The TARGET leaflet for respiratory tract infections was used as part of a trial involving information from 182 community pharmacies.

Of those 92 were assigned to the intervention group and were given webinar-based training on antimicrobial stewardship and used the TARGET leaflet. The other 90 community pharmacies were in the control group: they did not use the leaflet but received webinar information about taking part in the trial.

The participating pharmacies were located in the South West of England and Southwark in London in 2018. The pharmacies collected data from respiratory tract infection patient consultations over a four-week period in January and February about: referrals; self-care advice; provision of written information; signposting to over-the-counter medicines; referral to a pharmacist (where an initial consultation involved pharmacy support staff), or referral to another health service (eg hospital accident and emergency department).

Pharmacies in the intervention group were more likely to provide patients with self-care advice and less likely to refer them to their GP compared with pharmacies in the control group.

The researchers commented that: ‘interventions have the potential to support the government’s ambition to reduce inappropriate antibiotic consumption, particularly since interventions that help to both reduce referrals to GPs and inform patients on the appropriate use of antibiotics (including when they are necessary or unnecessary) may reduce patient expectation to receive antibiotics for self-limiting infections, and in turn reduce pressure on GPs to prescribe antibiotics when they are not needed.’¹⁷ 

Other organisations also serve to raise awareness and encourage participation in activities to improve the use of antimicrobials.¹⁸ For example, the Antibiotic Guardian annual campaign encourages healthcare organisations, GP practices, hospitals, community pharmacies, farmers, patients and the public to pledge responsible use of antibiotics. For pharmacy teams the suggested pledges include: ¹⁹

• I will review antibiotic prescriptions, assessing for adherence to local guidance. For those that do not I will contact the prescriber to discuss the rationale for the antibiotic choice

• Every time a person/patient presents with a potentially self-limiting infection I will use the patient information leaflet to explain the potential duration of illness and how to treat their symptoms available at: https://elearning.rcgp.org.uk/mod/book/view.php?id=12647

• When handing out a prescription that includes antibiotics, I will inform patients of the dosage and duration, to take their antibiotics exactly as prescribed and how to safely dispose of antibiotics in the context of preventing antimicrobial resistance

• When people pick up an antibiotic prescription, I will encourage them to visit the Antibiotic Guardian website to choose their own pledge to become Antibiotic Guardians

• To help address patient expectations for antibiotics in self-limiting conditions, I will promote nationally or locally agreed key messages, to raise awareness of antimicrobial resistance

• When I undertake structured medication reviews, I will review any antibiotics prescribed either on repeat, or regularly for acute conditions

The number of pledges recorded by the Antibiotic Guardian campaign up to August 2026 was over 217,500.¹⁹