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Purpose. The impact of a community pharmacist telephone follow-up intervention (PTFI) on clinical outcomes, pharmaceutical care, and costs for patients undergoing antibiotic treatment was studied. Methods. Patients receiving usual pharmacist intervention (UPI) were compared with PTFI patients in a multicenter, randomized, controlled trial. Results. Compared with the UPI group (n = 129), the PTFI group (n = 126) had more drug-related problems (DRPs) (PTFI = 53%, UPI = 8%; p < 0.001). Oral recommendations (PTFI = 52%, UPI = 6%; p < 0.001), as well as recognized (PTFI = 10%, UPI = 2%; p = 0.015) and study-specific (PTFI = 5%, UPI = 1%; p = 0.064) pharmaceutical advices, were issued for more patients. The mean difference in the change in the number of infectious symptoms between the two groups (-0.24 symptom, 95% confidence interval [CI] = -1.22 to 0.74) and the change in the infection severity score (mean difference = -0.05 unit, 95% CI = -0.35 to 0.25) were small and not statistically significant. Adherence to treatment and patient satisfaction did not differ across the two intervention groups. The incremental direct costs of the PTFI varied from $2.65 to $5.11 (Canadian dollars) per patient, depending on whether cognitive services were reimbursed. Conclusion. A telephone follow-up by community pharmacists during antibiotic therapy was simple and quick and created opportunities to intervene with patients, but it did not create a greater change in the number of infectious symptoms or the infection severity score than did usual care. [ABSTRACT FROM AUTHOR]