Media-Based Public Health Campaigns and Pharmacy Involvement in Antimicrobial Stewardship: A Systematic Review

Asim Ahmed¹, Abla Almalik², Giulia Ferrara³, Luca Moretti⁴, Elisa Conti⁵

Abstract

Doi : https://doi.org/10.5281/zenodo.20777834

Antimicrobial resistance remains a major public health challenge, and inappropriate antibiotic use in community and outpatient settings continues to require coordinated behavioral, professional, and health-system responses. Media-based health campaigns have been widely used to improve public understanding of antimicrobial resistance and to reduce unnecessary antibiotic demand, while pharmacists remain highly accessible medication experts who can reinforce appropriate antibiotic use at the point of care. This systematic review synthesized evidence on media-based antimicrobial stewardship campaigns and examined the extent to which pharmacists were incorporated into campaign design, delivery, and evaluation. The review included 20 studies from diverse geographic contexts, including high-income countries, low- and middle-income settings, and multi-country reviews. Most studies used narrative synthesis, process evaluation, survey-based assessment, prescribing trend analysis, or quantitative review methods. Mass media campaigns using television, radio, print materials, social media, and community-facing resources were the most common intervention type. Campaigns with sustained, multi-channel messaging were generally associated with improved public awareness, reduced antibiotic expectations, and favorable prescribing trends. However, only a minority of studies explicitly evaluated pharmacist involvement, and pharmacists were more often described as informal message reinforcers than as proactive campaign partners. Evidence on long-term behavioral durability, pharmacist-specific outcomes, localization for multilingual and low-literacy communities, and integration between public health planners and pharmacy networks remained limited. The findings suggest that future antimicrobial stewardship campaigns may benefit from formally embedding pharmacists into campaign planning, local adaptation, patient counseling, and outcome evaluation.