According to the Centers for Disease Control and Prevention (CDC), at least 2 million individuals are infected with antibiotic-resistant bacteria annually, resulting in more than 23,000 deaths. Antimicrobial stewardship programs offer strategies to improve appropriate antibiotic use, which can enhance patient outcomes and reduce adverse events. Pharmacists can play an important role through an interdisciplinary approach in the community and hospital settings.
More from this article: Antibiotic Counseling Pearls for the Community Setting
Antibiotics can be lifesaving, but they must be used judiciously to prevent antimicrobial resistance that can ultimately lead to longer hospital stays, higher medical costs, and increased mortality. The World Health Organization (WHO) considers antimicrobial resistance to be one of the 10 threats to global health in 2019. A variety of infections including pneumonia, tuberculosis, gonorrhea, and foodborne illness are becoming more difficult to treat. Overuse and misuse of antibiotics are the driving forces contributing to AMR, and it can also lead to serious adverse events such as Clostridium difficile infections. One example is the widespread use of antibiotics for viral infections. According to a study published in the Journal of the American Medical Association (JAMA), at least 30% of antibiotics prescribed in the United States are unnecessary.1 Hospitals can also be affected by antimicrobial resistant infections. In a study published in Clinical Infectious Diseases, 399 patients were assessed for multidrug-resistant organisms (MDRO) from two hospitals.2 The study found that 14% of patients had MDRO present on them at baseline. Also, 10% of patients had an MDRO contained on their hands.2 This emphasizes the importance of patient hand hygiene to reduce the transmission of infections.
Fighting Antibiotic Resistance
Fighting antimicrobial resistance in both the community and hospital settings is extremely important. Evidence demonstrates that antimicrobial stewardship programs improve patient outcomes, reduce antimicrobial resistance, and decrease healthcare costs. Pharmacists should educate patients and healthcare providers about antimicrobial resistance and appropriate use of antibiotics (See: Antibiotic Counseling: Pearls for the Community Setting).
Check with patients to ensure they are up-to-date on all recommended immunizations, as vaccine preventable diseases could cause infections that lead to antibiotic use. Pharmacists can administer any needed vaccines, which can help to reduce antibiotic resistance.
U.S. Antibiotic Awareness Week is Nov. 18-24, which is an annual observance to raise awareness of antimicrobial resistance and the importance of appropriate antibiotic prescribing and use. The CDC has provided free educational materials for patients, pharmacists, and other healthcare professionals (available at: cdc.gov/antibiotic-use/community/index.html).
The WHO has just launched the AWaRe tool with a goal to prevent antimicrobial resistance by classifying antibiotics into the following three groups: Access, Watch, and Reserve. The Access group indicates the first- and second-line options for each of the 25 most common infections that should be available at all times as well as affordable to the public. The WHO has a goal that by 2023, 60% of all antibiotics consumed should come from the Access group, since these medications have the lowest risk of antimicrobial resistance. For example, amoxicillin (Access group) is considered the drug of choice for strep throat. The Watch group includes first- and second-line antibiotics that should be used for a specific, limited number of infections. Finally, the Reserve group should only be used as a last resort for MDROs and be closely monitored. Colistin is often reserved for MDROs associated with pneumonia.
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