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New Quick Reference Guide to antimicrobial stewardship

The Royal Pharmaceutical Society (RPS) has published a new quick reference guide (QRG) to antimicrobial stewardship.

The guide, launched at the RPS Annual Conference 2017 on 3 September, provides an overview of how community pharmacists and their teams can contribute to antimicrobial stewardship. It includes advice on how to prevent the overuse of antimicrobials by assessing symptoms, offering advice on management of self-limiting conditions, recommending non-antimicrobial over-the-counter alternatives, and referring patients to their GP when appropriate.

Pharmacists can also use the guide to help ensure that patients who have already received an antimicrobial prescription use their medication correctly.

Additional advice on what community pharmacists can contribute to antimicrobial stewardship, such as providing an influenza vaccination service and minor ailments service, and ensuring the pharmacy team is ready to advise on good hygiene practices, is also included in the guide.

“All pharmacists have a role to play in tackling antimicrobial resistance”, said Ash Soni, president of the Royal Pharmaceutical Society. “I think there’s a perception that antimicrobial stewardship is the solely the domain of hospital pharmacists, but primary care and community colleagues also play an essential part in managing this huge challenge.

“Providing advice on self care, how long infections can be expected to last and how to take antimicrobials, as well as providing services such as flu vaccinations, can make an enormous difference.”

The Quick Reference Guide can be accessed on the RPS website: https://www.rpharms.com/resources/quick-reference-guides/antimicrobial-stewardship-ams-qrg

RPS campaigns on antimicrobial stewardship

Antimicrobial stewardship has long been a policy and campaign focus of the Royal Pharmaceutical Society (RPS).

Responding to the UK Government’s Antimicrobial Resistance Strategy, published 13 September 2013, the RPS said that “Training of community pharmacists has the potential to reduce GP consultations by means of public education and symptomatic management of self-limiting infections”. In another response, to a 2014 NICE consultation on guidance for ‘Antimicrobial resistance: changing risk-related behaviours’ the Society said that the “use of minor ailment schemes whereby patients can receive symptomatic treatments for infections can decrease visits to a GP by 50% and reduce the number of prescribed antibiotics”.

In July 2014 the Society, together with the Royal College of General Practitioners (RCGP), the Royal College of Physicians (RCP), the Royal College of Nursing (RCN) and the UK Faculty of Public Health (FPH) published a Joint Statement on Antimicrobial Resistance. Among the recommendations of this statement was a call for antimicrobial prescribing data to be monitored, and for licensing requirements for new antimicrobials changed to include data on the minimum dosage required for clinical effectiveness.

In 2014, RPS Scotland collaborated with the Scottish Antimicrobial Prescribing Group (SAPG), Community Pharmacy Scotland and Pharmacy Voice to produce a European Antibiotic Awareness day resource pack for community pharmacists, which included a patient-directed self-care information leaflet for treating infectious ailments. The packs were distributed in November 2014.

Later that month, on European Antibiotic Awareness Day itself —18 November 2014 — RPS Scotland held a parliamentary reception and debate on antimicrobial resistance, sponsored by Jim Eadie MSP. The event led to a Scottish Parliamentary debate on the subject, held on 5 February 2015. Also on European Antibiotic Awareness Day, RPS Wales and the Royal College of General Practitioners (RCGP) held a lunchtime discussion with Welsh Assembly Members (AMs) on the use of antibiotics in primary care. During the summit, the two professional bodies called for Wales to commit to a public education campaign on the subject, and greater antimicrobial stewardship.

At the 2017 annual conference, the RPS launched its new GB-wide campaign on antimicrobial stewardship. The campaign aims to show how pharmacists are contributing to a targeted 50% reduction in inappropriate prescribing of antibiotics by 2020. As part of this campaign, the AMS portal — a hub for health professionals co-produced by the RPS and University College London — will be updated and relaunched.

Throughout all antimicrobial campaign and policy activity, the Antimicrobial Expert Advisory Group — chaired by antimicrobial pharmacist Harpal Dhillon —acts to advise the Society and shape policy on the subject.

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Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2017.20203478

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