{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T06:17:16Z","timestamp":1778566636348,"version":"3.51.4"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nasal congestion is a frequent symptom of upper respiratory illnesses. Over-the-counter decongestants such as xylometazoline are widely used, providing rapid relief but prone to misuse. In Saudi Arabia, there is limited evidence of public attitudes, practices, and predictors. This study aimed to assess knowledge, attitudes, and practices toward xylometazoline among adults in Saudi Arabia and to identify sociodemographic predictors of appropriate use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey, conducted between May and July 2025, included adults (\u226518 years) residing in Saudi Arabia. A validated questionnaire was used to collect sociodemographic data, xylometazoline use, and assess KAP scores. Descriptive statistics summarized outcomes. Spearman\u2019s rho assessed correlations among KAP domains. Predictors of knowledge, attitude, and practice were examined using binary logistic regression, reported as adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Two-sided p &amp;lt; 0.05 was considered statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 422 individuals participated; 226 (53.6%) were female, and 185 (43.8%) were aged 18\u201330 years. Xylometazoline use in the past 12 months was reported by 295 (69.9%). Overall, 217 (51.4%) demonstrated good knowledge, 232 (55.0%) held a positive attitude, and only 37 (8.8%) reported good practice, while 187 (44.3%) reported poor practice. Postgraduate education was significantly associated with good knowledge (aOR 2.78, 95% CI 1.42\u20135.45), while chronic nasal infections with severe dryness were strongly associated with good practice (aOR 6.29, 95% CI 1.72\u201322.97). Good practice decreased with higher frequency of use (1\u20133 times\/year: aOR 0.37; 4\u20136: aOR 0.18; &amp;gt;6: aOR 0.05; all p &amp;lt; 0.001). Regional variations in knowledge and attitudes were also observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Xylometazoline use is highly prevalent in Saudi Arabia, with favorable knowledge and attitudes but suboptimal practices. Younger age and higher education were associated with better knowledge, while female sex and nasal conditions predicted safer practices. Public education and pharmacist-led counseling, particularly on safe duration of use, are essential to close the knowledge\u2013practice gap and reduce misuse.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1818680","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T05:46:03Z","timestamp":1778564763000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Knowledge, attitudes, and practices toward xylometazoline nasal spray use among adults in Saudi Arabia: a cross-sectional survey"],"prefix":"10.3389","volume":"17","author":[{"given":"Fahad H.","family":"Baali","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, Taif University","place":["Taif, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah A.","family":"Alshehri","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, Taif University","place":["Taif, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raghad D.","family":"Alsufyani","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Taif University","place":["Taif, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hawazin S.","family":"Alsufyani","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Taif University","place":["Taif, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wadia S.","family":"Alruqayb","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, Taif University","place":["Taif, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulkarim","family":"Alshammari","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, Northern Border University","place":["Rafha, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saeed Saad A.","family":"Alghamdi","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, Taif University","place":["Taif, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohra","family":"Aladwani","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, Taif University","place":["Taif, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fahad M.","family":"Alqarni","sequence":"additional","affiliation":[{"name":"Pharmaceutical Outcom Department, Quality and Outcomes Monitoring, Branch of Ministry in Taif","place":["Taif, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali H.","family":"Alwadai","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, Najran University","place":["Najran, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wael Y.","family":"Khawagi","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, Taif University","place":["Taif, Saudi Arabia"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"537","DOI":"10.3390\/healthcare11040537","article-title":"Knowledge of, attitudes towards, and practices of intranasal corticosteroids usage among the allergic rhinitis patients of Northern Saudi Arabia: a cross-sectional study","volume":"11","author":"Al-Rasheedi","year":"2023","journal-title":"Healthc. 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