Home' Australian Pharmacist : Australian Pharmacist Nov 2013 Contents Australian Pharmacist November 2013 I ©Pharmaceutical Society of Australia Ltd. 21
BE OUR GUEST
ghters -- pharmacists
on the front line
By Aine Heaney
Our society has forgotten the miracle
of antibiotics. Before the antibiotic age,
infections resulting from simple cuts and
scratches could result in hospitalisation
and death. Common children's ailments
such as tonsillitis could result in long
hospital stays, and surgical procedures
often resulted in complications or death
from secondary infections. Without
antibiotics, there was little that could be
offered in the way of effective treatments.
The advent of the antibiotic era
completely changed this bleak
picture, but now we are at risk of
again finding ourselves vulnerable to
bacterial infections that we currently
think of as simple. Today, our most
common pathogens have a high level
of resistance to first-line antibiotics. In
2008 there were around 1,700 deaths
from hospital-acquired MRSA infections.
It's hard to believe that in a period of less
than 100 years, we could have discovered
and lost one of the most important
advances in modern medicine.
The situation we face could be even
worse than the pre-antibiotic era.
After years of antibiotic use, the bacteria
in our community are increasingly
virulent and cause nastier and more
complex infections. According to WHO,
antibiotic resistance is one of the greatest
threats to human health today.
We thought it was just a problem
for hospitals. In Australia more than
30% of Staphylococcus aureus isolates
from hospital patients are resistant to
methicillin and vancomycin-resistant
enterococci are also common.
But the hospitals are getting their house
in order. Dedicated hospital program are
having a significant impact, reducing
inappropriate antibiotic use by 22-36%.
Hospital pharmacists have a critical role
in the success of these initiatives by
leading the education of hospital staff,
compiling prescribing data and feedback
mechanisms, and reporting on local
Now we recognise that, in fact, resistant
bacteria are much more entrenched in
the community than we first thought.
Around 25% of all MRSA infections are
now community acquired.
A primary driver of this is overprescribing.
Australia's overuse of antibiotics is one
of the highest in the developed world,
with around 22 million prescriptions
written every year in primary care.
Antibiotics are unique among medicines:
they're the only class of agents we
have whose widespread use actually
reduces their effectiveness. Instead of
inducing a physiological response in
the patient, antimicrobials target an
internal pathogen -- and the more we
wage war on them, the more they raise
It's a frightening thought -- but it's also
empowering. We all have a responsibility
to preserve the miracle of antibiotics and
we can all have an impact. Community
pharmacists must step up and act now.
In the war on antibiotic resistance,
pharmacists stand at the front line.
Pharmacists are consistently rated as one
of the most trusted professions in the
world. This is why people with respiratory
tract infections (RTIs) or urinary tract
Aine Heaney is the Design and Development
Manager at NPS Medicine Wise. She has been
working at NPS Medicine Wise since March
2007, previously in the health professional
quality use of medicine programs, and
has experience in program design and
implementation. Aine has a background in
hospital pharmacy and has worked in the UK,
NZ and Australia where she specialised in pain,
palliative care and rehabilitation medicine.
infections (UTIs) often go to their
pharmacist first. You have a duty to be
antibiotic resistance fighters. Here's what
you can do:
Educate the public
• Explain that common RTIs are likely to
be viral and not helped by antibiotics.
• Promote self-management of RTIs
and UTIs using simple symptom relief
techniques and over-the-counter
medicines. (For RTIs, try the NPS
Symptomatic Management Pad: www.
• Promote good hygiene practices to
• Advise about vaccinations, such as the
Know when to refer to a GP
• symptoms of serious illness e.g.
pus around the tonsils or signs
• older people with diabetes or
congestive heart failure, or who are frail
• those at higher risk of complications
due to comorbidities
• those with sore throat from a
community with a high incidence
of rheumatic fever e.g. some
• children with middle ear infection
• those with severe sinusitis with facial
pain for more than a few days.
When antibiotics are prescribed,
support their proper use
• Reinforce directions for use.
• Consider dispensing the number
of antibiotics required for the
indicated duration of treatment e.g.
by removing some tablets from a
pack. Advise patients to dispose of
unused antibiotics if dispensing more
• Question people who return with
a repeat prescription later than an
infection would be expected to resolve.
During Antibiotic Awareness Week
(18--24 November) NPS Medicine Wise
encourages all health professionals to
take a pledge to join the fight against
antibiotic resistance. To sign the pledge
and add your workplace to the map,
Links Archive Australian Pharmacist Oct 2013 Australian Pharmacist December 2013 Navigation Previous Page Next Page