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With the rising threat of antimicrobial resistance and greater awareness of the harms associated with antimicrobial use, antimicrobial stewardship programs (ASPs) are a vital component of healthcare systems. The overarching goal of ASPs includes optimizing the use of antimicrobial therapies to improve clinical outcomes in patients and reduce antimicrobial-related harm.1 Historically, ASPs targeted only acute care settings, in which ASPs performed prospective audit with feedback (PAF) stewardship and/or prior authorization (PA) of certain antimicrobials. Currently, ASPs also target ambulatory care settings and diagnostic stewardship. Beyond clinical tasks, ASPs develop clinical care pathways; provide education; collect, analyze, and disseminate data; and are increasingly vital to meeting regulatory and accreditation standards.1-3

Pharmacists are a fundamental part of the ASP because of their understanding of the pharmacology of antimicrobials, involvement in all aspects of the medication dispensing process, and experience collaborating with multiple types of healthcare professionals. Many healthcare institutions rely on their pharmacists and pharmacy services to develop, expand, and run the ASP.4 The Centers for Disease Control and Prevention (CDC) core elements of antimicrobial stewardship, The Joint Commission antimicrobial stewardship standards and the Centers for Medicare and Medicaid Services recommend pharmacists and physicians be coleaders of the ASP.1-3 Data from the 2022 CDC National Healthcare Safety Network annual survey identified that 64.9% of hospitals had an ASP co-led by a physician and a pharmacist.5 A statement published by the American Society of Health-System Pharmacists (ASHP) and the Society of Infectious Diseases Pharmacists (SIDP) encourages pharmacist involvement in ASPs. Specifically mentioned is the appointment of a pharmacist with education, training, or experience in infectious diseases (ID) as leader or coleader of the ASP, with adequate full-time equivalencies and protected time for ASP work, and the inclusion of ASP functions in job descriptions/titles.6 There is limited literature on how often these recommendations are followed across various healthcare systems.

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