Antimicrobial stewardship in community settings
Published: 17 November 2025
This article was published when the organisation was the Royal Pharmaceutical Society.
It’s no overstatement to say antimicrobial resistance (AMR) is one of the gravest threats to global health in the 21st century, which is why this year’s theme for international World AMR Awareness Week urges us to Act Now: Protect Our Present, Secure Our Future, and highlights the need for robust antimicrobial stewardship (AMS) across all settings.
The English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) reports that over 70% of all antibiotics are prescribed in primary care settings, a figure that is only likely to increase with the new NHS 10-year plan shifting care from hospital to community. As highlighted in the RPS policy, the AMS role for pharmacists in community settings goes beyond traditional roles, and we must remain competent and be supported in this challenge.
Pharmacists in community settings, including those working in community pharmacies, GP practices, primary care networks and out-of-hours services occupy a crucial position at the heart of antimicrobial use, extending across the whole patient pathway, including management of common conditions, supply of OTC and prescribed treatments, advice and guidance to other healthcare professionals, and patient counselling and education. Our role is key to ensuring that antimicrobials are used judiciously and in accordance with the latest evidence (resources such as those available on the AMS resource page can support this). For independent prescribers, frameworks such as the RPS Prescribing Competency Framework and the UKHSA Antimicrobial Prescribing and Stewardship Competency Framework can support reflection on practice and promote safe and effective use of antibiotics.
A leading role for pharmacists
Pharmacists can play a leading role in quality improvement initiatives beyond prescriptions and direct patient care, including conducting audits such as those outlined in the TARGET antibiotics toolkit, participating in public health campaigns, running an antibiotic amnesty scheme, or supporting accurate penicillin allergy labelling. By leading on AMS through these activities, we can help to identify trends, reduce inappropriate antibiotic use and influence prescribing behaviours across the wider healthcare team.
But, despite growing awareness, several challenges persist.
Patient expectations for antibiotics remain high, particularly for respiratory tract infections, and time pressures can make thorough AMS discussions difficult. However, significant opportunities are present, for example, in the increasing integration of pharmacists into general practice teams, the expansion of independent prescribing and increased commissioning of community pharmacists to manage common infections. Pharmacists are uniquely placed to reduce reliance on antibiotics, by informing and reassuring patients, dispelling misconceptions about antibiotics, highlighting the importance of AMS. and promoting vaccination, hygiene and self-care for minor ailments.
Every prescription counts
The fight against AMR is a collective responsibility. As trusted healthcare professionals, pharmacists working in community settings must continue to lead by example: championing AMS, influencing prescribing behaviours, and educating patients. Through innovation, collaboration and persistent advocacy, we can preserve the effectiveness of antimicrobials and protect public health for future generations. Let us seize this opportunity to make a lasting impact—because every prescription counts.
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