Global action on antibiotic awareness must progress (Guest blog)
As part of the celebration, we have looked at what pharmacists, including those in industrial settings, can do to combat AMR, and how FIP can support them.
FIP adopted its first statement on AMR in 2008. The problem of AMR has become more urgent since then, and new recommendations have been issued by scientific and healthcare communities. Notably, the WHO Global Action Plan specifically mentions the healthcare workforce as having “a vital role in preserving the power of antimicrobial medicines”. It says: “Inappropriate prescribing and dispensing can lead to their misuse and overuse if healthcare professionals lack up-to-date information, cannot identify the type of infection, yield to patient pressure to prescribe or dispense antibiotics or benefit financially from supplying the medicines. Inadequate hygiene and infection prevention and control in hospitals help to spread infections.”
In 2015, FIP published the reference document “Fighting antimicrobial resistance: The contribution of pharmacists” with a comprehensive overview of pharmacists’ activities from all over the world. It offers a menu of solutions, ranging from giving advice on influenza immunisation (thereby avoiding subsequent bacterial superinfections) and responsible prescribing of trimethoprim by pharmacists to treat urinary tract infections, to stewardship programmes that optimise antibiotic prescribing in hospitals, and the collection of leftover antibiotics. It is crucial that such activities are reflected in all national AMR policies. FIP will continue to support national pharmacy organisations in facilitating the essential contribution of pharmacists to action plans around the world, which includes surveillance and monitoring of antimicrobial use and resistance, their distribution and regulation. Examples of pharmacist-led services from various countries will be presented at the upcoming FIP congress in Abu Dhabi, UAE.
Last year in Seoul, South Korea, FIP in its new policy statement on AMR called on governments to ensure that all antibiotics listed in the WHO Essential Medicines Lists are available at all times. FIP also called on industry partners to develop a strategy for ensuring the sustainable production and registration of older generation antibiotics, to compensate for serious shortages of other antibiotics. Antibiotics should also be produced in pack sizes corresponding to their usual course length. The statement gives particular focus to medicines disposal. It recommends development of “return and disposal” programmes for unused or expired antimicrobials. And pharmacists should “take responsibility” for these programmes and proactively inform the public about the proper disposal of antibiotics. FIP will be working on a multidisciplinary competency framework to support antimicrobial stewardship (AMS) globally.
Immunisation generally (and specifically for influenza) is important for infection prevention and protection of the effectiveness of antibiotics. Health authorities and policy makers around the world are increasingly realising and tapping the potential of community pharmacists as highly accessible healthcare professionals who can have an important role in primary health care, health promotion and disease prevention, including through vaccination. FIP collected evidence that community pharmacies have an active role in vaccine administration in at least 27 countries. This figure has increased steadily in the past decade and several countries are working towards expanding pharmacists’ authority to vaccinate, thus contributing to infection prevention and control.
Combatting AMR and supporting rational use of antibiotics requires action by and collaboration of all stakeholders, including industry partners, governments, health authorities, healthcare professionals and patients. The global discussion on how to achieve progress must continue, and be followed by action and implementation. FIP and pharmacists around the world are committed to being part of the solution.