Antibiotic Pharmacology, Use Patterns, Resistance, and Stewardship Strategies Across Hospital and Community Settings

Antibiotics are among the most widely prescribed medicines globally, yet a persistent gap exists between what laboratory pharmacology tells us and how these agents are used in clinical practice. Pharmacokinetic and pharmacodynamic (PK/PD) principles provide the scientific basis for dosing decisions, but translating them into consistent, evidence-based prescribing across diverse patient populations remains a challenge. Antimicrobial resistance (AMR) continues to rise, shaped by the cumulative effect of prescribing choices made daily across hospital wards, outpatient clinics, and primary care settings alike. Resistance does not respect the boundary between secondary and primary care, yet research and policy have historically treated these two settings in isolation. Bridging that divide has become an increasingly recognized scientific and public health priority.The central gap this Research Topic addresses is the fragmentation of antibiotic stewardship science across healthcare levels. Hospital stewardship programs continue to generate new information in discussion. However, community settings, where most antibiotic prescriptions originate, remain underserved in terms of evidence, implementation frameworks, and surveillance infrastructure. Meanwhile, even within hospital care, PK/PD knowledge is inconsistently applied, with dosing in patients with altered physiology, such as critically ill individuals, older adults, or those with renal impairment, frequently diverges from evidence-based targets.This collection aims to consolidate research that connects pharmacological science with real-world prescribing decisions and stewardship practice across both hospital and community contexts. The goal is not to advance novel drug discovery, but to close the translation gap between existing pharmacological knowledge and how antibiotics are actually selected, dosed, monitored, and governed in clinical settings. Contributions spanning this continuum, from PK/PD-informed dosing to surveillance data, prescribing behavior, and stewardship program design, are particularly encouraged.This Research Topic welcomes contributions focused on antibiotics in real-world clinical use, across hospital and community settings. Relevant themes include: PK/PD-guided dosing optimization and therapeutic drug monitoring; antibiotic prescribing patterns and determinants of use across care levels; surveillance of resistance in hospital-acquired and community-acquired infections; design, implementation, and evaluation of stewardship interventions; rapid diagnostics as enablers of stewardship decisions; and policy, behavioral, and systems-level approaches to improving antibiotic use. Studies in low- and middle-income country contexts, community and primary care settings, and vulnerable or under-represented patient populations are especially welcome.Note to Authors: Manuscripts on novel antimicrobial compound development or mechanisms of drug-target interaction fall outside this topic’s scope. Topic editors: Irina Iaru, Cristina Ionela Mogosan, Anamaria Apan, Cristina Pop, Ana Tomas Source: https://www.frontiersin.org/research-topics/82586/antibiotic-pharmacology-use-patterns-resistance-and-stewardship-strategies-across-hospital-and-community-settings