Addressing antimicrobial resistance (AMR) stands as a major global health challenge threatening humanity. Resolving this issue can be initiated through emphasizing the significance of AMR education among students in health colleges during their undergraduate studies. Hence, the aim of this study is to assess the pharmacy students’ knowledge, attitudes, and practices regarding antibiotic resistance in 7 Middle Eastern countries. A cross-sectional study was conducted among undergraduate pharmacy students at universities in Egypt, Jordan, Saudi Arabia, Lebanon, the United Arab Emirates, Qatar, and Kuwait between March 2021 and January 2022. The first section of the questionnaire gathered demographic information. The knowledge section comprised 7 questions. Subsequently, the questionnaire explored participants’ attitudes (6 items) and practices (2 items) concerning antibiotic resistance. Mann-Whitney and Kruskal–Wallis tests were used to compare the median knowledge score between different demographic groups. Logistic regression was used to estimate odds ratios, with 95% confidence intervals (CIs) for being more knowledgeable about antibiotic resistance. A 2-sided P < .05 was considered statistically significant. A total of 4265 pharmacy students were involved in this study (Egypt (2249), Jordan (n = 704), Saudi Arabia (n = 531), Lebanon (n = 401), United Araba Emirates (n = 130), Qatar (n = 129), and Kuwait (n = 121)). The median knowledge score for the participating pharmacy students was 5.00 (IQR = 4.00–6.00) out of 7, equals to 71.4% with 4th, and 5th year students and bachelor of pharmacy program students have higher odds of being more knowledgeable about antibiotics resistance compared to other students (P < .05). The majority of the students agreed that antibiotic resistance is increasing, they should be more concerned regarding antibiotic consumption and that government should create more awareness of antibiotic resistance, and that they should have enough knowledge to prevent antibiotic resistance. Around 3 quarters of the students (73.0%) confirmed that they take antibiotic only after getting prescription from their physician and almost half (51.7%) reported that they take antibiotic to manage their fever. The study concluded good educational programs in Middle East pharmacy schools with the need for targeted educational interventions promoting responsible antibiotic stewardship practices among future pharmacists.

Adverse drug reactions (ADRs) are undesired, unintended responses to drugs, and are significantly underreported. Pharmacists are drug experts recognized as custodians of drug safety, who are expected to be prepared for and knowledgeable about ADR reporting. To identify Egyptian community pharmacists’ preparedness for and perceived barriers to spontaneous ADR reporting. This cross-sectional study recruited a sample of community pharmacists across Egypt, who were invited to complete a self-administrated questionnaire during April 2020. A total of 923 pharmacists across Egypt responded to the questionnaire. Most pharmacists were knowledgeable about the definition of ADRs (93.9 %) and indicated they felt reporting ADRs benefits the patients (82.2%). Despite recognizing their public health value, only a small percentage of participants conveyed familiarity with the reporting process for both paper (19.2%) and electronic (30.4%) forms, indeed 56.6% of participants did not remember what the ADR report form looked like. Moreover, 75.4% of respondents said they felt that community pharmacies are not the right place for reporting, with 49% suggesting that reporting was the responsibility of physicians. However, only 32.1% reported having insufficient time being a barrier to ADR reporting. Community pharmacists in Egypt are not well prepared for spontaneous ADR reporting due to a lack of knowledge about the formal process and not acknowledging their responsibility, although time was not a major barrier. Therefore, this highlights a clear opportunity for improvement likely involving targeted education.

Background: Community pharmacies provide an important healthcare service. Their significant value has been further highlighted during the COVID-19 pandemic crisis. Objectives: To identify and categorize potential barriers and facilitators to the role of community pharmacists during the pandemic and their association with demographic factors. Methods: A cross-sectional survey of community pharmacists was conducted using a self-administered questionnaire during April 2020 across all regions of Egypt. Key findings: Respondents (n = 1018; 98.4% response rate) revealed practical and psychological barriers, including inadequate levels of pandemic preparedness (mean 61.43%; ±SD 0.47), inadequate working environments (mean 56.23%; ±SD 0.49) and uncooperative behaviour from stakeholders (mean 65.3%; ±SD 0.47).The majority of respondents emphasized the universal, region-independent necessity for facilitators, including the availability of timely (94.9%) guidance (97.4%) published by the Egyptian healthcare authority (94.6%), in electronic format (82.1%), through smartphone application (80.0%) and the provision of a dedicated telephone hotline (89.5%). Furthermore, authorities must use the media to manage public perceptions (97.2%) and increase public trust (94.8%) towards the pharmacist. Conclusions: The barriers and facilitators identified herein could improve service provision in an integrated manner by overcoming the reported inadequate level of preparedness (barrier) through the provision of electronic guidance (facilitator), and the use of the media in managing public perceptions and trust (facilitators) to reduce the panic that negatively affects the working environment (barrier) for pharmacy staff. The varied level of healthcare authority cooperation reported in many regions requires further investigation.

Background: Self-medication with leftover antibiotics (SMLA) drives antimicrobial resistance (AMR), particularly in developing countries. This study examined knowledge–practice gaps regarding antibiotic use and handling among individuals with prior SMLA across seven developing countries. Methods: A cross-sectional study (February 2023–February 2024) included 3191 adults from Bangladesh, Brazil, Egypt, India, Jordan, Lebanon, and Serbia who reported previous leftover antibiotic use. The questionnaires assessed knowledge of antibiotic use (15 items), resistance (12 items), and SMLA risks (15 items). Storage and disposal practices were evaluated using dichotomized correct/incorrect measures. Results: Participants demonstrated above-average knowledge scores as follows: antibiotic use (54.4 ± 8.4), resistance (43.3 ± 6.1), and SMLA risks (58.4 ± 10.3). However, substantial practice gaps emerged. Only 21.9% properly disposed of leftover antibiotics, while 47.0% used household garbage. For storage, 55.1% used appropriate methods, but 32.6% stored antibiotics inappropriately, and 12.8% lacked protocols. Serbian participants showed the highest SMLA risk knowledge (64.3 ± 10.6), Bangladeshi participants the lowest (52.0 ± 8.5, p < 0.001). Women had superior knowledge (59.6 ± 10.4 versus 56.5 ± 9.8, p < 0.001) and storage practices (56.6% versus 52.7%, p = 0.031). Paradoxically, higher AMR knowledge was associated with poorer disposal practices (OR = 0.97, p < 0.001). Conclusions: Despite extensive theoretical knowledge, unsafe medication practices persist, revealing a critical knowledge–practice gap. Our findings challenge education-focused AMR approaches, suggesting cognitive awareness alone cannot drive behavioral change. Effective interventions must address structural barriers, cultural factors, and individual health beliefs beyond traditional knowledge-deficit models.