OBJECTIVES: Worldwide, antimicrobial stewardship (AMS) teams include pharmacists, but their impact is little known. This study aimed to explore the relationship between pharmacists' actions and antibiotic consumption. METHODS: Hospital pharmacists involved in the French antibiotic consumption surveillance network (ATB-Raisin) were invited to participate in a retrospective observational multicentre study. Collected data were: the previous year's (2016) antibiotic consumption expressed in Daily Defined Dose per 1.000 Patient-Days, AMS measures, including pharmacist-specific actions and use of a computerized prescription order entry (CPOE) system. Associations between antibiotic consumption and AMS measures were assessed by linear regression, after adjustment for hospital activities. RESULTS: Annual data for 2016 from 77 hospitals (7,260,000 bed-days in 24,000 beds) were analysed. Pharmacists were involved in AMS programs in 73% of hospitals, and were the antibiotic advisor in 25%. Pharmaceutical review of prescriptions was organized in almost all hospitals (97%). The univariable analysis identified five measures associated with lower overall antibiotic consumption: CPOE use (if >80% of prescriptions; or 100%), pharmaceutical review (if >80% of beds; or 100%), and the antibiotic advisor being a pharmacist (p = 0.04, 0.004 and 0.003, respectively). In the multivariable analysis, two explanatory variables were significantly, independently associated with a lower overall antibiotic consumption: antibiotic advisor being a pharmacist and pharmaceutical review covering all beds (- 19.9% [-31.6%; -8.1%], p = 0.002 and - 18.3% [-34.0%; -2.6%], p = 0.03, respectively). CONCLUSIONS: Antibiotic consumption was lower when the antibiotic advisor was a pharmacist and when the pharmaceutical team reviewed all prescriptions. These results highlight that actions initiated by pharmacists have a positive impact and should be supported.Read less <