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Public Health England tells pharmacists to act as gatekeepers of antibiotic use

Pharmacists should act as “gatekeepers” to ensure that antibiotics are used appropriately, a pharmacist at Public Health England said at the Clinical Pharmacy Congress last week (26 April 2014).

Diane Ashiru-Oredope, pharmacist lead on antimicrobial resistance and healthcare-associated infections at PHE, told participants that pharmacists should educate all patients prescribed antibiotics to ensure that they follow dosage instructions and return any unused medicine. She added that it is also important to manage patients’ expectations so that they are aware of how long illnesses can last.

“If you see a patient with a prescription for co-amoxiclav you might think the worst thing that can happen is that the patient experiences diarrhoea. But you need to think about the wider cost to society of not using co-amoxiclav appropriately.” Dr Ashiru-Oredope explained that since the introduction of surveillance initiatives, the prescribing of cephalosporins has decreased and the rates of Clostridium difficile infection have dropped. However, she warned that prescriptions for co-amoxiclav were on the increase and asked pharmacists to try to help reduce the number of broad-spectrum antibiotics that are prescribed.

Hospital pharmacists were urged to adopt the “Start smart then focus” guidance from the Department of Health. “Do not start antibiotics before tests confirm it is a bacterial infection. Then 48 hours later, review medication decisions. If you have not implemented ‘start smart then focus’ in your trust then talk to your antimicrobial pharmacist,” she said. She added that a key frustration for antimicrobial pharmacists is that review stickers are often not used, and she asked hospital pharmacists to ensure that patients’ charts are properly annotated. Another strategy to reduce the use of antibiotics is the promotion of vaccinations and Dr Ashiru-Oredope told participants that pharmacists should ask their patients if they are up to date with theirs.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.11138025

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  • Pharmacist handing over medicine (Taylor Olsen/

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