Being a student of Pharmaceutical Sciences, I know to select, prescribe, handle, administer and counsel about Antibiotics.
Being a student of Pharmaceutical Sciences, I know to select, prescribe, handle, administer and counsel about Antibiotics is a very important task and indeed is a vast topic joining medication, research, experiments and hospitality. Now a question arises, how can a Pharmacist be a helping hand for the rational use of Antimicrobials?
Antibiotics fall under the vast category of Antimicrobials. Antimicrobial comprises a large category of the substances that kills the living microorganisms (bacteria, viruses, fungi and parasites) or inhibit their growth or reproduction. Use of Antibiotics includes both resistance as well as stewardship.
The World Health Organization (WHO) defines antimicrobial resistance as a microorganism's resistance to an antimicrobial drug that was once able to treat an infection by killing or inhibiting that microorganism. Stewardship refers to the act of taking responsibility and improving the use of anything. Antimicrobial stewardship if not followed properly leads to Antimicrobial Resistance.
Antimicrobial resistance develops from the inappropriate use of antibiotics and the non-application of hygiene rules. Especially in the winter months, the consumption of antibiotics for the treatment of upper respiratory infections increases rapidly. The majority of upper respiratory infections are caused by viruses that are not affected by antibiotics. Therefore, consult your prescriber and do not take antibiotics without medical advice.
From 2008, at European level, the (18-24)th November was established as Awareness Day for Rational use of Antibiotics, and efforts are made using campaigns aimed at rationalizing and reducing the over-consumption of antimicrobial agents. World Antibiotic Awareness Week has been held every November since 2015. The appropriate Antimicrobial stewardship includes dose, duration of treatment, optimal selection, as well as control of antibiotic use will prevent or slow the emergence of resistance among microorganisms. The goals of antimicrobial stewardship are to help the Pharmacists pick the right drug at the right dose and duration of therapy while preventing misuse and minimizing the development of resistance. Antimicrobial resistance is increasing globally because of greater access to antibiotic drugs in developing countries. 700,000 to several million death results per year are estimated due to Antimicrobial Resistance and misuse of these drugs.
The use of antibiotics in human medicine is caused by increasing global availability and uncontrolled sale in many developing countries. They can be obtained over the counter without a prescription. So, overuse of antibiotics has become the primary cause of rising levels of antibiotic resistance. The environmental degradation and pollution take place due to the release of large quantities of antibiotics waste products into the environment during pharmaceutical manufacturing. It is through inadequate wastewater treatment. The main problem is, it increases the risk that antibiotic-resistant strains will develop and spread. There are several causes and factors related to causality for antimicrobial resistance. Increasing bacterial resistance is mainly linked with the volume of antibiotic prescribed, as well as missing doses when taking antibiotics. It also increases with the duration of treatment. Shorter courses of antibiotics are likely to have advantages like decreases rates of resistance, reduce cost, and have better outcomes with fewer complications. But longer courses are frequently used. Naturally occurring antibiotic resistance is common nowadays. Use of antibiotics in animal husbandry is an underlying contributor to the emergence and spread of antibiotic-resistant germs. The Antibiotic use in livestock feed at low doses for growth promotion is an accepted practice in many industrialized countries and is known to lead to increased levels of resistance.
Narrow-spectrum antibiotics are preferred over broad-spectrum antibiotics when possible. A Pharmacist can give education about proper use for people who take these medications at home. Self-administration of medication technique to the patient can also reduce the use of Antibiotics. We can help to minimize the spread of resistant infections by guiding for proper sanitation and hygiene, including handwashing and disinfecting between patients, and also encouraging the same for the visitors and family members. The antibiotic prescribing practices in animals are increasing the resistance so proper education to the farmers as well as practitioners should be given.
Pharmacy services like Procurement of Antibiotics, Receiving and Storage of different drugs and dispensing is given all around the world. A Pharmacist with other health professionals can conduct various educational programs; improve awareness and understanding of antimicrobial resistance through effective communication, education and training. It can increase global awareness of antibiotic resistance. It also promotes the correct usage of antibiotics across all fields to prevent further instances of antibiotic resistance.
Research is the backbone of our profession. We can strengthen the knowledge and evidence base through surveillance and research. A Pharmacist participates in the development of new antimicrobial product design and lab testing. The participation of a pharmacist in the development of a new compounding procedure or Quality Control (QC) testing method for the existing antimicrobial product is also necessary. The analysis of the antimicrobial activities of medicinal plants is increasingly in the focus of scientific experiments. The increasing attention is being paid to herbs and the reason is to avoid the undesirable side effects and use of synthetic drugs.
References
1. Kourkouta L, Kotsiftopoulos CH, Papageorgiou M, Iliadis CH & Monios A (2017). The Rational Use of Antibiotics Medicine. Journal of Healthcare Communications, 2(3), 1-4
2. "Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship"
3. WHO (April 2014). "Antimicrobial resistance: global report on surveillance 2014"
4. WHO - Antimicrobial resistance, Retrieved by https://www.who.int/en/news-room/fact-sheets/detail/antimicrobial-resistance
5. "World Antibiotic Awareness Week", Retrieved by http://www.who.int/campaigns/world-antibiotic-awareness-week/2017/launch-event/en/
6. Wikipedia: Antimicrobial resistance, Retrieved by https://en.wikipedia.org/wiki/Antimicrobial_resistance
7. Accessed on 21st September Antimicrobial Stewardship, Retrieved by https://apic.org/professional-practice/practice-resources/antimicrobial-stewardship/
8. Awareness Day for Rational Use of Antibiotics, Retrieved by https://www.onmed.gr/ygeia-eidhseis/story/349561/keelpno
Shristi Wagle
19th Batch
SHAS, Pokhara University
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