PhD defence M. (Maarten) Lambert

The context of antibiotic use in primary care and the role of the community pharmacist

This thesis aimed to study the context of antibiotic use in primary care, with a specific focus on the role of the community pharmacist. The underlying reason for this is the growing threat of what the World Health Organization considers one of the greatest threats to public health: antibiotic resistance. We explored the development of antibiotic resistance, the broad context of antibiotic use, and the challenges community pharmacists face. The current role of the pharmacist was examined, the implementation of improved antibiotic dispensing in practice was assessed, and opportunities for the future role of the pharmacist were investigated. This thesis describes that optimizing antibiotic use in primary care is crucial for improving antibiotic use by individuals. Although community pharmacists in Europe are essential to achieving this, they do not sufficiently translate their potential and willingness to contribute to reducing antibiotic resistance into practice. To further contribute to solving antibiotic resistance, the pharmacy practice must improve in three areas: 1) more intensive collaboration between pharmacists and general practitioners, 2) medication safety, and 3) providing person-centered care. To achieve these changes in pharmacy practice, pharmacy education, policymakers, and pharmaceutical practice research must better align their activities and content. The sooner community pharmacists embrace a larger role in primary care, the sooner their colleagues in primary care and patients can benefit from their expertise.