Fighting antimicrobial resistance The contribution of pharmacists 2015 | Fighting antimicrobial resistance Colophon Copyright 2015 International Pharmaceutical Federation (FIP) International Pharmaceutical Federation (FIP) Andries Bickerweg 5 2517 JP The Hague The Netherlands www.fip.org All rights reserved. No part of this publication may be stored in any retrieval system or transcribed by any form or means — electronic, mechanical, recording, or otherwise — without citation of the source. FIP shall not be held liable for any damages incurred resulting from the use of any data and information from this report. All measures have been taken to ensure accuracy of the data and information presented in this report. Editor: Zuzana Kusynová, FIP Policy Analyst & Project Coordinator Co-editor: Luc Besançon, FIP General Secretary & CEO Recommended citation International Pharmaceutical Federation (FIP). Fighting Antimicrobial Resistance: The Contribution of Pharmacists. The Hague: International Pharmaceutical Federation; 2015. Cover image: MinervaStudio & Lukasz Bartczak/Dreamstime.com Fighting antimicrobial resistance | p1 Contents Executive summary ..................................................................................................................................... 3 1 Antimicrobial resistance: Global health threat ............................................................................................ 4 1.1 Background .................................................................................................................................................... 4 1.2 Why is AMR a problem? ................................................................................................................................. 4 1.2.1 Individual consequences: Burden on health ............................................................................................. 4 1.2.2 Population consequences: Economic burden ........................................................................................... 4 1.3 Future trends ................................................................................................................................................. 4 2 Need for better management .................................................................................................................... 6 2.1 Responsible vs irresponsible use of antimicrobials.......................................................................................... 6 2.1.1 Current use of antimicrobials ................................................................................................................... 6 2.1.2 Responsible use of antimicrobials ............................................................................................................ 8 2.2 Gaps in research and development ................................................................................................................ 8 3 Translating needs into policies ................................................................................................................. 10 3.1 Policy at international level ........................................................................................................................... 10 3.2 Policy at regional or national level ................................................................................................................. 10 3.2.1 Governmental policies ............................................................................................................................ 10 3.2.2 Policies on pharmacists’ roles ................................................................................................................. 11 4 Community pharmacists fighting AMR ..................................................................................................... 12 4.1 Health promotion ......................................................................................................................................... 12 4.2 Infection prevention and control ................................................................................................................... 12 4.2.1 Educating on infection prevention .......................................................................................................... 12 4.2.2 Infection control via immunisation ......................................................................................................... 12 4.3 Triage ........................................................................................................................................................... 13 4.3.1 Appropriate treatment of symptoms without antimicrobials .................................................................. 13 4.3.2 Direct supply of antimicrobials by pharmacists ....................................................................................... 14 4.3.3 Referral to appropriate health professionals ........................................................................................... 14 4.4 Optimal treatment management .................................................................................................................. 15 4.4.1 Adherence support ................................................................................................................................. 15 4.4.2 Minimising interactions .......................................................................................................................... 15 4.5 Ensuring quality of medicines ....................................................................................................................... 16 5 Hospital pharmacists fighting AMR .......................................................................................................... 17 5.1 Pharmacist-led stewardship programmes ..................................................................................................... 17 5.2 Sterilisation .................................................................................................................................................. 18 5.3 Hygiene in hospitals ...................................................................................................................................... 18 6 Collaborative practice .............................................................................................................................. 19 6.1 Interprofessional collaboration model ........................................................................................................... 19 6.2 Feedback on prescribed antimicrobial regimens ...........................................................................................20 7 Engaging stakeholders ............................................................................................................................ 21 7.1 Monitoring AMR threats ................................................................................................................................ 21 7.2 Pharmacists engagement in R&D .................................................................................................................. 21 7.3 Reducing antimicrobials in food and the environment ................................................................................... 21 8 Summary ................................................................................................................................................ 23 Acknowledgements ................................................................................................................................... 24 References ................................................................................................................................................ 25 Appendices ............................................................................................................................................... 31 p2 | Fighting antimicrobial resistance Appendix 1. Objectives of the WHO Global AMR Action Plan ...................................................................... 31 Appendix 2. Examples of activities organised by pharmacist associations ................................................. 31 Fighting antimicrobial resistance | p3 Executive summary Antimicrobial resistance (AMR) is one of the greatest threats facing humanity. Action to confront and help overcome the problem must be taken now. Policies already exist or are being formulated at international, regional and national levels. Pharmacists are increasingly being involved in providing their expertise when AMR policies are being created, evaluated and implemented. This can be seen in the World Health Organization (WHO) Global Action Plan to tackle AMR (1) and in the expansion of antimicrobial and infection control programmes that require approaches from both hospital and community settings. The International Pharmaceutical Federation (FIP) is a global federation of national associations of pharmacists and pharmaceutical scientists. In order to support these associations in their fight against AMR, FIP has prepared this briefing document. It is an overview of the different activities that community and hospital pharmacists are involved in.to prevent AMR and to reverse AMR rates. Pharmacists work to protect and promote the health, safety and well-being of patients and the public, making them more resilient to infections. Pharmacists’ unique position in health care systems makes them the most