The role of the community pharmacist in antibiotic use - a commentary on current status and future perspectives

Most antibiotics are prescribed, dispensed, and consumed in the community setting. Community pharmacists have a great potential to optimise antibiotic use and mitigate antibiotic resistance in this setting through antibiotic stewardship. This commentary aims to highlight critical areas where community pharmacists can contribute to optimising antibiotic use and to offer suggestions for how this can be implemented in practice. Currently, the role of the community pharmacist is mostly limited to dispensing of antibiotics and treatment of minor infectious ailments. This role needs to evolve to optimise antibiotic use and mitigate resistance development. Following the Social Care Framework for applying person-centred healthcare, there are five strategies through which the role of the community pharmacist can evolve: awareness, adjustment, assistance, alignment, and advocacy. Concretely, this could include many different activities such as better informing and counselling patients, optimising antibiotic treatment duration and choice, exact quantity dispensing, performing point-of-care tests, pharmacist prescribing of antibiotics, and joining academic detailing and public health campaigns. To achieve this, education, policy, and research need to be further aligned. In many countries, pharmacy education on antimicrobial stewardship needs a stronger basis in universities, followed by early career specialisation and continuous professional development. National and international policy changes are needed to recognise such specialisations and allow more advanced pharmacy services. Pharmacy research must be expanded and tailored to the community setting with innovative and practice-based designs. This will allow community pharmacists to fully embrace an enhanced position in antibiotic use and primary care.