Introduction: The ambulatory care pharmacy practice in the Kingdom of Saudi Arabia (KSA) is a fairly new but evolving specialty that has provided patient‐centered care in various clinics over the past 20 years. It mainly resembles the United States in its structure and provides its services to patients mostly free of charge. The Saudi Vision 2030 and the new transformation in its health care system present many opportunities for ambulatory care clinical pharmacists with some expected challenges. Method: This is a review written by a group of experts under the Saudi Society of Clinical Pharmacy umbrella propose a definition and comprehensively review the history of ambulatory care pharmacy practice in KSA, the currently available services, potential future opportunities, and expected challenges. Results: The expert's insight would support the ambulatory care pharmacy practice in KSA, evaluate the need to expand its services, define its role, and suggest set requirements for pharmacists to be eligible to provide ambulatory care pharmacy services. Conclusion: The position statement recommendations may help legislative bodies provide a more explicit explanation of ambulatory care pharmacy services in KSA to build a more robust base structure for such services.

The data collected in this study does appear to indicate there may be an increased incidence of blood dyscrasias in Saudi Arabs which warrants further, more detailed, study. It would be of concern to psychiatric clinicians if the case of a genetic predisposition to clozapine-induced blood dyscrasias were proven in the future.

Introduction The evolving specialty of ambulatory care pharmacy practice under the clinical pharmacy profession in the Kingdom of Saudi Arabia (KSA) has blossomed recently. It has provided patient‐centered care in multiple areas such as medication therapy management, anticoagulation, diabetes management, and immunization that advanced over the past two decades. In light of the Saudi Vision 2030, the ambulatory care pharmacy practice awaits tremendous opportunities with expected challenges that require consequential efforts and vigilant planning by clinical pharmacists and concerned governmental and non‐governmental bodies. Objectives Describe the current and future development of ambulatory care pharmacy services in KSA and propose a scheme for collaborative practice agreement (CPA). Methods This is a review written by a group of experts under the umbrella of the Saudi Society of Clinical Pharmacy (SSCP) to propose a structured strategy for building an ambulatory care pharmacy practice in KSA, describe the currently available services and training requirements, and suggest a scheme for CPA. Results and Conclusion The experts' vision support the ambulatory care pharmacy practice in KSA, recommends a framework and constructed elements for a unified and comprehensive CPA in the region. It emphasizes on the training and set requirements for pharmacists to be eligible to provide ambulatory care clinical pharmacy services in a defined care setting.

days prior to hospitalisation. Crude in-hospital mortality and composite cure rate (significant resolution or complete resolution of all signs and symptoms of the infection), defined as both clinical cure and microbiological eradication were evaluated. Statistical analysis was performed using SPSS statistics v24.0. Results A total of 155 infections in 87 patients were included. Mean age was 67 (IQR 50-75) years. Median CCI was 3 (IQR 1-5). 43.9% of patients had previous hospitalisation and in 42.4% of patients antibiotics were administered previously. Thirty-three per cent of patients were transferred from another hospital or a social-sanitary centre. Death occurred in 19.4% of infections. The main infections were urologic (42.6%). 5.8% were PDR strains, 17.4% were colistin-resistant and 40.0% meropenem-resistant strains. The main systemic antibiotics used were: colistin 22.7% and meropenem 20.7%. Intratracheal and inhaled antibiotics were used in 4.0% and 1.0% of episodes respectively: 27.1% were combined treatments. Microbiological resolution was achieved in 54.2% of infections, while clinical resolution was observed in 75.5%. Non-statistically significant results were obtained when comparing the effectiveness of combination therapy versus monotherapy in achieving clinical resolution (OR:0.539; 95% CI: 0.246 to 1.181). Conclusion In our hospital these kinds of infections were produced in the older population with a moderate CCI and previous exposure to antibiotics. A high percentage of meropenem-resistant strains were found. Combination therapy was not more effective than monotherapy in achieving clinical resolution.

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