Saudi Cultural Missions Theses & Dissertations
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Item Restricted Improving Saudi Arabia's Pharmaceutical Self-Reliance by Leveraging Innovation and Technology.(University College London (UCL), 2024) Alharthy, Khaled; Sheikh, KabirThis study explored existing the state of knowledge on innovation in the pharmaceutical sector and its transformative potential in enhancing access to antibiotics within Saudi Arabia’s pharmaceutical sector. To achieve this goal, the study developed two main objectives: a). To evaluate the use and purpose of innovation for inducement of pharmaceutical access in Saudi Arabia b). To evaluate the use and purpose of innovation for inducement of pharmaceutical access in Saudi Arabia. The study utilised a systematic review methodology guided by PRISMA guidelines to search relevant educational databases to find literature that has been published in recent years. The databases consulted included PubMed, Scopus, Web of Science, Cochrane, MEDLINE, and Google Scholar. The search strategy focused on keywords related to antibiotics access, innovation, digital health, and pharmaceuticals in the Saudi context. Key findings indicated that technology and innovation have great potential of enhancing access to antibiotics and pharmaceuticals in general as well as improving the country's ability of self reliance. The development and integration of telehealth and e-prescription tools in Saudi Arabia’s healthcare has increased efficiency in service delivery and prescription. However, these technologies have not been optimised to facilitate access to essential drugs. The implementation of such innovations is hindered by high development costs and stringent regulatory frameworks. The study findings identified the critical need for policy reforms, investment in technological infrastructure and fundings towards pharmaceutical research and development to optimise antibiotics procurement, distribution, and patient adherence to facilitate access to antibiotics. Another critical finding was lack of studies on the significance of technology in enhancing access to antibiotics especially following the government restrictions on non-prescribed antibiotics. Future research should prioritise in identifying more ways for Saudi Arabia to become self-reliant in terms of pharmaceutical means of approach, empirical studies to establish concrete links between technological interventions and enhanced pharmaceutical access to inform evidence based policy decisions to address accessibility challenges.16 0Item Restricted Development of Liposomal Inhaled Antibiotic Formulations to Target Pulmonary Infection(Queen’s University Belfast, 2024) Alhamod, Mona; Kett, Vicky; Tunney, MichaelThe lungs of people with cystic fibrosis, bronchiectasis and chronic obstructive pulmonary disease are susceptible to bacterial infection which is difficult to eliminate; this results in repeated and prolonged antimicrobial treatment that is frequently associated with systemic side effects. Inhaled antimicrobial liposomal formulations present a promising alternative to systemic administration. They offer several potential advantages, including enhanced drug concentration in the airways, minimized systemic side effects, and sustained drug release. This thesis focuses on the encapsulation of vancomycin and rifampicin into liposomes using a liposomal composition of soy-phosphatidylcholine (SPS), dimethyldioctadecylammonium bromide (DDAB), and D-α tocopherol polyethylene glycol 1000 succinate (TPGS). Vancomycin was successfully encapsulated into liposomes using two methods; Thin film hydration (TFH) and organic free solvent (OSF) with high EE%. Spray drying and freeze drying converted the formulation into a dry powder suitable for inhalation, with both techniques producing particles of appropriate size, low water content %, and high Tg. The dried liposomal vancomycin demonstrated controlled in vitro release. Stability testing showed that the product remained stable for 24 weeks at 20°C but degraded at higher temperatures 40 °C with 75 % humidity. The efficacy of liposomal vancomycin was comparable to that of free vancomycin when tested against Staphylococcus aureus and MRSA isolates. The results indicate that both free and liposomal vancomycin have antimicrobial effects, and liposomal vancomycin exhibits a higher antimicrobial effect against some clinical isolates tested. Furthermore, the TFH method was employed to load rifampicin into liposomes. The resulting liposomal rifampicin was converted into a powder form using mini spray drying. During this process, key formulation characteristics such as particle size, PDI, surface charge, and encapsulation efficiency and morphology were investigated. The findings indicated that trehalose-based formulations produced spherical particles with properties suitable for inhalation, although further optimization was needed due to slightly larger liposomes sizes and PDI. Subsequently, a nano spray-drying technique was used, resulting in smaller, positively charged liposomes with favourable powder characteristics. In addition, rifampicin-loaded liposomes reduced both the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) for most clinical isolates of Nontuberculous Mycobacteria (NTM), indicating enhanced antibacterial efficacy. In time kill assays, liposomal rifampicin exhibited greater bactericidal and bacteriostatic activity against most isolates tested compared to free rifampicin. The liposomal formulation was able to more effectively target intracellular bacteria within macrophages compared to the free drug. Furthermore, the liposomal formulation was found to have no toxic effects on common lung cell lines at concentrations up to 512 µg/ml of rifampicin and vancomycin. This work has demonstrated that inhalable liposomal antibiotic formulations could potentially serve as a promising new therapeutic option for treating lung infections associated with respiratory diseases.15 0Item Restricted Impact of the COVID-19 pandemic on the utilisation and quality of antibiotic use in the primary care settings in England: a population-based, segmented interrupted time series analysis(Saudi Digital Library, 2023) Almutairi, Najla; Kurdi, AmanjBackground: Antimicrobial resistance (AMR) is a public health threaten driven by inappropriate use of antibiotics. During covid-19 there were concerns of increased AMR, but the evidence is limited. this study assessed the impact of Covid-19 on the quantity and quality of antibiotic utilization in primary care in England. Research design and methods: A population-based segmented interrupted time series analysis was conducted to monthly dispensed antibiotics prescriptions using the prescription cost analysis (PCA) of England from March 2019 to March 2023. Antibiotic quantity was measured using the number of antibiotics items dispensed (TID)/1000 inhabitants and Defined Daily Dose (DDD)/1000 inhabitants/day. during and after the first and second lockdown (March 2020, Novembre 2020) stratified to 11 groups based on British National Formulary (BNF) antibiotics classification. While the quality of antibiotics was evaluated using 3 quality indicators: WHO AWaRe classification, and 4C antibiotics, and proportion of broad-spectrum antibiotics. Results: For all antibiotics, there was a non-significant increased TID Before the first lockdown but, non-significant decrease in the level after the first and second lockdown. However, a significant increase in the trend after the second lockdown for all antibiotic classes was observed, with an average increase of .56, and .315 for (DDD). For the quality outcomes, there were no impact of covid 19 on WHO AWaRe antibiotics classes (Access antibiotics increased from 77% in March 2019 to 86% in March2023) and broad-spectrum antibiotics. The proportion of 4C antibiotics decreased significantly after the first lockdown (β3 = -.886, p=.019). Conclusion: The study concludes that, Covid-19 has not significantly impacted the utilization of antibiotics. Also, the quality of the utilization remains unaffected. This study supports further investigation into the impact of remote consultation during Covid-19 and use detailed patient and prescription information. Keywords: Antibiotics, COVID-19, Antimicrobial stewardship, primary healthcare, England9 0