Community Pharmacy Interventions Contribute to Appropriate Antibiotic Care

Antibiotic Awareness Week took place from November 18 to 24, 2025, marking an annual weeklong observance to raise awareness about antibiotic resistance and the importance of responsible antibiotic use. Antibiotic resistance occurs when microbes resist the effects of the medication, allowing them to continue to grow. It is difficult, and sometimes impossible, to treat.^1,2

The CDC states that antimicrobial resistance is an urgent public health threat globally, with 1.27 million patients dying from it worldwide. In 2019, it was associated with nearly 5 million deaths. In the US, more than 35,000 patients died in 2019, and more than 2.8 million antimicrobial-resistant infections occur each year.²

Because of the nature of antibiotic resistance, pharmacists play a significant role in antimicrobial stewardship (AMS), which promotes the responsible use of antibiotics. Both hospital and community pharmacists can play a role, with the latter providing patient counseling and point-of-care testing. In a review published in the Journal of Antimicrobial Chemotherapy-Antimicrobial Resistance, the authors said, “Community pharmacy (CP) team members are rarely considered as part of AMS activities. Given the access most patients have to a CP, the involvement of CP team members as part of a structured intervention may support the achievement of the AMS objectives set at the local and international level.”³

Approximately 30% to 50% of antibiotics prescribed in hospital settings are deemed inappropriate or unnecessary, and an additional 40% to 75% of antibiotics prescribed in nursing homes are also inappropriate or unnecessary, according to the CDC. Finally, 30% of antibiotics prescribed in physicians’ offices and emergency departments are also unnecessary.⁴

In the current review, investigators aimed to understand the current evidence for community pharmacists in AMS-related interventions as well as identify any barriers to these interventions. They included 38 reports from 36 studies for the final review, with 12 from the US, 9 from the UK, 3 from both Canada and Nigeria, 2 from both Australia and France, and 1 each from Japan, Malta, Poland, Spain, the Netherlands, Turkey, and Bolivia. The most frequent data sources included patient interviews, point-of-care testing, and drug prescription orders, with screening results, drug selection, and medication adherence making up the most common variables assessed.

“Most of the interventions in the review were service outcomes (30/38); these types of outcome were often related to medication optimization, with CP-based interventions leading to a more appropriate use of antimicrobials according to local guidelines in many cases,” the study authors said.³ “Humanistic outcomes were reported in 17 interventions, with medication adherence being addressed in all of them; most of these interventions reported improvements in the groups of patients attending the CP compared with those who did not.”

Most of the barriers included the cost to implement interventions, including technology. However, for interventions that were considered simple, inexpensive, or cost-effective, it was easier to implement them. In 10 of the studies, the lack of or inadequate remuneration was considered a major barrier, and the easy accessibility of community pharmacists was considered the predominant facilitator.³

“Financial issues represented a dominant construct, with the lack of adequate remuneration being reported as a barrier for intervention implementation in 10 cases,” the study authors wrote.³ “Lack of time significantly impacting CP workload (n = 7) was the most common barrier in terms of available resources and lack of training in intervention delivery (n = 3) resulted in lack of access to knowledge and information.”

The authors stated that their findings show how the pharmacist’s role expands past the supply of medication and encompasses AMS, in addition to other conditions such as cardiovascular disease, diabetes, and asthma. Further, they concluded that there is a lack of AMS implementation across community settings, but the implementation of these interventions for community pharmacists is essential.³

“The review highlights and confirms the need of incorporating CPs in remunerative schemes when involved in AMS; such involvement is facilitated by positive relationships between community pharmacists and patients,” the study authors wrote.³ “Future research may look towards building relationships of trust between community pharmacists and [general practitioners] to work collaboratively in AMS-related interventions.”

REFERENCES

1. Antibiotic Awareness Week. Society of Infectious Diseases Pharmacists. Accessed October 27, 2025. https://sidp.org/Antibiotic-Awareness-Week/

2. About antibiotic resistance. CDC. January 31, 2025. Accessed October 27, 2025. https://www.cdc.gov/antimicrobial-resistance/about/index.html

3. Zerbinato F, Cunningham S, Tonna AP. Antimicrobial stewardship interventions involving community pharmacy teams: a scoping review. JAC Antimicrob Resist. 2025;7(5):dlaf156. doi:10.1093/jacamr/dlaf156

4. Improve antibiotic use. CDC. Updated March 9, 2022. Accessed October 27, 2025. https://archive.cdc.gov/#/details?url=https://www.cdc.gov/sixeighteen/hai/index.htm