What can pharmacists do to halt the alarming rise of antimicrobial resistance and why will they need to look further than their shop walls if they are to make a difference asks Rachel Mountain, reporter.
The relentless march of antimicrobial resistance (AMR) across the globe threatens drastically reduced life expectancies, a staggering rise in killer infections and the end of healthcare as we know it.
It is a naturally-occurring phenomenon that has been injected with the rocket fuel of rampant overuse and misuse in human and animal medication.
There is simply no quick way to put the brakes on the rapidly swelling resistance of bacteria to antibiotics that are depended upon daily by the global population.
So where, in the midst of this international predicament, do community pharmacists fit in?
A World Health Organisation (WHO) survey found that 65 per cent of respondents across 12 countries had taken antibiotics in the past six months.
A staggering 93 per cent of that medication was obtained via a pharmacy or medical store, meaning community pharmacists are literally at the frontline for the fight.
“As experts in medicines and their responsible use, pharmacists have many of the solutions to AMR,” says Luc Besançon, general secretary and CEO of the International Pharmaceutical Federation (FIP).
“But we must all act now.”
While antibiotic use has increased in England by 6.5 per cent over the past four years, it has been 30 years since a new class of antibiotics was last introduced.
Those statistics, coupled with the evidence that antibiotic resistant bacteria has already hit our shores, supports the urgent action Besançon calls for.
One example of the spread of AMR is Colisitin, a last-resort antibiotic for the treatment of infections including E. coli.
Doctors believed it would take three years for Colistin-resistant bacteria to reach the UK after it was discovered in China in November 2015.
But in just a month, following tests by Public Health England (PHE) and the Animal and Plant Health Agency, the bacteria was found on British soil in 15 out of 24,000 samples taken.
A second, and equally worrying, example is the spread, probably through air travel, of genes including CTX-M-15 across continents.
“AMR simply does not recognise boundaries,” says Marie Philbin, antimicrobial pharmacist and chair of the Irish Antimicrobial Pharmacist Group.
Her words are true for the spread of antibiotic resistant bacteria across oceans, but also resonate closer to home where there is evidence of resistant bacteria moving from the hospital setting into the wider community and vice versa.
Philbin explains: “Historically, AMR was seen as an issue in hospitals because we had such a high intensity of antibiotic use and that is where a lot of those resistant organisms would have originated.
“But now there are issues like community-acquired MRSA and we are seeing Clostridium difficle-associated diarrhoea cases presenting in the community where patients have had no contact with the hospital.
“So it’s definitely an issue outside of hospitals also and we need to have antimicrobial stewardship within the community.”
Join us each day this week as we publish the instalments of our AMR special feature.