Developing a Pharmacist-Centered Novel Antimicrobial Stewardship (AMS) Approach for Healthcare in Pakistan: A...

Antimicrobial resistance (AMR) is one of the most significant global health threats of the 21st century, endangering healthcare systems worldwide as a silent pandemic. Despite the globally recognized role of pharmacists as antimicrobial stewards, their involvement remains limited in antimicrobial stewardship (AMS) endeavors in Pakistan.

By utilizing the Straussian grounded theory methodology, this study aimed to develop a pharmacist-centered novel AMS approach for healthcare in Pakistan in order to enhance the engagement of pharmacists in AMS and reduce the burden of AMR in Pakistan. Through 13 semi-structured in-depth interviews with pharmacists and AMS experts, this study explored the facilitators and obstacles faced by pharmacists in Pakistan pertaining to their participation in AMS.

The findings highlighted the underutilization of pharmacists in AMS owing to persistent policy, institutional, and resource-level barriers. Several facilitators were also identified, including institutional ownership and pharmacist-prescriber-patient (3P) communication. The evidence generated informed the development of the pharmacist-centered novel AMS approach, which recommends extending AMS policy support to pharmacists, improving One Health interdisciplinary collaborations, promoting pharmacist-led behavior change campaigns, granting prescribing rights to pharmacists for minor ailments, and advancing AMS trainings and education.

Formally integrating pharmacists into AMS efforts is the need of the hour to contain the consequences of AMR in Pakistan.