{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T21:30:02Z","timestamp":1790199002131,"version":"4.1.0"},"reference-count":34,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T00:00:00Z","timestamp":1761350400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: AMR causes a large global health burden, with approximately 4.95 million deaths linked to bacterial AMR in 2019, 1.27 million due to AMR directly. Although Brazil mandated prescriptions for systemic antibiotics in 2010\/2011, self-medication and access without prescriptions continue, with community pharmacists playing a vital part in antimicrobial stewardship (AMS). This study examined antibiotic misuse and AMR in Brazil through community pharmacists\u2019 perspectives, emphasising their dual role as professional actors and frontline observers of public behaviour. Methods: We conducted 20 semi-structured interviews with community pharmacists and performed reflexive thematic analysis of their accounts, repeating five independent analytic cycles to confirm thematic robustness. Results: Six themes were consistently identified as recounted by pharmacists in their practice contexts: Access and Self-Medication; Relationships with Healthcare Professionals; Knowledge and Beliefs about Antibiotics; Use and Adherence; Healthcare System Barriers; and Regulation and Enforcement. Pharmacists mentioned regular requests for antibiotics without prescriptions, drug reuse, and significant impact from community, i.e., from relatives, and peers. The common misunderstanding was that antibiotics treat viral illnesses. Structural issues, for instance GP appointment costs and long waits, made patients seek help from pharmacies. Due to regulation being applied inconsistently, pharmacies struggled to refuse unsuitable requests. Conclusions: Framed through pharmacists\u2019 dual vantage as professionals and frontline observers, the findings highlight intertwined factors underpinning inappropriate antibiotic use in Brazil and support a multi-pronged intervention spanning health system strengthening, professional education, economic considerations, and community engagement.<\/jats:p>","DOI":"10.3390\/antibiotics14111074","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:51:42Z","timestamp":1761526302000},"page":"1074","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Through the Pharmacist\u2019s Lens: A Qualitative Study of Antibiotic Misuse and Antimicrobial Resistance in Brazilian Communities"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5967-5254","authenticated-orcid":false,"given":"Timo J.","family":"Lajunen","sequence":"first","affiliation":[{"name":"Department of Psychology, Norwegian University of Science and Technology, NO-7491 Trondheim, Norway"},{"name":"Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, Nicosia CY-1700, Cyprus"},{"name":"Department of Psychology, University of Helsinki, 00014 Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2162-6569","authenticated-orcid":false,"given":"L\u00edria","family":"Souza Silva","sequence":"additional","affiliation":[{"name":"Microorganisms Biotechnology Laboratory (LABIOM), Federal University of S\u00e3o Jo\u00e3o del-Rei (UFSJ), Divin\u00f3polis 35501-296, Minas Gerais, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7920-6818","authenticated-orcid":false,"given":"Mark J. M.","family":"Sullman","sequence":"additional","affiliation":[{"name":"Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, Nicosia CY-1700, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0140-6736(21)02724-0","article-title":"Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis","volume":"399","author":"Murray","year":"2022","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1016\/S0140-6736(24)01867-1","article-title":"Global burden of bacterial antimicrobial resistance 1990\u20132021: A systematic analysis with forecasts to 2050","volume":"404","author":"Naghavi","year":"2024","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1378","DOI":"10.1016\/S2214-109X(25)00198-6","article-title":"Global, regional, and na-tional prevalence of kidney failure with replacement therapy and associated aetiologies, 1990\u20132023: A systematic analysis for the Global Burden of Disease Study 2023","volume":"13","author":"Rafferty","year":"2025","journal-title":"Lancet Glob. 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