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To evaluate current antimicrobial stewardship (AMS) practices in regulated retail medicine settings, which include community pharmacies, accredited drug dispensing outlets (ADDOs), and patient proprietary medicine vendors (PPMVs), British and Nigerian researchers conducted a review and meta-analysis of 26 studies examining the types of AMS interventions that are available in those settings, the factors that facilitate or hinder the implementation of such interventions, and the level of knowledge about antimicrobial resistance (AMR) and AMS activities among regulated retail medicine staff. The success of AMS programmes led by community pharmacists in LMICs [low- and middle-income countries] including SSA, is hindered by factors like limited AMR and AMS knowledge, time constraints, and inadequate resources," the study authors wrote. 68% of retail medicine outlets dispense antibiotics without a prescription While the review found that community pharmacists generally have an awareness of the role that inappropriate antibiotic use plays in AMR, knowledge gaps among ADDO and PPMV staff, who have limited formal training, were more pronounced. The authors say the findings reveal a "concerning disconnect" between knowledge of appropriate antibiotic use and actual dispensing behaviors, along with substantial barriers to proper AMS in these settings."