Skip to main content

Advertisement

Log in

Role of pharmacists in antimicrobial stewardship programmes

  • Commentary
  • Published:
International Journal of Clinical Pharmacy Aims and scope Submit manuscript

Abstract

Antimicrobial resistance is a growing public health problem of global concern and, unless action is taken, the burden of death could reach 10 million per year by 2050. Resistance has been associated with increasing mortality, treatment failure and healthcare costs. In order to help combat this, antimicrobial stewardship programmes, have been implemented in many countries. These stewardship programmes can help, reduce inappropriate prescription and broad-spectrum use of antimicrobials, improve, clinical outcomes for the population as a whole, slow down the emergence of antimicrobial resistance and conserve healthcare resources. Pharmacists are an integral part of the stewardship team and have an important role in tackling antimicrobial resistance. This article aims to review the role of pharmacists within antimicrobial stewardship programmes and the opportunities for pharmacist-driven antimicrobial stewardship strategies in hospital and community settings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Adapted from [14, 36]

Similar content being viewed by others

References

  1. Akpan MR, Ahmad R, Shebl NA, Ashiru-Oredope D. A review of quality measures for assessing the impact of antimicrobial stewardship programs in hospitals. Antibiotics (Basel). 2016;5(1):5.

    Article  Google Scholar 

  2. O’Neill J. Tackling drug-resistant infections globally: final report and recommendations. The review on antimicrobial resistance. 2016. http://amr-review.org/sites/default/files/160525_Final%20paper_with%20cover.pdf. Accessed 22 May 2017.

  3. Garau J, Nicolau DP, Wullt B, Bassetti M. Antibiotic stewardship challenges in the management of community-acquired infections for prevention of escalating antibiotic resistance. J Glob Antimicrob Resist. 2014;2(4):245–53.

    Article  Google Scholar 

  4. Spoorenberg V, Hulscher ME, Akkermans RP, Prins JM, Geerlings SE. Appropriate antibiotic use for patients with urinary tract infections reduces length of hospital stay. Clin Infect Dis. 2014;58(2):164–9.

    Article  Google Scholar 

  5. Ortega M, Marco F, Soriano A, Almela M, Martinez JA, Pitart C, et al. Epidemiology and prognostic determinants of bacteraemic catheter-acquired urinary tract infection in a single institution from 1991 to 2010. J Infect. 2013;67(4):282–7.

    Article  CAS  Google Scholar 

  6. Dalfino L, Bruno F, Colizza S, Concia E, Novelli A, Rebecchi F, et al. Cost of care and antibiotic prescribing attitudes for community-acquired complicated intra-abdominal infections in Italy: a retrospective study. World J Emerg Surg. 2014;9:39.

    Article  Google Scholar 

  7. United Nations. Draft political declaration of the high-level meeting of the General Assembly on antimicrobial resistance. 2016. https://www.un.org/pga/71/wp-content/uploads/sites/40/2016/09/DGACM_GAEAD_ESCAB-AMR-Draft-Political-Declaration-1616108E.pdf. Accessed 22 May 2017.

  8. Goff DA, Rybak MJ. Global antimicrobial stewardship: challenges and successes from frontline stewards. Infect Dis Ther. 2015;4(Suppl 1):1–3.

    Article  Google Scholar 

  9. Society for Healthcare Epidemiology of America. Infectious diseases society of America, pediatric infectious diseases society. policy statement on antimicrobial stewardship by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Diseases Society of America (IDSA), and the Pediatric Infectious Diseases Society (PIDS). Infect Control Hosp Epidemiol. 2012;33(4):322–7.

    Article  Google Scholar 

  10. Dellit TH, Owens RC, McGowan JE Jr, Gerding DN, Weinstein RA, Burke JP, et al. Infectious diseases society of America and the society for healthcare epidemiology of America guidelines for developing an institutional program to enhance antimicrobial stewardship. Clin Infect Dis. 2007;44(2):159–77.

    Article  Google Scholar 

  11. Bishop BM. Antimicrobial stewardship in the emergency department: challenges, opportunities, and a call to action for pharmacists. J Pharm Pract. 2016;29(6):556–63.

    Article  Google Scholar 

  12. Howard P, Pulcini C, Levy Hara G, West RM, Gould IM, Harbarth S, et al. An international cross-sectional survey of antimicrobial stewardship programmes in hospitals. J Antimicrob Chemother. 2015;70(4):1245–55.

    CAS  Google Scholar 

  13. European Centre for Disease Prevention and Control. Proposals for EU guidelines on the prudent use of antimicrobials in humans. 2017. http://ecdc.europa.eu/en/publications/Publications/EU-guidelines-prudent-use-antimicrobials.pdf. Accessed May 23 2017. Stockholm.

  14. Gilchrist M, Wade P, Ashiru-Oredope D, Howard P, Sneddon J, Whitney L, et al. Antimicrobial stewardship from policy to practice: experiences from UK antimicrobial pharmacists. Infect Dis Ther. 2015;4(Suppl 1):51–64.

    Article  Google Scholar 

  15. Bessesen MT, Ma A, Clegg D, Fugit RV, Pepe A, Goetz MB, et al. Antimicrobial stewardship programs: comparison of a program with infectious diseases pharmacist support to a program with a geographic pharmacist staffing model. Hosp Pharm. 2015;50(6):477–83.

    Article  Google Scholar 

  16. Crader MF. Development of antimicrobial competencies and training for staff hospital pharmacists. Hosp Pharm. 2014;49(1):32–40.

    Article  Google Scholar 

  17. Sneddon J, Gilchrist M, Wickens H. Development of an expert professional curriculum for antimicrobial pharmacists in the UK. J Antimicrob Chemother. 2015;70(5):1277–80.

    Article  CAS  Google Scholar 

  18. Falcione BA, Meyer SM. Development of an antimicrobial stewardship-based infectious diseases elective that incorporates human patient simulation technology. Am J Pharm Educ. 2014;78(8):151.

    Article  Google Scholar 

  19. Messina AP, van den Bergh D, Goff DA. Antimicrobial stewardship with pharmacist intervention improves timeliness of antimicrobials across thirty-three hospitals in South Africa. Infect Dis Ther. 2015;4(Suppl 1):5–14.

    Article  Google Scholar 

  20. Goff DA, Karam GH, Haines ST. Impact of a national antimicrobial stewardship mentoring program: insights and lessons learned. Am J Health Syst Pharm. 2017;74(4):224–31.

    Article  Google Scholar 

  21. Ashiru-Oredope D, Fleming N, Ladenheim D. The role of the pharmacist in antimicrobial stewardship. Hosp Pharm Europe. 2015;(78). http://www.hospitalpharmacyeurope.com/drug-shortages/importance-becoming-antibiotic-guardian.

  22. Nault V, Pepin J, Beaudoin M, Perron J, Moutquin JM, Valiquette L. Sustained impact of a computer-assisted antimicrobial stewardship intervention on antimicrobial use and length of stay. J Antimicrob Chemother. 2017;72(3):933–40.

    PubMed  Google Scholar 

  23. Wenzler E, Wang F, Goff DA, Prier B, Mellett J, Mangino JE, et al. An automated, pharmacist-driven initiative improves quality of care for staphylococcus aureus bacteremia. Clin Infect Dis. 2017;65(2):194–200.

    Article  Google Scholar 

  24. Taggart LR, Leung E, Muller MP, Matukas LM, Daneman N. Differential outcome of an antimicrobial stewardship audit and feedback program in two intensive care units: a controlled interrupted time series study. BMC Infect Dis. 2015;15:480.

    Article  Google Scholar 

  25. Morrill HJ, Caffrey AR, Gaitanis MM, LaPlante KL. Impact of a prospective audit and feedback antimicrobial stewardship program at a veterans affairs medical center: a six-point assessment. PLoS ONE. 2016;11(3):e0150795.

    Article  Google Scholar 

  26. Dryden M, Saeed K, Townsend R, Winnard C, Bourne S, Parker N, et al. Antibiotic stewardship and early discharge from hospital: impact of a structured approach to antimicrobial management. J Antimicrob Chemother. 2012;67(9):2289–96.

    Article  CAS  Google Scholar 

  27. Nathwani D, Dryden M, Garau J. Early clinical assessment of response to treatment of skin and soft-tissue infections: how can it help clinicians? Perspectives from Europe. Int J Antimicrob Agents. 2016;48(2):127–36.

    Article  CAS  Google Scholar 

  28. Dyar OJ, Pagani L, Pulcini C. Strategies and challenges of antimicrobial stewardship in long-term care facilities. Clin Microbiol Infect. 2015;21(1):10–9.

    Article  CAS  Google Scholar 

  29. Doernberg SB, Dudas V, Trivedi KK. Implementation of an antimicrobial stewardship program targeting residents with urinary tract infections in three community long-term care facilities: a quasi-experimental study using time-series analysis. Antimicrob Resist Infect Control. 2015;4:54.

    Article  Google Scholar 

  30. Riordan DO, Walsh KA, Galvin R, Sinnott C, Kearney PM, Byrne S. The effect of pharmacist-led interventions in optimising prescribing in older adults in primary care: a systematic review. SAGE Open Med. 2016;4:2050312116652568.

    Article  Google Scholar 

  31. ASHP. ASHP Statement on the pharmacist’s role in antimicrobial stewardship and infection prevention and control. 2013. Medication Therapy and Patient Care: Specific Practice Areas-Statements. https://www.ashp.org/-/media/assets/policy-guidelines/docs/statements-pharmacists-role-antimicrobial-stewardship.ashx. Accessed 18 Sept 2017.

  32. Kokta N. Antimicrobial stewardship: how the community pharmacist can help. Inside Pharmacy. 2017;5(1). http://www.insidepatientcare.com/issues/2017/january-2017-vol-5-no-1/452-antimicrobial-stewardship-how-the-community-pharmacist-can-help.

  33. International Pharmaceutical Federation. Fighting antimicrobial resistance: the contribution of pharmacsists. https://www.fip.org/files/fip/publications/2015-11-Fighting-antimicrobial-resistance.pdf. Accessed 18 Sept 2017. The Hague.

  34. Johnson AP, Ashiru-Oredope D, Beech E. Antibiotic stewardship initiatives as part of the UK 5-year antimicrobial resistance strategy. Antibiotics (Basel). 2015;4(4):467–79.

    Article  CAS  Google Scholar 

  35. McNulty CA, Francis NA. Optimizing antibiotic prescribing in primary care settings in the UK: findings of a BSAC multi-disciplinary workshop 2009. J Antimicrob Chemother. 2010;65(11):2278–84.

    Article  CAS  Google Scholar 

  36. Barlam TF, Cosgrove SE, Abbo LM, MacDougall C, Schuetz AN, Septimus EJ, et al. Implementing an antibiotic stewardship program: guidelines by the infectious diseases Society of America and the society for healthcare epidemiology of America. Clin Infect Dis. 2016;62(10):e51–77.

    Article  Google Scholar 

Download references

Acknowledgements

Medical writing and editorial assistance was funded by Merck Sharp and Dohme, Zürich, Switzerland, and provided by Christina Campbell, PhD, of PAREXEL.

Funding

Financial support for this study was provided by Merck Sharp and Dohme, Zürich, Switzerland to support medical writing and editorial assistance.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Javier Garau.

Ethics declarations

Conflicts of interest

Dr. Bassetti reports grants and personal fees from MSD and Pfizer and personal fees from Astellas, Menarini and Angelini outside the submitted work. Dr. Garau reports grants and personal fees from Astellas, AstraZeneca, Bayer, Novartis, Pfizer, Vifor Pharma, grants from MSD and The Medicines Company, and personal fees from Durata, GSK, Theravance, Nabriva, Menarini and Paratek outside the submitted work.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Garau, J., Bassetti, M. Role of pharmacists in antimicrobial stewardship programmes. Int J Clin Pharm 40, 948–952 (2018). https://doi.org/10.1007/s11096-018-0675-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-018-0675-z

Keywords

Navigation