Role of Pharmacists in Antimicrobial Stewardship During COVID-19 Outbreak: A Scoping Review

Figures & data

Table 1 Inclusion and Exclusion Criteria

Included	Excluded
Full-text available	Review articles
English Language	Handbooks
Associated with AMS in COVID 19 pandemic	Guidelines
Focused on the pharmacist as AMS team	Protocol studies

Abbreviations: AMS, Antimicrobial stewardship; COVID 19, the Coronavirus Disease 2019.

Figure 1 Preferred Reporting Items for Systematic reviews extension for Scoping Reviews (PRISMA-ScR) flow diagram.

Notes: Adapted from: Page MJ, McKenzie JE, Bossuyt PM et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi:10.1136/bmj.n71.¹⁴ Creative Commons Attribution (CC BY 4.0) license (https://creativecommons.org/licenses/by/4.0/legalcode).

Table 2 Results of Scoping Review on the Role of Pharmacist in Antimicrobial Stewardship (AMS) During COVID-19 Outbreak

References	Publication Type	Region	Health Care Sector	Pharmacist Role During COVID-19
Elbeddini et al (2020)^Citation15	Commentary	Canada	All Professional Setting	Community pharmacists perform the following tasks: delivering medications to patients; educating patients on telehealth services; assessing patients for renewal of chronic medications; performing consultations on minor ailments; clarifying misconceptions about COVID-19 treatments; and contributing to COVID-19 screening. Hospital pharmacists: management of drug shortages for COVID-19 treatments; development of treatment protocols; participation in patient rounds; interpretation of lab results for COVID-19; participant recruitment for clinical trials; exploration of new drugs; medication management advice; antimicrobial stewardship; and control of vaccine stock.
Ashiru-Oredope et al (2022)^Citation27	Research Article	United Kingdom	All Professional Setting	During pandemics, pharmacists were critical in ensuring ongoing medicine supply and access, supporting public health measures, and assisting in case identification and management.
Marwitz et al (2021)^Citation28	Commentary	United Kingdom	All Professional Setting	Pharmacists help patients spot false information about medications, vaccinations, COVID-19 pharmacotherapy, and information about public health.
Alnajjar et al (2022)^Citation21	Original Article	Jordan	All Professional Setting	Community pharmacists educated their patients and counseled the public about the currently available therapeutic options for managing COVID-19 symptoms Hospital pharmacists explored new drug therapies or uses; participated in the antimicrobial stewardship programs; and monitored antibiotic uses for COVID-19 cases and co-infections.
Goff et al (2020)^Citation18	Original Article	United States of America	Community Pharmacy	During the COVID-19 pandemic, pharmacists from Florida and all over the world set up an online platform (IDStewardship) to share reliable information.
Al-Quteimat et al (2022)^Citation24	Original Article	Uni Emirat Arab	Clinic	Pharmacist interventions to improve communication and medication use in admitted adult patients with COVID-19, optimizing medication use in patients with COVID-19 through prevention, identification, and resolution of existing or potential drug-related problems.
Martins et al (2020)^Citation29	Current Opinion	Brazil	Hospital	Pharmacists manage drug shortages for COVID treatments, redesign workflow, and review drug formularies and protocols to improve patient and healthcare professional (HCP) safety during the pandemic.
Liu et al (2021)^Citation20	Original Article	China	Hospital	Clinical pharmacists were responsible for all the clinical wards and antimicrobial education (lectures, online teaching, appraisals) to help physicians, surgeons, nurses, and pharmacists understand and master the rational use of antimicrobials, including the indications, dosage, cautions, and common adverse drug events for COVID-19 treatment.
Jones et al (2021)^Citation16	Commentary	Georgia	Hospital	Pharmacists are responsible for combining the times when medications are given, improving pharmacotherapy, and keeping track of therapeutic drugs using SARS-CoV-2 PCR surveillance software.
Schmid et al (2022)^Citation25	Original Article	Germany	Hospital	Hospital pharmacists have responsibility for the indication for and selection of therapy, optimization of dosing, drug interactions, side effects, and other pharmacokinetic, pharmacodynamic, and pharmacoeconomic issues during pandemics.
Al-Qamariat et al (2021)^Citation22	Original Article	Saudi Arabia	Hospital	Pharmacists are involved in handling infectious disease management during the COVID-19 pandemic.
Ng et al (2021)^Citation23	Original Article	Singapore	Hospital	Pharmacists maintained the review rate of antibiotic use and provided daily prospective review and feedback on piperacillin-tazobactam, carbapenem, and ciprofloxacin use. They work closely with a team of five infectious diseases physicians who take turns performing PRF on complex cases.
Ashiru-Oredope et al (2021)^Citation26	Original Article	United Kingdom	Hospital	Pharmacists undertook additional responsibility for managing drug shortages (antimicrobial and non-antimicrobial), managing the supply of medication to patients with COVID-19, and providing PPE advice in extension to routine responsibilities (the provision of infection prevention and round-ward activities) during the COVID-19 pandemic.
Goldstein et al (2020)^Citation17	Article Navigation	United States of America	Hospital	The pharmacist’s role is to control antimicrobial use based on minimal guidance for selecting appropriate treatment versus non-antimicrobial treatment.
Collins et al (2020)^Citation19	Article Navigation	United States of America	Hospital	Pharmacists intervened to address a wide scope of medication-related issues, giving advice on regimen simplification, timing and dosing adjustments, antimicrobial therapy, and COVID-19 treatment adjustments.

Abbreviations: COVID 19, the Coronavirus Disease 2019; SARS-CoV-2 PCR, SARS-CoV-2 P Polymerase Chain Reaction; PRF, prospective review and feedback; PPE, personal protective equipment.

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