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Background and Importance Oral antibiotic therapy for bone and joint infections (BJIs) is often prolonged and frequently associated with adverse events (AEs), which can compromise adherence and clinical outcomes. Pharmacist involvement during the hospital to home transition may enhance patient safety and treatment continuity.Aim and Objectives To assess, through a prospective randomised controlled trial, the impact of pharmacist–patient consultations (PCs) on AE management and patient knowledge during oral antibiotic therapy for BJIs.Material and Methods This prospective, randomised controlled trial (EFIRAD) included adults hospitalised for BJI, undergoing surgery, and discharged with a 4–12 week oral antibiotic prescription. Patients were randomised 1:1 to receive either a structured pharmacist–patient consultation (PC group) or standard discharge counselling (control). Telephone follow-ups were conducted at day 7 (D7) and day 14 (D14) to collect AEs and evaluate AE management, classified as optimal or non-optimal using a predefined decision tree. Patient knowledge was assessed using a validated 12-item questionnaire.Results Eighty-four patients were included (PC: n=41; control: n=43), with comparable baseline characteristics. At D7, 74% of patients reported ≥1 AE, mostly gastrointestinal (72%) and mild (grade I, 84%). Adverse event evolution between D7 and D14 was monitored, showing a decrease in overall AEs (74% vs 59%) and in gastrointestinal events (72% vs57%), but an increase in infectious AEs such as oral candidiasis and fungal infections (11.1% vs 3.5%). Optimal AE management was significantly higher in the PC group (95% vs 79%, p=0.03). Knowledge scores were greater in the PC group (p=0.0019), particularly regarding AE recognition, drug interactions, dosing, and appropriate responses. Non-optimal management in the PC group involved minor misuse of symptomatic treatment (n=1) or lack of medical consultation for hypersensitivity (n=1), while in controls it mainly included misuse or non-use of symptomatic treatments (n=7) and absence of medical contact (n=2). No AE required hospital readmission.Conclusion and Relevance This prospective randomised controlled trial demonstrates that pharmacist–patient consultations significantly improve AE management and patient knowledge during oral antibiotic therapy for BJIs. These results highlight the clinical relevance of pharmacist involvement in antimicrobial stewardship and support the integration of structured pharmacist-led interventions into post-hospital care pathways.Conflict of Interest No conflict of interest