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Approach to antibiotics needs to improve

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Approach to antibiotics needs to improve

There is much to do to meet the new NICE guidance on antimicrobial stewardship.

In August NICE published guidance on antimicrobial stewardship (AMS) systems and processes1. The guidance recommends setting up multidisciplinary AMS teams working across all care settings to review prescribing and resistance data and feed this information back to prescribers.

In its response, the Royal Pharmaceutical Society said that pharmacists should educate and advise patients on how to take antibiotics correctly at the point of dispensing and went on to describe the role of community pharmacists in giving self-care advice on minor infections to ease pressure on GP surgeries. With prescribing in all sectors of healthcare a problem, it is clear that community pharmacy is in a prime position to improve antimicrobial use.

Did you read it?

The CPPE booklet, ‘Antimicrobial resistance – a global threat to public health: the role of the pharmacist’, was distributed to pharmacists in 2013. A recent questionnaire by undergraduate pharmacy students shows that 40 per cent of pharmacists who received the booklet did not read it, and only 12 per cent of those who did read it completed the learning activities.2

Ten per cent said they always ask what infection the antibiotics are intended to treat, 72 per cent said they sometimes ask and 18 per cent never ask. About two-thirds (64 per cent) said they always check for allergy. Most always explain the relevant dose and frequency and the importance of completing the course (82 and 80 per cent respectively), but 46 per cent never tell patients of the importance of not sharing their antibiotics with friends and relatives.

Nearly all did not monitor local prescribing of antibiotics, or know the local antibiotic prescribing guidelines for their area (84 and 80 per cent respectively). Despite these worrying figures, almost half (48 per cent) of those questioned rated themselves as ‘acceptable’ and 28 per cent as ‘good’ antibiotic stewards.

Small snapshot

While this is a small snapshot of the current situation in community pharmacy, it is clear there is much to do. However, if we are to do as the NICE guidance recommends, and encourage and support prescribers to prescribe antimicrobials only when it is clinically appropriate, we will need to know what the antibiotic is being prescribed for.

 Community pharmacy is in a prime position to improve antimicrobial use

References

  1. Antimicrobial stewardship: systems and processes for effective antimicrobial medicine use
  2. An evaluation of antimicrobial stewardship in community pharmacy: Hancock L, Mellor C, Hawksworth G. University of Huddersfield
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