jordanian population. Methods: We conducted a cross-sectional observational survey between September 2023 and January 2025, targeting males and females in Jordan. A QR code was used to distribute an online convenience sampling strategy with 57 questions across social media channels. The survey investigated a variety of aspects, including demographic traits, antibiotic knowledge and behaviour, and public awareness of resistance. The questionnaire was completed by 1031 people. The data was analysed using descriptive statistics. The chi-square test was performed to compare demographic groupings, and p < 0.05 was considered significant. Results: Among the 1031 participants, 61.3% were female and 37.8% were male. Recent utilization of antibiotics was prevalent, with 37.8% indicating usage in the preceding month and 26.4% within the last six months. It is noteworthy that 61% (n = 624) of participants indicated that they had consumed antibiotics without a prescription, while 33.6% (n = 345) reported acquiring antibiotics for children without a prescription. Furthermore, pharmacies constituted the predominant source of antibiotics, accounting for 90.4% of the total. Common misconceptions regarding the indications for antibiotics were observed, with a segment of participants under the impression that antibiotics are effective in treating symptoms such as fever (40.6%) and body pain (15%). Additionally, participants exhibited a moderate level of awareness regarding antimicrobial resistance, with 69.2% demonstrating familiarity with the concept, while 90% acknowledged the increased difficulty in treating infections caused by antimicrobial-resistant organisms. Nevertheless, major misconceptions persisted, including 84.8% incorrectly believing that antibiotic resistance occurs when the human body becomes resistant to antibiotics and then antibiotics cannot work properly. More than half of the respondents (n = 569; 57.1%) also believed that AMR only or mainly affects individuals who frequently take antibiotics and does not concern others. Conclusions: This study has identified that non-prescription antibiotic use remains prevalent in Jordan and is accompanied by substantial misconceptions regarding antimicrobial resistance. Although general awareness of the seriousness of AMR was relatively high, important knowledge gaps persisted. In the adjusted analysis, among the covariates, participants aged 51–60 years had higher odds of reporting non-prescription antibiotic use than those aged 18–30 years (aOR = 1.872, 95% CI 1.072–3.268; p = 0.028). Moreover, participants with a high-school education (aOR = 0.415, 95% CI 0.196–0.879; p = 0.022) and those with a master’s degree (aOR = 0.411, 95% CI 0.181–0.933; p = 0.034) had lower odds than the no-formal-education reference group. No other covariate was statistically significant. The findings clearly indicate the need for strengthened enforcement of prescription-only antibiotic dispensing regulations, targeted public education to address specific misconceptions, and expanded antimicrobial stewardship initiatives involving community pharmacists to promote responsible antibiotic use and lessen the growing threat of antimicrobial resistance.

Non-invasive prenatal testing (NIPT) is a method that uses cell-free fetal DNA in maternal blood sample to detect common fetal chromosomal aneuploidies. It has been recognized as the most clinically robust screening method and widely used worldwide. Although clinical validation and implementation of NIPT studies have consistently demonstrated high sensitivity and specificity for trisomy 21(Down syndrome), trisomy 18(Edwards syndrome), and trisomy 13(Patau syndrome) and sex chromosomes, evidence reflecting real-world implementation in Middle Eastern cohorts remains limited, especially in Jordan. This study aimed to evaluate the real world clinical implementation, distributions of fetal fractions, and screening outcomes of NIPT in a cohort of pregnancies in Jordan. A retrospective observational study was performed on 255 NIPT results obtained from a single diagnostic laboratory in Jordan. Collected variables included maternal age, gestational age at testing, fetal fraction, conception status [natural or in vitro fertilization (IVF)], and final screening result. NIPT results were classified as low risk, high risk, or no result (inconclusive). Descriptive statistics were used, and comparisons between low-risk and high-risk groups were performed using Welch’s t-test and Fisher’s exact test for continuous and categorical variables, respectively. A two-sided P-value <0.05 was considered statistically significant. Among 255 NIPT tests performed, 87.5% (n=223) generated reportable result and were included in the final analysis. The mean maternal age was 33.28 years, and the median gestational age at testing was 11 weeks. The overall screen-positive rate was 3.59% (8/223). Trisomy 21 was the most frequently detected aneuploidy (1.79%), followed by trisomy 13(0.90%), trisomy 18(0.45%), and 47, XXY [Klinefelter syndrome] (0.45%). Advanced maternal age (≥35 years) was not significantly associated with increased screen-positive rates (p=0.86). Notably, mean fetal fraction was significantly lower in screen-positive cases compared with low-risk cases (7.86% vs 9.91%; P = 0.008). In this real world Middle Eastern cohort, NIPT demonstrated screening outcome distributions consistent with established international data. Lower fetal fraction was significantly associated with screen-positive results. However, it was found no significant association between advanced maternal age and screen-positive status. The results presented in the current study support the effective integration of NIPT in routine prenatal care in Middle Eastern, particularly in Jordan and provide a critical region specific NIPT performance data.