The Role of Pharmacists in Supporting Adherence to Antimicrobial Therapy During Breastfeeding: An Uncontrolled...

Community pharmacists have the potential to provide adherence-support interventions, address adverse effects, and optimize health outcomes in vulnerable patient populations such as breastfeeding women who need rational antimicrobial therapy.

The primary aim of this study was to investigate the influence of community pharmacists' adherence support interventions on outcomes of antimicrobial therapy use and breastfeeding continuation in breastfeeding women.

A prospective interventional before-after study was conducted in community pharmacies in Serbia (May-October 2022) within the Mama Friendly Pharmacy project. Breastfeeding women (N = 182) receiving antimicrobial therapy completed validated questionnaires and received pharmacist-led counseling, including risk assessment using specialized databases. A follow-up assessment included evaluated adherence, breastfeeding continuation, infant safety, and factors associated with intervention outcomes. Data were analyzed using SPSS (Version 24).

The results indicate that 84.71% of participants who believed that medications should be avoided during breastfeeding-regardless of clinical indication-expressed concerns about using the prescribed antimicrobial agent. Likewise, 58.76% of participants who generally held a positive attitude toward medication use during breastfeeding also reported uncertainty regarding antimicrobial therapy. Overall, 95.2% of participants accepted the recommended therapy and monitoring advice. Follow-up was completed by 80.8%, with positive outcomes and only 14 minor infant adverse effects reported, none requiring medical intervention. Logistic regression identified maternal age as the only significant predictor of follow-up participation.

By improving both therapy acceptance and duration and supporting informed decision-making regarding breastfeeding, community pharmacists play a critical role in resolving uncertainties, preventing interruption of breastfeeding, and helping address antimicrobial resistance.