Search Results (223)

Background/objectives: Antimicrobial stewardship (AMS) is essential to optimize antibiotic use and limit antimicrobial resistance (AMR), particularly in pediatric populations where diagnostic uncertainty and system constraints complicate care. This study investigated critical AMS indicators, namely, missed antibiotic doses, microbiological diagnostics, and antibiotic prescribing at hospital discharge, which are key challenges that may affect treatment outcomes in hospitalized children under five years old. Methods: A prospective descriptive study was conducted in two tertiary pediatric hospitals in Zambia among children aged 29 days to 59 months. Information on missed antibiotic doses, microbiological investigations, and antibiotic prescribing at discharge from hospitalization was obtained from medical records and medication charts. Results: Patients experienced 1–8 missed doses, most commonly involving benzylpenicillin and ceftriaxone. Documentation of reasons for missed doses was largely absent. Microbiological testing was requested in 36.6% of patients, but only 14.8% of antibiotic prescriptions were supported by culture and susceptibility testing. Of requested tests, 80.9% of results were unavailable at discharge, limiting clinical utility. Only 19.1% of results were available, with a low culture positivity rate (27.3%). Overall, 41.8% of patients were discharged on antibiotics, predominantly from the WHO “Access” group (78%), though 22% were “Watch” antibiotics, and none from the “Reserve” group. Shorter hospital stay was significantly associated with discharge antibiotic prescribing (p = 0.0079; χ² = 78.577, p < 0.001). Conclusions: Significant AMS gaps exist, including frequent missed doses, limited diagnostic support, and high discharge antibiotic use. Strengthening medication administration systems, improving laboratory capacity and turnaround times, and optimizing discharge prescribing are critical for enhancing pediatric AMS and reducing AMR. Full article

Background/Objectives: Infective endocarditis (IE) is a condition with complex management, and several guidelines exist to guide clinicians. Adherence to these recommendations varies and could even be described as poor. The aim of this study was to determine whether the medical specialty of the unit that initiated first-line treatment for IE was associated with risk factors of non-adherence to the 2015 ESC treatment guidelines in a population of patients aged 75 years and over. Method: We analysed data from patients with possible or definite IE included in the ENDOLA cohort, an observational, longitudinal, retrospective, nationwide, real-life cohort study involving 34 French hospitals. Logistic regression was performed using a manual stepwise method to identify variables independently associated with non-compliance of antibiotic treatment of IE with the recommendations of the 2015 ESC guidelines. Results: In total, 899 patients were included (Mean age: 83 ± 5 years, mean Charlson comorbidity score: 3 ± 2). The distribution across the medical units was 51.9% infectious disease (n = 467), 19.8% geriatric ward (n = 178), 18.5% cardiology (n = 166), and 9.8% other wards (n = 88). Patients admitted to geriatric wards were older (p < 0.0001) and were more likely to be dependent for activities of daily living (p < 0.0001). Admission to a geriatric unit was associated with a higher rate of non-compliance with the ESC guidelines (OR 1.6 (1.1–2.4); p: 0.03); prescriptions by cardiologists were more often in compliance with the guidelines (OR 0.6 (0.4–1.0); p: 0.04). Conclusions: The first-line antibiotic treatment prescribed for IE varies considerably depending on the unit responsible for providing care at the time of initial admission. Full article

Background/Objectives: The optimal antibiotic strategy for acute rhinosinusitis (ARS) in patients with comorbidities remains unclear. Guidelines often recommend amoxicillin-clavulanate (amx/clv) for high-risk patients, despite limited comparative evidence. This study compared ARS outcomes of patients with comorbidities receiving amoxicillin and amx/clv. Methods: This retrospective cohort study utilized electronic medical records from the Israeli community (2012–2023). Adults aged ≥18 years with ≥1 selected comorbidity and an ARS diagnosis were categorized according to the type of antibiotic prescribed. The primary outcome was treatment failure, defined as a follow-up ARS visit with an antibiotic prescription within 30 days of the initial visit. Secondary outcomes included ARS complications, emergency room referrals, chronic or subacute sinusitis diagnosis, and 90-day mortality rates. Adjusted odds ratios were estimated using multivariable logistic regression. Results: Of the 38,810 eligible patients, 4953 were prescribed amoxicillin, 7436 were prescribed amx/clv, and 26,421 were not prescribed antibiotics. Treatment failure rates were not significantly different when comparing amoxicillin to amx/clv or either antibiotic to no antibiotic therapy. Chronic or subacute sinusitis was more frequent with amx/clv than with amoxicillin alone. No significant intergroup differences were observed in terms of complications, emergency room referrals, or mortality rates. These findings remained consistent in a sensitivity analysis of filled prescriptions and when analyzing the outcomes of individual comorbidities separately. Conclusions: Among adults with specified comorbidities diagnosed with ARS, the rates of treatment failure, complications, and ER referrals did not differ significantly between amoxicillin and amx/clv, supporting narrow-spectrum therapy. Full article

Background/Objectives: Antimicrobial stewardship programmes (ASPs) are essential for improving antimicrobial use and limiting the emergence of antimicrobial resistance. Although national ASP key performance indicators (KPIs) have been implemented across Saudi Ministry of Health (MOH) hospitals, large-scale evaluations of programme performance remain limited. This study evaluated national ASP performance across MOH hospitals from 2021 to 2024 using formal KPIs and complementary stewardship measures. Methods: This retrospective multicentre surveillance analysis included 124,452 antimicrobial prescription reviews from 96 Saudi MOH hospitals actively reporting stewardship activities. Hospitals were classified according to ASP capacity as category A, B, or C. The evaluated KPIs included protocol adherence, restricted-antibiotic dispensing compliance, active intervention rate, annual trends in optimization interventions, and physician acceptance of ASP recommendations. Secondary assessments included appropriateness of therapy management, therapeutic drug monitoring (TDM) for vancomycin and aminoglycosides, and hospital-level antimicrobial use expressed as defined daily doses per 100 available bed-days. Multivariable logistic regression was used to identify factors associated with guideline non-adherence and physician non-acceptance. Results: Overall protocol adherence was 87.1%, exceeding the national target of 80%, while the active intervention rate was 64.6%, exceeding the 60% benchmark. Restricted-antibiotic dispensing compliance reached 87.6% but remained below the 100% target. Physician acceptance of ASP recommendations was high at 93.0%, although it did not achieve the national target of 98%. The optimization-intervention KPI was not met because de-escalation, antibiotic discontinuation, and intravenous-to-oral conversion did not demonstrate a sustained annual increase. Appropriate ongoing therapy management was documented in 68.3% of cases with available data, whereas TDM was requested in 44.5% of eligible vancomycin or aminoglycoside cases. Antimicrobial use varied across years and hospital categories, with higher monitored broad-spectrum and reserve-agent use in higher-capacity hospitals. Lower ASP capacity, non-critical care settings, and combination therapy were consistently associated with less favourable stewardship outcomes. Conclusions: Saudi MOH hospitals actively reporting stewardship activities demonstrated favourable performance in protocol adherence, intervention activity, and physician acceptance. However, persistent gaps in restricted-antibiotic dispensing, optimization interventions, TDM, and inter-hospital variation indicate the need for continued strengthening of ASP infrastructure, monitoring, and feedback systems. Future research should link stewardship indicators with clinical outcomes, antimicrobial resistance trends, and patient safety. Full article

Skin diseases are among the most frequently diagnosed conditions in companion animals and have historically been treated empirically with antibiotics, contributing to the emergence and persistence of antimicrobial resistance (AMR). In recent years, greater awareness of AMR has led to a reduction in antibiotic use in veterinary medicine, particularly in dermatology. To assess AMR trends in skin infections and evaluate the use of diagnostic tools to guide antimicrobial prescriptions, we conducted a retrospective study of medical records from a veterinary hospital in northwestern Italy between 2013 and 2024. A total of 447 antimicrobial susceptibility tests from dogs and cats with clinical signs of skin disease were analyzed. Of these, 391 yielded positive bacterial cultures, and 56 were negative. Most positive samples came from dogs (83.4%), with cats accounting for 16.6%. The most frequently isolated bacterial families were Staphylococcaceae, Enterobacteriaceae, and Pseudomonadaceae. Amoxicillin-clavulanic acid was prescribed in 36.6% of patients, fluoroquinolones in 25.9%, while 17% received only detergent–disinfectant products. Among first-line drugs, ampicillin showed the lowest susceptibility, with resistance exceeding 60%, whereas imipenem (used as an indicator of carbapenemase production but avoided in veterinary medicine) retained high activity, with susceptibility rates of 77.2% in dogs and 90.3% in cats. These findings are clinically relevant, but continuous AMR surveillance remains essential within a One Health framework to limit the spread of resistant bacteria and resistance genes to cohabiting humans. Full article

Background/Objectives: Antimicrobial resistance (AMR) is a major public health problem driven partly by inappropriate antibiotic use. Students of health studies represent future healthcare professionals with an important role in patient education, infection prevention, and antimicrobial stewardship. This study assessed knowledge, attitudes, and behaviours regarding antibiotic use and AMR among students of the Faculty of Health Studies, University of Mostar. Methods: An anonymous cross-sectional online survey was conducted in March 2025 using a self-selected convenience sample. The questionnaire was adapted from a previously published survey among Cypriot university students and distributed through student WhatsApp groups and by e-mail. Of 1113 invited students, 220 completed the survey, yielding a response rate of 19.8%. Results: During the previous 12 months, 39.5% of respondents reported antibiotic use. Most respondents reported adherence to medical instructions regarding dosage and duration of therapy, while 20.5% reported self-medication with antibiotics and 29.5% reported keeping unused antibiotics at home. Approximately 42% perceived antibiotics as easy or very easy to obtain without a prescription. Only 36.4% of respondents correctly distinguished antibiotics from other medications. Although most respondents recognised that bacteria can develop resistance, misconceptions persisted regarding humans and viruses. Differences between study programmes were observed for some attitudes and perceptions, whereas gender and year of study were not significantly associated with most responses. Conclusions: Health studies students demonstrated partial knowledge of antibiotics and AMR, together with behaviours that may contribute to inappropriate antibiotic use. Strengthened curricular content on rational antibiotic use, infection management, infection prevention, and antimicrobial stewardship appears justified. The findings are also consistent with the need to consider broader stewardship measures, including better enforcement of existing prescription-only dispensing requirements in Bosnia and Herzegovina. Full article

Chronic inflammatory enteropathy (CIE) has historically been divided into food-responsive chronic inflammatory enteropathy (CIE-FR), immunosuppressant-responsive chronic inflammatory enteropathy (CIE-IR), non-responsive chronic inflammatory enteropathy (CIE-NR) and antibiotic-responsive chronic inflammatory enteropathy (CIE-AR). Given the rising concern for antimicrobial resistance (AMR) and the effects of antibiotics on the microbiome, replacement of CIE-AR with microbiota-modulation-responsive enteropathy (MrMRE) has been suggested, and antibiotic use questioned. The objective of this study was to assess the prescribing habits of antibiotics for dogs with CIE prior to referral. This was a single-centre retrospective study of cases between 2020 and 2024 assessing antibiotic prescription for CIE in the six months prior to referral. Data including signalment, clinical signs, diagnosis, antibiotic administration and the antibiotics used were recorded. A total of 144 dogs with chronic inflammatory enteropathy were included, of which 128 had CIE without protein-losing enteropathy (PLE) and 16 had PLE. Overall, 57.6% of dogs with CIE referred for investigation were prescribed antibiotics in the six months prior to referral. Of the dogs prescribed antibiotics, metronidazole was the most prescribed (74.7%), followed by amoxicillin-clavulanate (36.1%). Dogs with diarrhoea were more likely to be prescribed antibiotics overall and were also more likely to receive metronidazole. Antibiotic use differed across the years, with the lowest rate prescribed in 2024 (26/46 [56.5%] in 2020/2021, 24/33 [72.7%] in 2022, 22/35 [62.9%] in 2023, and 11/30 [36.7%] in 2024; p = 0.031). Further work is required to understand continued antibiotic use in CIE and inform antimicrobial stewardship strategies. Full article

Background: Antimicrobial stewardship programs (ASPs) are critical for promoting rational antibiotic use. While early implementation outcomes have been reported, extended follow-up sustainability and the impact on high-priority broad-spectrum antibiotics in South Korean secondary/tertiary hospitals require further validation. This study aimed to evaluate the extended outcomes and sustainability of an ASP over a 14-month period. Methods: This retrospective, single-center study analyzed ASP activities from January 2025 to February 2026 at a tertiary hospital in South Korea. Interventions included prospective audit and feedback (PAF) for restricted antibiotics and recommendations for prolonged prescriptions (≥14 days). Primary outcomes were the monthly rejection rate of restricted antibiotics and the acceptance rate of ASP interventions. Secondary outcomes included the days of therapy (DOT) per 1000 patient–days for meropenem and piperacillin/tazobactam (Pip/Taz). Results: During the 14-month period, the ASP intervention acceptance rate increased significantly from a mean of 72.0% in the implementation phase (January–April 2025) to 81.2% in the stabilization phase (May 2025–February 2026) (p = 0.035). The DOT for Pip/Taz decreased significantly from 169.4 to 151.8 per 1000 patient–days (p = 0.002), with a significant negative correlation identified between the intervention acceptance rate and Pip/Taz consumption (r = −0.625, p = 0.017). Although overall meropenem DOT showed seasonal fluctuations without reaching statistical significance across phases, a year-over-year comparison revealed a 7.5% reduction in meropenem DOT (January–February 2025: 54.8 vs. January–February 2026: 50.7 per 1000 patient–days). The rejection rate for restricted antibiotics declined from 3.8% to 2.6%, suggesting that clinicians increasingly self-regulated inappropriate prescribing attempts. Conclusions: The ASP demonstrated extended follow-up sustainability with a significant reduction in the consumption of key broad-spectrum antibiotics. A progressive increase in clinician acceptance of ASP interventions from 72.0% to 81.2%, combined with a concurrent decline in the restricted antibiotic rejection rate, reflected a measurable shift in institutional prescribing culture and confirmed the successful transition to a stabilized program. These findings support the necessity of sustained multidisciplinary ASPs, even in resource-limited settings, to combat antimicrobial resistance effectively. Full article

Background/Objectives: This intervention study compared the impact of the PA-100 AST System (PA-100) with the standard of care on antibiotic-prescribing behaviour for community-acquired urinary tract infections in a Spanish primary care setting. Methods: Women seeking care for symptoms of uncomplicated urinary tract infections were recruited based on the last digit of their regional personal identification number in a control (no PA-100 result available) or intervention (PA-100 result available) arm. Differences in antibiotic-prescribing behaviour were analysed using Fisher’s exact test, with the sample size powered to detect a change in prescription in ≥6% of patients. Results: Availability of the PA-100 revealed resistance to fosfomycin in 21.5% of confirmed infections. This significantly shifted prescription away from fosfomycin towards nitrofurantoin and amoxycillin/clavulanic acid (p < 0.001). In accordance with local guidelines, fosfomycin was the most frequently prescribed antibiotic in the control arm (65.9%), whereas a significantly lower rate (37.7%) was observed in the intervention arm. Conclusions: The PA-100 shows potential to support antimicrobial stewardship by enabling targeted antibiotic treatment at the first visit and improving care in primary care settings. Full article

Background/Objective: Respiratory syncytial virus (RSV) is an often under-recognized cause of respiratory illness in older adults. Clinical overlap with bacterial infections and delayed virologic confirmation may lead to the unnecessary prescription of antibiotics and antimicrobial resistance (AMR). This systematic review was conducted to assess antibiotic prescription in older adults with RSV and the factors influencing these decisions. Methods: This systematic review was preregistered in PROSPERO (CRD42024586905) and reported according to PRISMA guidelines. PubMed/MEDLINE, Embase, Web of Science, Cochrane CENTRAL, and Scopus were searched for studies published between January 2000 and August 2025. Eligible studies were those including adults aged ≥60 or ≥65 years with RSV infection and reporting antibiotic use. Data on antibiotic prescription, confirmed bacterial infection, hospitalization, length of stay (LOS), and prescribing indications were extracted. Results: Eight observational studies across inpatient, outpatient, emergency, and primary-care settings were included. Antibiotic prescribing ranged from 40.0% to 97.7%, whereas confirmed bacterial infection did not exceed 20% in any study. Antibiotic prescribing was associated with diagnostic uncertainty, radiologic findings, inflammatory markers, respiratory distress, delayed RSV testing, and multimorbidity rather than microbiological confirmation. Hospitalization rates varied across settings, and the LOS ranged from 3.5 to 11 days. None of the studies reported antibiotic discontinuation following RSV confirmation. Conclusions: Older adults with RSV frequently receive antibiotics despite low rates of confirmed bacterial infection, indicating substantial empirical prescribing. Improved rapid diagnostics, reassessment of therapy, and strengthened antimicrobial stewardship may help reduce unnecessary antibiotic use. RSV vaccination may be a promising strategy for reducing severe disease and hospitalization, with a potential indirect effect on antibiotic use, although these effects remain hypothetical. Full article

Background: Antibiotic misuse and prescribing errors are significant concerns in clinical practice, contributing to unnecessary antibiotic exposure, increased adverse effects, rising healthcare costs, and the escalation of antibiotic resistance. Understanding the prevalence, patterns, and risk factors of these prescription errors is essential for improving patient safety and healthcare efficiency in the future. Aim: Our aim was to evaluate the prevalence, patterns, and risk factors of antibiotic prescription errors in Saudi Arabia. Methods: A comprehensive search of three databases (PubMed, Scopus and ProQuest) was conducted to identify eligible cohort and cross-sectional studies in Saudi Arabia published up to January 2025. Studies that reported on error rates of antibiotic prescription errors and those that did not provide quantitative data were excluded. The primary outcome was the prevalence and patterns of inappropriate antibiotic use, while the secondary outcomes included the pooled prevalence of specific errors (i.e., selection, dose, duration, etc.). The quality of the studies was assessed using the Newcastle–Ottawa scale. This review was registered in PROSPERO (CRD42024611747). Results: Fourteen eligible cohort (n = 2) and cross-sectional (n = 12) studies conducted in Saudi Arabia were included in the review. Two studies reviewed medical records and orders of patients. Patient selection varied from emergency department to intensive care units and outpatients. The pooled prevalence of antibiotic prescription errors was 42.7% [95% CI: 37.5–47.8], with common errors including dosage (29.3%), duration (24.3%), selection (15%) and frequency (11.1%) errors. However, there was a high heterogeneity among the results. Overall, the quality assessment revealed a low risk of bias, except for one study with a high risk of bias. Conclusions: These findings highlight the high prevalence of antibiotic prescription errors. Future efforts should strengthen antibiotic stewardship, enhance clinician training, and ensure adherence to evidence-based guidelines to reduce prescription errors and combat antibiotic resistance. Full article

Background/Objectives: Acute otitis media (AOM) remains a leading cause of pediatric morbidity and a primary indication for antibiotic prescription worldwide. Given the potential for serious complications and the evolving landscape of antimicrobial resistance, up-to-date epidemiological data on causative bacteria are essential. This study aimed to assess the global prevalence of major bacterial pathogens in pediatric AOM and evaluate variations across geographic regions and temporal periods (pre-2000 vs. post-2000). Methods: A systematic search of PubMed, Embase, and Web of Science (1980–2025) was conducted to identify studies reporting middle ear fluid culture results in children (0–18 years) with AOM. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 45 studies encompassing 16,305 AOM episodes were included. Data were synthesized from North America, Europe, the Middle East, Asia, Oceania, and Africa. Pooled prevalence estimates and 95% confidence intervals (CIs) were calculated using a random-effects model, and heterogeneity was assessed via the I² statistic. Results: The overall pooled culture-positive rate was 66.6% (95% CI, 62.2–70.8%). Regional pooled estimates ranged from 56.1% in the Middle East (95% CI, 40.3–70.6%; underlying counts, 3776/10,652) to 77.5% in North America (95% CI, 68.2–84.7%; underlying counts, 1567/2125). Streptococcus pneumoniae was the most prevalent pathogen, with a pooled proportion of 29.0% (95% CI, 26.3–31.8%), followed by Haemophilus influenzae (22.3%; 95% CI, 19.3–25.6%) and Moraxella catarrhalis (4.6%; 95% CI, 3.4–6.1%). While S. pneumoniae remained the leading pathogen in most regions, H. influenzae showed marked geographic variability, peaking in the Middle East at 27.5% (95% CI, 17.0–41.2%; underlying counts, 2280/10,652) and reaching its lowest level in Asia at 13.5% (95% CI, 7.8–22.4%; underlying counts, 336/1854). The pooled culture-positive rate declined from 72.5% before 2000 (95% CI, 67.6–76.9%; underlying counts, 5769/8199) to 59.4% in 2000 and later (95% CI, 52.1–66.3%; underlying counts, 6661/15,707), although S. pneumoniae remained the predominant isolate in both periods. Conclusions: S. pneumoniae remains the primary bacterial driver of pediatric AOM globally. However, the observed geographic disparities and the temporal shift in pathogen prevalence following pneumococcal conjugate vaccine (PCV) introduction underscore the necessity for region-specific empirical antibiotic selection. These findings highlight the critical need for sustained microbiological surveillance to inform future vaccination and treatment strategies. Full article

Background: The goal of this study was to evaluate whether medical recommendation of Angocin^® Anti-Infekt N (hereafter referred to as Angocin^®) on the day of diagnosis of an acute upper respiratory tract infection (aURTI) or acute sinusitis (AS) is negatively associated with a recurrence of these diagnoses, incidence of antibiotic prescriptions, incidence of chronic sinusitis, nasal polyps, or sick leave duration. Methods: This retrospective cohort study utilized the IQVIA^TM Disease Analyzer database and included patients by general practitioners with at least one diagnosis of aURTI or AS from 2005 to 2024 and a prescription of Angocin^®, nasal medications (xylometazoline, oxymetazoline) and mucolytics (ambroxol or acetylcysteine), other phytopharmaceutical drugs, or antibiotics on the day of diagnosis. Patients who received Angocin^® were matched separately to each of the three comparison cohorts in a 1:5 ratio using a nearest-neighbor propensity score approach. The relationship between Angocin^® prescription and the risks of a recurrence, subsequent antibiotic use or progression to chronic disease was then estimated with Cox proportional hazard models. To examine whether Angocin^® exposure was associated with the length of sick leave, univariable conditional logistic regression was applied. Results: A total of 3501 Angocin^® patients and 17,505 patients in each further cohort were investigated. Angocin^® prescription was associated with a significantly lower incidence of a newly diagnosed aURTI/AS as compared to other phytopharmaceuticals (Hazard ratio (HR): 0.78; 95% confidence interval (CI): 0.68–0.86), nasal medications and mucolytics (HR: 0.79; 95% CI: 0.71–0.88), or antibiotics (HR: 0.85; 95% CI: 0.77–0.95). In addition, there was a significantly lower incidence of subsequent further prescriptions of antibiotics when compared to other phytopharmaceuticals (HR: 0.92; 95% CI: 0.82–0.99), nasal medications and mucolytics (HR: 0.87 (95%; CI: 0.80–0.95), or antibiotics (HR: 0.62; 95% CI: 0.57–0.67). Furthermore, Angocin^® was associated with the most advantageous pattern of work absence across all time periods examined. Conclusions: Considering the limitations of the study, the results cast a positive light on Angocin^® prescription in the management of aURTI/AS, particularly with regard to recurrence rates, subsequent antibiotic prescriptions, and sick leave duration. Full article

Prescription drug misuse disproportionately impacts American Indian communities, yet limited research explores how trust in healthcare settings affects behaviors related to prescription drug use. Using data from a 2017 cross-sectional survey of 781 American Indian adults in the Plains region, this study aims to examine the association between trust in health information provided by physicians and the misuse of prescribed medication, while identifying demographic and structural factors that influence trust levels. To assess trust, the study utilized a tool consisting of questions adapted from the Health Information National Trends (HINTS) survey, which asked respondents to rate how much they trust health and medical information from their doctors. Results showed that 29.3% of participants reported high trust in provider information. Trust was significantly higher among women, individuals with private insurance, and those with a personal healthcare provider. Notably, participants who misused prescription drugs reported significantly lower trust (30.0%) than those who did not (40.0%). The study concludes that while historical trauma influences mistrust, structural factors like continuity of care and regular provider access are vital. Improving patient–provider relationships may reduce medication misuse and associated risks like antibiotic resistance. Full article

Background: Antibiotic misuse and overuse remain a critical driver of antimicrobial resistance (AMR), a global health threat associated with increased morbidity, mortality, and healthcare costs. In Greece, where antibiotic consumption and resistance rates are among the highest in Europe, community pharmacists are well-positioned to contribute to antimicrobial stewardship efforts. Objective: This study aimed to assess the knowledge and attitudes of community pharmacists in Achaia, Western Greece, regarding antibiotic use and AMR, in order to identify knowledge gaps and inform future educational interventions. Methods: A cross-sectional survey was conducted between May and July 2023 among 207 pharmacists using a structured, self-administered questionnaire. The survey assessed demographics, knowledge of antibiotic indications, dispensing practices, and awareness of AMR. Statistical analysis included Chi-square tests and multivariate logistic regression. Results: Pharmacists demonstrated high levels of knowledge regarding appropriate antibiotic use in conditions such as sore throat (95%), bronchitis (76%), influenza (77.5%), and diarrhea (95%). However, knowledge was lower for rhinitis (60%) and sinusitis (56%). Almost all pharmacists (99%) were aware of AMR, and 86% perceived it as a significant public health issue in Greece. Logistic regression showed that pharmacists with 5–10 years of experience were significantly less likely to believe that antibiotics are always effective (OR = 0.08, p = 0.042). Conclusion: Pharmacists in Western Greece are generally well-informed about antibiotic use and AMR, yet misconceptions persist, especially for viral infections. Targeted educational interventions, interprofessional collaboration, and stricter enforcement of prescription regulations are needed to strengthen the role of pharmacists in combating AMR at the community level. Full article