Antibiotic Shortages: Pharmacists' Experiences, Perspectives, and Perceived Clinical Impacts

Background: Australia has experienced high rates of antibiotic shortages, yet little is known about how Australian pharmacists experience and manage them. This study aimed to explore Australian community and hospital pharmacists' experiences of antibiotic shortages, including their perceived clinical impact and approaches to managing shortages. Methods: An exploratory qualitative study using semi-structured interviews was conducted with Australian community and hospital pharmacists between May and August 2024. Participants were recruited via convenience sampling through professional networks and social media. Interviews were audio-recorded, transcribed verbatim, and analysed thematically using an inductive-deductive approach, with coding performed independently by two researchers. Results: Fifteen interviews were conducted before data saturation was reached. Sixty percent of participants were female, 67% worked in hospital settings, and pharmacists were located across five Australian states. Four overarching themes were identified: factors driving shortages, communication and collaboration, impact of shortages, and mitigation and prevention. Pharmacists described antibiotic shortages as frequent and unpredictable, attributing them to supply-chain vulnerabilities, limited manufacturing, and market competition. Shortages were reported to affect treatment choice, contribute to antimicrobial resistance concerns, increase pharmacist workload and stress, and negatively affect patients. Pharmacists used strategies such as stock management, collaboration, and importing alternatives, but felt that lasting solutions required coordinated national action. Conclusions: Australian pharmacists perceive antibiotic shortages as a complex challenge affecting patient care, antimicrobial stewardship, workload, and healthcare efficiency. While pharmacists have developed reactive strategies to manage shortages, stronger communication, collaboration, and national policy coordination, alongside improved supply-chain resilience, are needed to reduce the impact of future shortages.