Bridging knowledge and practice: Antimicrobial Stewardship by community pharmacists in New Zealand

Abstract Objective: This study assessed knowledge, perceptions, practices, and barriers regarding Antimicrobial Stewardship (AMS) among community pharmacists in New Zealand. Design: A cross-sectional study using a self-administered online questionnaire distributed nationwide to community pharmacists. Methods: A structured questionnaire was distributed via email to 3,226 pharmacists between January and March 2025, assessing demographics, knowledge of antimicrobial resistance (AMR) and antibiotic use, perceptions of AMS, current practices, and barriers. A total of 325 responses underwent quantitative analysis using Mann–Whitney U and Kruskal–Wallis tests ( P < .05). The Relative Importance Index ranked barriers. Results: Most respondents (82.8%) perceived community pharmacists as holding a significant role in AMS. While demonstrating strong AMR knowledge (median score 5/7) and positive attitudes (82.7% agreed AMS should be implemented in community pharmacies), practices varied considerably. Patient education on proper antibiotic use was consistent (81.6% always/often), but education on resistance issues was less frequent (40.6% occasionally). Only 27.7% always/often reviewed prescriptions against local guidelines. Primary barriers were lack of time (66.5%), lack of support from higher authorities (64.3%), inadequate staff numbers (61.5%), and limited access to patient records (54.2%). Younger, less experienced pharmacists demonstrated higher knowledge scores ( P < .05). Conclusions: Community pharmacists in New Zealand are well-positioned for effective AMS but are hindered by structural and system-level barriers rather than knowledge deficits. Recommendations include developing AMS guidelines tailored to community pharmacists, implementing joint training with prescribers, and establishing annual e-learning refresher modules.