Assessment of Antibiotic Stewardship Program Effectiveness in a Community Pharmacy Network

Thesis Abstract

Antibiotic misuse and overprescription in community pharmacy settings remain significant contributors to antimicrobial resistance, posing a critical challenge to public health. This study aims to evaluate the effectiveness of existing antibiotic stewardship programs (ASPs) implemented within a network of community pharmacies, focusing on measuring their impact on prescribing practices, pharmacy staff knowledge, and patient outcomes. The specific objectives include assessing changes in antibiotic dispensing patterns pre- and post-ASP implementation, determining the level of antibiotic stewardship knowledge among pharmacy staff, and exploring patient adherence and understanding of antibiotic use following stewardship interventions. Employing a mixed-methods research design, the study integrates quantitative analysis of prescription data and survey results with qualitative insights from semi-structured interviews. The quantitative component involves a retrospective review of 12 months’ worth of pharmacy dispensing records collected from a sample of 150 community pharmacies, selected through stratified random sampling across urban and rural settings. Prescription data are analyzed using interrupted time series analysis to identify shifts in antibiotic dispensing trends post-implementation. Surveys assessing pharmacy staff’s knowledge and attitudes towards antibiotics are administered to 300 pharmacy professionals using validated questionnaires, with data analyzed via descriptive statistics, paired t-tests, and multiple regression analysis to identify predictors of stewardship compliance. Qualitative data obtained from 30 semi-structured interviews with pharmacists, pharmacy technicians, and patients are analyzed thematically using NVivo software, guided by the Health Belief Model and Social Cognitive Theory to interpret behavioral factors influencing antibiotic use and stewardship practices. Validity and reliability of survey instruments are established through pilot testing, Cronbach’s alpha, and expert review. The anticipated findings indicate a statistically significant reduction in inappropriate antibiotic dispensing rates following ASP interventions, with improved knowledge and positive attitudes among pharmacy staff towards antibiotic stewardship. The study expects to reveal key behavioral and systemic barriers to effective ASP implementation, including misconceptions about antibiotics, lack of continuous training, and insufficient collaborative practices with healthcare providers. These findings will contribute novel insights into the contextual determinants of antibiotic stewardship effectiveness in community pharmacy settings, addressing a notable gap in regional and practice-specific evidence. The study’s contribution extends theoretical understanding by applying established behavior change theories to the realm of pharmacy practice and stewardship success, and it provides empirical data to inform policy and education strategies tailored to community pharmacists. Policy implications include advocating for targeted training programs, improved communication channels between pharmacies and prescribers, and the integration of stewardship principles into routine pharmacy operations. It is concluded that well-structured ASPs, reinforced by continuous professional development and behavioral interventions, can significantly improve antibiotic prescribing behavior in community pharmacy networks. The study recommends the adoption of standardized stewardship protocols, ongoing monitoring, and multisectoral collaboration. Further research is suggested to explore long-term sustainability of stewardship practices and patient-centered outcomes in diverse community settings. This research, therefore, offers a comprehensive assessment of stewardship program efficacy, with practical implications for reducing antimicrobial resistance and enhancing pharmaceutical care quality.