Pharmacists Are Essential in Combating Antibiotic Misuse, Resistance

Every time a patient walks into a pharmacy and asks whether they really need a specific antibiotic, or whether they can stop taking it once they start feeling better, they are presenting their pharmacist with one of the most consequential teaching moments in modern public health.

In a recent conversation with Josh Caraccio, PharmD, BCIDP, BCPS, principal implementation engineer of pharmacy and ambulatory care surveillance with Inovalon, he broke down the most persistent myths surrounding antibiotic use and made a compelling case for why pharmacists are one of the most powerful and underutilized forces in the fight against antibiotic resistance.

The 2 most common misconceptions Caraccio encounters are also the most contradictory. Some patients believe they need an antibiotic for every illness, while others wonder why they have to finish the full course once they start feeling better. The answer to both, he explained, is nuanced but critical.

Antibiotics do nothing against viral infections and taking them unnecessarily can cause real harm. But when a bacterial infection is confirmed, finishing the full course is non-negotiable. Stopping early may leave behind resistant bacteria, quietly setting the stage for harder-to-treat infections down the line.

Much of today's antibiotic misinformation, Caraccio argued, stems from a broader cultural expectation that there is a pill for everything. In 2026, that assumption is deeply embedded in how many people approach their health, and it is leading to overuse of medications that were never designed to be taken indiscriminately.

The goal of antimicrobial stewardship is to preserve the antibiotics we have by using them only when they are truly indicated, for the right duration, and for the right infection.

The Pharmacist’s Role in Advancing Antimicrobial Stewardship

Pharmacists are ideally positioned to advance that goal. With physical locations embedded in grocery stores, chain pharmacies, and community hubs across the country, pharmacists offer something most other health care providers cannot: immediate, trusted access.

Patients who cannot get their doctor on the phone can walk up to a pharmacy counter and get a knowledgeable answer in real time.

Caraccio recalled an instance early in his career when a clinic he had never worked with called to ask if they could simply reach out to him directly with antibiotic-related questions. He told them they absolutely could. To Caraccio, that kind of informal but meaningful relationship is exactly the kind of bridge that moves stewardship efforts from hospital policy into everyday practice.

The Value of Clinical Surveillance

Clinical surveillance tools are also changing the way antimicrobial stewardship is conducted, particularly in hospital settings.

Before these tools existed, Caraccio described spending significant time manually hunting through lists of positive cultures and antibiotic orders to identify mismatches or de-escalation opportunities.

Surveillance platforms now surface that information automatically, alerting pharmacists when a prescribed antibiotic does not align with culture results and giving them a clear entry point into conversations with providers about adjusting care. Rather than concentrating all of that knowledge among a single specialist, these tools distribute stewardship capacity across entire pharmacy teams, empowering practicing pharmacists and new practitioners alike to catch problems and ask the right questions.

That spirit of asking questions is ultimately what Caraccio wants both pharmacists and patients to take away from this conversation.

Why was this antibiotic chosen? Why is the duration this long and not longer? What does this culture result actually mean for the patient in front of me? Those questions, he said, are not a sign of distrust; they are the foundation of better antibiotic use and a smarter, safer health care system.

For pharmacists looking to sharpen their role in antimicrobial stewardship, and for patients who want to understand what is actually in the bottle they are taking home, this conversation offers practical insights that make a real difference at the point of care.