PGEU Best Practice Paper on Antimicrobial Resistance (AMR)

The emerging and steady increase of microbes that are resistant to antimicrobial treatments has become a global public health concern that threatens the effective treatment of infectious diseases. In the EU alone, it is estimated that 33,000 people die each year due to infections caused by resistant bacteria.

Community pharmacists are often the first and final contact in the health system before a pharmaceutical, a device or another health intervention is supplied. They play pivotal roles in counselling patients and promoting antimicrobial stewardship. They provide preventative action, referral, disposal, treatment in the pharmacy and constantly strive for quality improvements and innovation in pharmacy practice.

Because the use of antibiotics in both human and veterinary medicine is associated with the emergence of resistance, it is crucial that antibiotics are prescribed and dispensed responsibly and used correctly. Non-adherence to antibiotic therapies may result in antibiotic resistance, as suboptimal doses of antibiotic therapy can result in insufficient antibiotic exposure for eradicating infectious bacteria and potentially create an environment that promotes antibiotic resistance. Therefore understanding the correct use of antibiotics and the reasons behind poor adherence to antibiotic therapies (e.g. regimens having several daily doses), is crucial if the developing phenomenon of antibiotic resistance is to be controlled.

Pharmacists intervention in this area includes not only the best dispensing practices, but also information about the importance of taking the antibiotic as prescribed, both in terms of regimen (e.g. every 12h) and extension of treatment (e.g. for 7 days).

Furthermore, by monitoring and informing patients about possible side effects, adverse reactions and drug interactions, pharmacists contribute to the correct use of antibiotics and identify possible causes for non-adherence.

European Antibiotics Awareness Day
Since its inception in 2008, PGEU has systematically supported and engaged in the European Centre for Disease Prevention and Control’s (ECDC) European Antibiotic Awareness Day (EAAD) to promote the prudent use of antibiotics. In recent years this has been further enhanced by the use of social media to raise awareness of the issue of AMR and to encourage the prudent use of antibiotics.

In 2013-2014 the PGEU actively contributed to the ECDC’s consultation on the development of a toolkit for self-medication of antibiotics in collaboration with the Standing Committee of European Doctors (CPME). This resulted in a suite of materials available in all EU languages which can be adapted as necessary to raise awareness of the dangers of self-medication with antibiotics and their ineffectiveness against colds and seasonal influenza (‘flu).

PGEU also provided significant input into the ECDC’s EU guidelines on the prudent use of antimicrobials in humans which specifically mentions the role of pharmacists in ensuring the prudent use of antimicrobials.

WHO Europe
In 2014, PGEU collaborated with WHO Europe to survey community pharmacists, other healthcare professionals, government institutions and health service providers to outline the role community pharmacists can play in tackling AMR and encouraging the prudent use of antimicrobials. This collaboration resulted in a report which identifies community pharmacists as important allies in the fight against AMR and that pharmacists already have experience in treating their patients with antibiotics, both responsibly and within the appropriate legal framework.

Additionally, the report concludes that pharmacists are among the best positioned healthcare professionals to facilitate the appropriate use of antibiotics and, therefore, have an essential role to play in tackling AMR alongside policy-makers and general practitioners. PGEU also engages in WHO’s World Antibiotics Awareness Week (WAAW) campaign which complements the ECDC’s EAAD.

Multi-stakeholder Collaboration
PGEU is one of the founding partners of the pan-European interdisciplinary stakeholder collaboration “medsdisposal”. #medsdisposal is a campaign to raise awareness on the appropriate disposal of expired or unused medicines in Europe and includes associations representing European healthcare, industry and student organisations. Crucial to this project’s relevance is an interactive map of Europe with direct links to the official websites providing information on the appropriate way of disposing medicines in each country in the national language(s).

In order to increase awareness of this website, social media is used extensively to guide members of the public to the resources on the campaign’s website:

•    https://www.youtube.com/channel/UCAX8cA8IfIwk7iH4DtB5FZg/videos
•    https://www.facebook.com/medsdisposaleu-890282831045021/
•    https://twitter.com/hashtag/medsdisposal