Prescribing by community pharmacists could improve antibiotic use and help minimise resistance, according to a study from Western Australia.

During the study, 240 community pharmacists responded to case vignettes and a questionnaire to assess the appropriateness of, and their confidence about, oral antibiotic prescribing.

Most community pharmacists said they were confident prescribing antibiotics for “simple infections” such as uncomplicated urinary tract infections (89.0 per cent), impetigo (79.3 per cent), mild bacterial skin infections (75.6 per cent), moderate acne (72.4 per cent) and traveller’s diarrhoea (68.3 per cent). However, relatively few pharmacists felt confident prescribing oral antibiotics for diabetic foot infections (17.1 per cent).

Most community pharmacists felt confident prescribing amoxicillin (89.0 per cent), trimethoprim (87.8 per cent), amoxicillin and clavulanic acid (85.4 per cent), flucloxacillin (85.4 per cent) and cephalexin (82.9 per cent). In addition, most pharmacists selected the most appropriate primary treatment for uncomplicated UTIs (87.8 per cent), bacterial sinusitis (82.9 per cent) and adolescent acne (75.6 per cent).

However, relatively poor antibiotic prescribing was seen in the vignettes for bacterial sinusitis and paediatric ear infection. Eight pharmacists inappropriately prescribed a penicillin-based antibiotic based on a vignette of a child with an allergy to penicillin.

“Given pharmacists’ level of antibiotic knowledge and their accessibility to the community, this role could potentially fill a gap in the fight against antimicrobial resistance through minimisation of patients’ self-diagnosis and self-management of limited infections in the community,” the authors conclude.

^{Int J Clin Pharm DOI:10.1007/s11096-016-0396-0}