Ruchita S. Math,
Jay B. Prajapati,
Dhvanil J. Desai,
Krishna J. Desai,
Jalpesh B. Rathod,
- Assistant professor, Shetty Institute of Pharmaceutical sciences, Gulbarga, Karnataka, India
- Researcher, Department of Pharmacy Practice, Maliba Pharmacy College, Uka Tarsadia University, Bardoli, Gujarat, India
- Researcher, Department of Pharmacy Practice, Maliba Pharmacy College, Uka Tarsadia University, Bardoli, Gujarat, India
- Researcher, Department of Pharmacy Practice, Maliba Pharmacy College, Uka Tarsadia University, Bardoli, Gujarat, India
- Researcher, Department of Pharmacy Practice, Maliba Pharmacy College, Uka Tarsadia University, Bardoli, Gujarat, India
Abstract
Antibiotic resistance is now one of the crucial health issues of the world, especially in hospitals where high usage of antimicrobials is increasing the rate at which multi-drug resistant (MDR) organisms appear. Misprescription, extended treatment, and over-use of broad spectrum antibiotics play a large role in the development of resistance resulting in the growth of morbidity, mortality and health care expenditure. This review analyses the essentiality of pharmacists in controlling the use of antibiotics and preventing MDR with the help of antimicrobial stewardship programs (ASPs). Pharmacists can play a role in prescription review and optimization, dose change, therapeutic drug monitoring, de- escalation plan, intravenous-oral conversion, and adverse drug reaction surveillance. It has been shown that pharmacist-based interventions lead to a decrease in the use of inappropriate antibiotics, increase in clinical outcomes, hospital length of stay, health care spending, and the stabilization or reducing MDR rates. Even though challenges of implementation include resource constraints and policy gaps, institutional support can be strengthened by implementing advanced technologies and improving the effectiveness of stewardship. Owing to the above, pharmacist-led antimicrobial stewardship is a sustainable approach and cost- efficient in maintaining antibiotic efficacy and enhancing patient safety within hospitals.
Keywords: Multidrug resistance, Antibiotic resistance, Antimicrobial stewardship, Clinical pharmacist, Hospital settings, Rational antibiotic use, Healthcare outcome.
[This article belongs to International Journal of Antibiotics ]
References
1. Bhagwat A. ANTIMICROBIAL RESISTANCE: AN INCREASINGLY GRAVE THREAT TO GLOBAL PUBLIC HEALTH. World journal of pharmaceutical science and research. 2025.
2. Kumar H, Mukherjee D. Antibiotic Resistance in India: An Emerging Threat and Public Health Concern. SYNERGIES IN HEALING. 2025;81:33.
3. Deshwal R, Kaur B, Chanchal RK. Antibiotic Resistance in Bacteria: Mechanisms, Causes, Global Impact, and Future Strategies.
4. Karmakar S, Das A, Nandi A. Antimicrobial stewardship: Strategies, challenges, and case studies. Antimicrobial Resistance in Humans, Animals, and the Environment: Elsevier; 2026. p. 311-42.
5. Alolayyan MN, Hamadneh S, Al-Faraj H, Abedalkader T. Assessing management strategies and societal challenges of antibiotics available policies: A systematic literature review. International Journal of Healthcare Management. 2025:1-21.
6. Carneiro M, Pillonetto M. Fighting antimicrobial resistance in Brazil: strengthening diagnostic stewardship, antimicrobial stewardship, and policies for a healthier future. Frontiers in Public Health. 2026;13:1726000.
7. KhaN N. A Narrative Review on Microbial Response to Antibiotic Stress: Mechanisms of Resistance and Adaptation. Journal of Clinical & Diagnostic Research. 2025;19(1).
8. Wachino Ji. Horizontal Gene Transfer Systems for Spread of Antibiotic Resistance in Gram‐Negative Bacteria. Microbiology and Immunology. 2025;69(7):367-76.
9. Wang Y, Liu Y, Yang J, Geng M, Jia H, Wang J. Antibiotics at environmentally relevant concentrations can promote the dissemination of antibiotic resistance via both vertical and horizontal gene transfer. Biocontaminant. 2025;1(1).
10. Elbaiomy RG, El‐Sappah AH, Guo R, Luo X, Deng S, Du M, et al. Antibiotic Resistance: A Genetic and Physiological Perspective. MedComm. 2025;6(11):e70447.
11. Nusrat S, Aliyu M, Zohora FT. Mechanisms of antimicrobial resistance: From genetic evolution to clinical manifestations. AIMS microbiology. 2025;11(4):1007.
12. Slusarek D. Exploring Genetic Pathways Involved in Antibiotic Collateral Sensitivity Through the Evolution of Antibiotic Resistant Klebsiella pneumoniae: Albany College of Pharmacy and Health Sciences; 2025.
13. Khan A, Nazir A, Yousaf I, Akram A, Rashid MTB, Irshad A. The Expanding Role of Pharmacists in Antimicrobial Stewardship: Strategies to Combat Antibiotic Resistance in Healthcare Systems. Open Access Public Health and Health Administration Review. 2025;1(1):1-15.
14. OKTAVIANI F, Binti Hamid H. Effectiveness of Antimicrobial Stewardship Training on Pharmacists’ Competence and Hospital ASP Implementation: A Multidisciplinary Approach in Riau Islands Province, Indonesia. F1000Research. 2025;14:1150.
15. Thomas NV, Samanta S, Sushma M, RH SR. Clinical Pharmacists vs. Antimicrobial Resistance: Evidence-Based Strategies and Stewardship Impact in Modern Healthcare: A Review. Journal of Drug Delivery & Therapeutics. 2025;15(8).
16. Albaqawi AF. The Synergistic Role of Interprofessional Healthcare Teams in Advancing Antimicrobial Stewardship Programs. Saudi J Med Pharm Sci. 2025;11(7):581-93.
17. Yulistiani Y, Barkah HH, Utomo FN, Andrianto L, Jathi AP, Yudistira NGPR. Analysis of Defined Daily Dose (DDD) and antibiotic problems in Intensive Care Unit (ICU) patients. Exploratory Research in Clinical and Social Pharmacy. 2025:100688.
18. Ahmed R, Tamim TR. Enhancing medication safety: the role of community and hospital pharmacists in modern healthcare systems. Radinka Journal of Health Science.2025;2(3):328-55.
19. Puri B, Vaishya R, Vaish A. Antimicrobial resistance: Current challenges and future directions. Medical Journal Armed Forces India. 2025;81(3):247-58.
20. Kaur P, Aggarwal S, Arora V. Chemical and Strategic Approaches to Addressing Antimicrobial Resistance and Preserving Antibiotic Efficacy: A Systematic Review. Current Enzyme Inhibition. 2025.
21. Kubai D, Adome R, Munanura E, Ashiru-Oredope D, Moriasi G. Implementation status and challenges affecting antimicrobial stewardship programmes in private hospitals in Kampala, uganda: insights from a cross-sectional descriptive survey. PLOS Global Public Health. 2025;5(9):pgph. 0004333. exml.
22. Dreser A, Hegewisch-Taylor J, Cortés-Ortiz MA, Levy-Hara G. Progress and challenges in the implementation of antimicrobial stewardship programs in 50 hospitals in Mexico. Journal of Global Antimicrobial Resistance. 2025;43:40-50.
23. Pauwels I, Versporten A, Ashiru-Oredope D, Costa SF, Maldonado H, Porto APM, et al. Implementation of hospital antimicrobial stewardship programmes in low-and middle- income countries: a qualitative study from a multi-professional perspective in the Global- PPS network. Antimicrobial Resistance & Infection Control. 2025;14(1):26.
24. Mudenda S, Chizimu JY, Daka V, Hangoma J, Mwangilwa K, Gardner P, et al. Antimicrobial stewardship program implementation, perceptions, and barriers in Zambia: across-sectional study among healthcare professionals. Antibiotics. 2025;14(11):1094.
25. Jamil H, Nuhrio SM, Memon AA, Soomro AA, Nohri AR. Uncovering the roadblocks: Challenges to implementing antimicrobial stewardship in Pakistan. Link Medical Journal. 2025:e2-e.

International Journal of Antibiotics
| Volume | 03 | |
| Issue | 02 | |
| Received | 07/05/2026 | |
| Accepted | 16/05/2026 | |
| Published | 30/05/2026 | |
| Publication Time | 23 Days |