Antimicrobial stewardship in primary care — what are pharmacists doing?

By Cliodna McNulty, Tracey Guise, Kieran Hand, Philip Howard, Matthew Dryden and Jonathan Cooke



To ascertain what medicines managers in English primary care trusts were doing to promote antimicrobial stewardship.


Online survey

Subjects and setting

All medicines managers of PCTs in England.


108 medicines managers representing 79% of PCTs responded. 54% of PCTs had an antimicrobial committee, 61% had an antimicrobial audit strategy, 29% had an antimicrobial training strategy and 23% had a substantive primary care antimicrobial prescribing adviser. 

All PCTs had evidence-based antimicrobial community guidance suggesting choice, dose and duration; 73% gave guidance on delayed prescribing. 95% of PCTs reported antimicrobial use back to practices and 32% of practices undertook annual audit. 90 PCTs used the HPA guidance to develop their local guidance; but only 6 respondents reported the web-based HPA guidance was easy to find. 63 referred to NICE, 57 Clinical Knowledge Summaries and 52 NPC resources to develop their guidance, but they were reportedly less useful than HPA guidance.


These results are encouraging, as all PCTs have guidance. There is an opportunity to improve antimicrobial use in primary care, as 73% of PCTs do not have an antimicrobial training strategy for community clinicians and a third have no defined audit strategy. As medicines managers valued resources that were national, comprehensive, evidence-based, concise, easy to navigate and read; these characteristics should be a feature in any resources. Short, concise guidance should be supported, as most PCTs use a national template to develop their local guidance. There should be easy access to national templates.

Last updated
The Pharmaceutical Journal, October 2012;Online:DOI:10.1211/PJ.2012.11110425