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New initiatives are needed to encourage the development of more antimicrobials, says Professor John Cromarty, chair of the RPS Scottish Pharmacy Board

Earlier this month we learnt that healthcare-associated infections have fallen to the lowest recorded level in Scotland.

I welcome this progress and commend healthcare professionals' co-ordinated efforts across the NHS in Scotland in relation to infection prevention and control. It demonstrates the importance of measures taken to avoid infections in the first place and illustrates why David Cameron's announcement of a review into why so few antimicrobial drugs have been introduced in recent years is important.

Without new antimicrobials, many procedures and interventions, which we today consider to be fairly routine, could end up costing patients' lives due to antimicrobial resistance.

The RPS's recently launched 'New medicines, better medicines, better use of medicines €“ a guide to the science underpinning pharmaceutical practice' demonstrates the interdependencies that are critical to the development of new and better medicines and ensure the better use of medicines. Notably, it recommends stimulating new antimicrobial development and improving antimicrobial stewardship.

Antimicrobials currently available (as well as any future ones) need to be used appropriately and must be underpinned by the understanding of good hygienic practice. We must maintain the maximum effectiveness of currently available antimicrobials through effective antimicrobial stewardship.

Pharmacists working particularly in the community and hospital sectors have a key role to play, and increasingly so as more pharmacists become independent prescribers. This also needs to be underpinned by strong therapeutic partnerships with other healthcare professionals and matched with public and patient education on the use of antimicrobials.

Funding new discoveries

With the continuing growth of antimicrobial resistance, our current arsenal €“ and our attempts to protect its efficacy €“ will not be enough. A sea change in funding new discoveries is needed, as it can take up to 12 years and cost up to £1bn to take a drug from an initial idea to the market.

As some antimicrobials are only used for short periods the volume of sales often isn't enough to recoup the investment in R&D. The fact that the last new class of antibiotics was discovered in 1987 demonstrates that new initiatives are badly needed to encourage the development of novel antimicrobials.