Second audit of the Happy Patient project: impact of training on the dispensing of antibiotics in community pharmacies in Spain.

Introduction: Antibiotic resistance is a major public health problem. The European Happy Patient project aims to optimize antimicrobial use through audits and training of healthcare professionals, including community pharmacists. Objectives: To evaluate the impact of an educational intervention on the quality of antibiotic dispensing in Spanish community pharmacies and to identify areas for improvement following the training. Materials and Methods: A five-hour multifactorial intervention was conducted at IDIAP Jordi Gol (Barcelona) in January 2023, including feedback on results, communication workshops, and educational materials. Subse-quently, a second audit (February-April 2023) was carried out using the Audit Project Odense® method in 16 community pharmacies. A total of 450 dispensations of oral antibiotics for acute infections were analyzed. Results: Sixty percent of patients were women, and 90% were aware of the indication for the antibiotic. Relevant increases were observed in safety checks: drug interactions (+26%), contraindications (+23%), and allergies (+20%), with all three being performed in 60% of cases. Personalized information provided to patients increased regarding treatment duration (66%à80%), antimicrobial resistance (30%à48%), and medicine return/disposal (6%à28%). Contact with the prescriber increased from 0.9% to 9.3%. Conclusions: The educational intervention significantly improved the quality of antibiotic dispensing by increasing patient counseling and safety checks. These results support the implementation of ongoing training programs that strengthen the clinical role of community pharmacists in the rational use of antibiotics and the fight against antimicrobial resistance.