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The role of pharmacists in antimicrobial resistance
Educate patients, prescribers about antibiotics
All pharmacists need to play an active role in the fight against antimicrobial resistance, says Michael Rybak, PharmD, MS, FCCP, president of the Society of Infectious Diseases Pharmacists in Austin, TX, and professor of pharmacy and medicine at the Eugene Applebaum College of Pharmacy and Health Sciences at Wayne State University in Detroit. "Education of the prescriber and patient regarding the overuse and abuse of antimicrobials is key to preserving our current armament of antimicrobials to fight another day."
Pharmacists can educate in the community or hospital settings or on a one-on-one basis, he says. They can give lectures to health care providers or communicate to them about the problem in writing. "They have to realize that we are quickly running out of useful antibiotics that we have to fight infections," he says.
Pharmacists have access to many resources, such the Centers for Disease Control and Prevention’s "12 Steps to Prevent Antimicrobial Resistance Among Hospitalized Adults," found at www.cdc.gov/drugresistance/healthcare/ha/12steps_HA.htm. Other relevant information can be gathered from sources such as the Society of Infectious Diseases Pharmacists in Austin, TX, and the Infectious Diseases Society of America in Alexandria, VA.
Pharmacists with specialized training in the area of infectious diseases pharmacotherapy can make an especially big difference in the fight against antimicrobial resistance. "Their expert knowledge of antimicrobial action, interaction, and impact on the development of resistance can play a vital role [in helping] the prescriber make the most appropriate choice of an antimicrobial. This includes the choice of drug and the most effective dosage that will eradicate the pathogen in the shortest period of time and have the least amount of undue side effects, as well as the regimen least likely to develop antimicrobial resistance," Rybak says.
"Pharmacists can ensure that the prescribers they work with, as well as their patients, use antibiotics appropriately and rationally," adds Frank Romanelli, PharmD, BCPS, assistant professor of pharmacy and clinical specialist in HIV/AIDS at the College of Pharmacy and College of Health Sciences at the University of Kentucky in Lexington. "Prescribers should be aware of resistance patterns and the killing profiles of various antibiotics. More expensive is often equated with better, and that is not always true."
Pharmacists can educate patients by speaking to them, especially patients who are seeking advice on cough-and-cold over-the-counter products, Romanelli says. "I also think it’s important for pharmacists to role-model appropriate medication-taking behaviors for both patients and other health care practitioners."