The Role of Pharmacists in Supporting Adherence to Antimicrobial Therapy During Breastfeeding: An Uncontrolled Interventional Study

Abstract

Background:

Community pharmacists have the potential to provide adherence-support interventions, address adverse effects, and optimize health outcomes in vulnerable patient populations such as breastfeeding women who need rational antimicrobial therapy.

Research Aim:

The primary aim of this study was to investigate the influence of community pharmacists’ adherence support interventions on outcomes of antimicrobial therapy use and breastfeeding continuation in breastfeeding women.

Methods:

A prospective interventional before–after study was conducted in community pharmacies in Serbia (May–October 2022) within the Mama Friendly Pharmacy project. Breastfeeding women (N = 182) receiving antimicrobial therapy completed validated questionnaires and received pharmacist-led counseling, including risk assessment using specialized databases. A follow-up assessment included evaluated adherence, breastfeeding continuation, infant safety, and factors associated with intervention outcomes. Data were analyzed using SPSS (Version 24).

Results:

The results indicate that 84.71% of participants who believed that medications should be avoided during breastfeeding—regardless of clinical indication—expressed concerns about using the prescribed antimicrobial agent. Likewise, 58.76% of participants who generally held a positive attitude toward medication use during breastfeeding also reported uncertainty regarding antimicrobial therapy. Overall, 95.2% of participants accepted the recommended therapy and monitoring advice. Follow-up was completed by 80.8%, with positive outcomes and only 14 minor infant adverse effects reported, none requiring medical intervention. Logistic regression identified maternal age as the only significant predictor of follow-up participation.

Conclusion:

By improving both therapy acceptance and duration and supporting informed decision-making regarding breastfeeding, community pharmacists play a critical role in resolving uncertainties, preventing interruption of breastfeeding, and helping address antimicrobial resistance.

Graphical Abstract

This is a visual representation of the abstract.

Keywords

adherence support interventions antimicrobial drug resistance breastfeeding community pharmacy prospective study

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