Abstract
This paper examines the implications of Spain's recent legislative reform enabling nurses to prescribe antibiotics for uncomplicated urinary tract infections (UTIs) in women, positioning it as a critical development in antimicrobial stewardship (AMS) and nursing practice. The paper aims to assess how this policy aligns with international models of nurse prescribing, evaluating its potential to enhance workforce flexibility, and identifying some challenges and opportunities regarding its implementation. While this reform may reduce pressures on general practitioners and optimize primary care delivery, it raises questions regarding diagnostic accuracy, restricted formularies and the need for rigorous surveillance. The viewpoint highlights the importance of robust training in diagnostic and clinical reasoning, regular updates to antibiotic formularies and comprehensive auditing mechanisms to ensure safe and effective prescribing. Additionally, we explore broader considerations, such as professional incentives and inter-professional collaboration, essential for the sustained impact of nurse prescribing. By centring the discussion on nursing leadership in AMS, we highlight an underexplored area of policy implementation, with implications for other countries considering similar reforms.