Repositioning Indian Pharmacists from Antimicrobial Dispensers to Stewards-A Call for Action (Dispenser AMSP Model)

ABSTRACT

Pharmacists in India occupy a critical yet underutilized position in antimicrobial governance, functioning as the final checkpoint before antibiotics reach patients across community and hospital settings. Despite regulatory controls under Schedule H/H1, widespread nonprescription dispensing, inadequate counseling, and lack of audit mechanisms continue to fuel inappropriate antimicrobial use and Antimicrobial Resistance (AMR). Within the Integrated Antimicrobial Stewardship (IAS) framework advocated by Society of Antimicrobial Stewardship Practices, pharmacists are uniquely positioned to transition from passive dispensers to active stewards of antimicrobial use. This editorial proposes the DISPENSER Amsp model, a ten-point pharmacist-driven stewardship approach encompassing prescription validation, indication and regimen verification, AWaRe-aligned selection, patient education, safety vigilance, referral, record keeping, and stewardship participation with surveillance. By embedding these practices into routine pharmacy workflows across rural, urban, online, and hospital pharmacies, pharmacists in India can significantly reduce irrational antimicrobial exposure. Strengthening pharmacist stewardship is therefore essential for aligning local dispensing practices with national AMR priorities and global One Health containment efforts.

KEYWORDS

• AWaRe Classification
• Antimicrobial Resistance
• Antimicrobial Stewardship
• Drug Dispensing
• Pharmacy Practice

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• DOI10.5530/jppcm.20260757Copy