Antimicrobial Pharmacists Optimize Antibiotic Use to Mitigate Resistance

As antimicrobial resistance (AMR) becomes an increasing threat to public health, the health care community’s recent focus on infectious disease has been paramount to the lives and outcomes of millions of patients in the US.¹ Compounding the growing threat of AMR is Secretary of the US Department of Health and Human Services Robert F. Kennedy Jr’s January 5, 2026, move to scale back childhood vaccine recommendations.²

The direct result, researchers explain, will be fewer children receiving vaccines for infectious diseases and many more children seeking prescriptions for antibiotics due to their risk of sickness. Amid the dual threats of AMR and vaccine hesitancy, accessible community pharmacists certified in antimicrobial stewardship (AMS) are more crucial than ever.

“Most antibiotics are prescribed, dispensed, and consumed in the community setting,” wrote the authors of a study recently published in Exploratory Research in Clinical and Social Pharmacy.¹ “Community pharmacists have a great potential to optimize antibiotic use and mitigate antibiotic resistance in this setting through antibiotic stewardship (ABS).”

However, the authors noted, community pharmacists are still predominantly limited to dispensing—mainly antibiotics—and treating minor infectious disease outcomes and symptoms. Although there is a much greater conversation to be had regarding pharmacists’ scope of clinical practice and expertise in the entirety of health care, these providers are quietly making themselves known as AMS experts.

Intersection of Policy Shifts and AMR Surge

During the COVID-19 pandemic, community pharmacists and pharmacies were recognized for their contributions to public health through the provision of vaccines, as well as extensive education on drug formularies, drug shortages, and the prevention and management of the disease.³

However, throughout the pandemic, conversations surrounding immunizations and health care in general became significantly politicized.

In 2026, many of these conversations continue, with Republican-leaning individuals becoming increasingly skeptical of vaccine technology, while those identifying as Democrats often continue to support them. According to a Pew Research Center survey, Democrats are much more aligned than Republicans on childhood vaccine schedules, which the Republican-led Trump administration just scaled back.^2,4 The report stated that 32% of Republicans and 71% of Democrats surveyed have “high confidence” in these vaccines. Of the respondents who reported low confidence, 31% identified as Republicans and 7% identified as Democrats.

Many experts agree that the continuation of distrust in vaccines comes at a detrimental time, as growing rates of AMR make it more difficult to keep patients healthy amid increased infectious disease rates. “As per the World Health Organization (WHO), AMR is responsible for millions of deaths annually and is predicted to claim up to 10 million lives per year by 2050 if left uncurbed,” noted the authors of a study published in Infection and Drug Resistance.⁵

All of these trends, despite being potentially harmful to public health in the US, open the door for pharmacists to enroll in ABS and AMS programs.

From Dispensers to Stewards

“Antimicrobial stewardship pharmacists facilitate the safe and appropriate use of antimicrobial drugs,” wrote Timothy P. Gauthier, PharmD, BCPS, BCIDP, for ID Stewardship.⁶ “It involves education, informatics, drug information, performance improvement, team building, coaching, regulatory preparedness, championing campaigns, implementation science, systems optimization, engaging stakeholders, facilitating medication or lab test utilization evaluations, data analysis, running meetings, and much more.”

Through the Society of Infectious Diseases Pharmacists’ ABS certificate program, pharmacists can become certified antibiotic stewards and practice their knowledge in a wide range of settings.^6,7 Giving them the necessary knowledge in microbiology and pharmacology, and the fundamentals of addressing AMR, this program is getting more attention from pharmacy personnel focused on public health, infectious disease, respiratory viruses, and more.

But as this certificate is quite specific to certain public health issues, what is the US health care system’s capacity to actually use these programs for public health efforts?

“Community pharmacists are essential in fighting one of the most pressing threats to public health: antibiotic resistance,” Lambert et al wrote.¹ “Yet, the high potential for community pharmacists to optimize antibiotic use is insufficiently reflected in practice.”

Regardless of whether practicing community pharmacists are aware of the ABS program, researchers and health care experts believe a ripple effect will occur from fewer vaccinations and greater infectious disease rates.²

Although pharmacists are encouraged to be proactive and use their judgment in addressing AMR in the community, they also have other practice-related concerns that require attention. With prescribing usually performed by a primary care physician, those prescriptions—often antibiotics—can be managed by the pharmacists who dispense them. Access to primary care and pharmacy services, according to the authors, can make a real difference in addressing the growing trends of infectious diseases.

“The community pharmacist operates in a complex and multidisciplinary field, underlining the importance of collaboration with general practitioners and other health care professionals to rationalize antibiotic use,” Lambert et al wrote.¹ “The complexity of antibiotic use in primary care means that changes to community pharmacy practice can only be achieved by aligning pharmacy education, primary care policy, and pharmacy practice research.”

REFERENCES

1. Lambert M, van Dijk L, Benko R, et al. The role of the community pharmacist in antibiotic use - a commentary on current status and future perspectives. Explor Res Clin Soc Pharm. 2025;20:100652. doi: 10.1016/j.rcsop.2025.100652

2. Nowosielski B. HHS limits vaccine recommendations for childhood schedules. Drug Topics. January 5, 2026. Accessed January 8, 2026. https://www.drugtopics.com/view/hhs-limiting-vaccine-recommendations-for-childhood-schedules

3. Hussain K, Ambreen G, Muzammil M, Raza SS, Ali U. Pharmacy services during COVID-19 pandemic: experience from a tertiary care teaching hospital in Pakistan. J Pharm Policy Pract. 2020;13(1):74. doi:10.1186/s40545-020-00277-5

4. Yam E, Kikuchi E, Pula I. How do Americans view childhood vaccines, vaccine research and policy? Pew Research Center. November 18, 2025. Accessed January 8, 2026. https://www.pewresearch.org/science/2025/11/18/how-do-americans-view-childhood-vaccines-vaccine-research-and-policy/

5. Patil S, Singh I, Verma IK. Vaccines as potential frontliners against antimicrobial resistance (AMR): a focused review. Infect Drug Resist. 2025;18:5023-5041. doi:10.2147/IDR.S544665

6. Gauthier TP. What is an antimicrobial stewardship pharmacist? ID Stewardship. Accessed January 8, 2026. https://www.idstewardship.com/id-pharmd-qa/antimicrobial-stewardship-pharmacist/

7. Antimicrobial stewardship certificate program. Society of Infectious Diseases Pharmacists. Accessed January 8, 2026. https://sidp.org/Stewardship-Certificate