Community pharmacists-Leaders for antibiotic stewardship in respiratory tract infection.

Hospital-based pharmacists are established antibiotic stewards, but the potential for community pharmacists is largely untapped. This commentary explores the potential leadership role of the community pharmacist in antibiotic stewardship using upper respiratory tract infection (URTI) as an example. Community pharmacists are well placed for antibiotic stewardship, possessing the capability (knowledge of medicines), opportunity (contact with prescribers and patients) and inherent commitment. Providing further motivation with information on patient education has great potential to change patient behaviour with respect to consulting a healthcare professional for an antibiotic prescription. A Global Respiratory Infection Partnership pharmacy-led educational initiative was shown to have a positive impact and can promote appropriate self-management of URTI and reduce levels of inappropriate antibiotic use. Community pharmacists are ideally placed as antibiotic stewards to lead the quest to contain the threat of antibiotic resistance.

Essack S ，Bell J ，Shephard A 《-》

Prescriber and dispenser perceptions about antibiotic use in acute uncomplicated childhood diarrhea and upper respiratory tract infection in New Delhi: Qualitative study.

Kotwani A ，Joshi PC ，Jhamb U ，Holloway K ... -  《-》

An underutilised resource for Antimicrobial Stewardship: a 'snapshot' of the community pharmacists' role in delayed or 'wait and see' antibiotic prescribing.

Various strategies have been implemented in primary care to address the inappropriate use of antibiotics, with varying degrees of success. One such intervention is delayed or 'wait and see' prescribing, where the prescriber indicates to wait a few days before dispensing the antibiotic. The aim of this study was to explore community pharmacists' perceptions and practice experiences with delayed antibiotic prescribing. An online survey was advertised in two professional pharmacy organisations' e-newsletters for community and internship pharmacists in Queensland, Australia, from January to April 2016. We received 120 responses. 103 (86%) worked in a community pharmacy. Sixty per cent of the respondents would not dispense the delayed antibiotic prescription if a patient presented to the pharmacy within 24 h of seeing a doctor. Instead, they would advise the patient to wait and fill the prescription if they are not improving. The concept of delayed or a 'wait and see' antibiotic prescription was well received by the participating community pharmacists. These healthcare professionals are well placed to be effective stewards of antibiotics and can play an important role in collaboration with other healthcare professionals to optimise the quality use of antibiotics in primary care.

Avent ML ，Fejzic J ，van Driel ML 《-》

Community pharmacy interventions to improve antibiotic stewardship and implications for pharmacy education: A narrative overview.

Antibiotic resistance is one of the world's most pressing public health problems, resulting in over 23,000 deaths per year. One of the main contributing factors to antimicrobial resistance is antibiotic misuse and overuse. Community pharmacists can play a role in reducing antibiotic resistance, since they are one of the most accessible healthcare professionals. The purpose of this paper is to describe community pharmacy interventions and strategies to reduce antibiotic misuse and overuse and to discuss the implications for pharmacy training. A narrative overview strategy was employed to identify papers on antibiotic stewardship and the role of the community pharmacist. Our review examined potential stewardship strategies and interventions within community pharmacy practice that provide opportunities for pharmacists to engage or lead in the reduction of antimicrobial resistance. We describe five promising community pharmacist-led intervention strategies: Collaborative Practice Agreements (CPAs), point-of-care (POC) testing, patient consultations, academic detailing and serving as an advocate for patients and other healthcare providers CONCLUSIONS: This review highlights topics that may warrant increased attention in pharmacy school curricula. Pharmacy schools may want to consider modifying their curricula to address the shifts in practice of the community pharmacist - emphasizing the expanded role of the pharmacist in patient care and public health issues such as outpatient antibiotic stewardship.

Bishop C ，Yacoob Z ，Knobloch MJ ，Safdar N ... -  《-》

Community pharmacists as antibiotic stewards: A qualitative study exploring the current status of Antibiotic Stewardship Program in Bahawalpur, Pakistan.

The World Health Organization released a Global Action Plan to overcome the threatening concerns of antibacterial resistance. One of the cornerstones of this plan is the Antibiotic Stewardship Program (ASP). The study aimed to assess the community pharmacists' knowledge, perceptions and current practices regarding ASP. A qualitative study was conducted in Bahawalpur, Pakistan, in which data were collected from the community pharmacists through in-depth, semi-structured interviews. The convenience sampling technique was used to recruit the study participants. Interview protocol was pilot tested and the sample size was limited by applying the saturation point criteria. All interviews were audio recorded and transcribed verbatim. The thematic analysis approach was used to analyze the data and draw conclusions based on study objectives. A total of fifteen community pharmacists were interviewed. Analysis of the data yielded five themes and 16 subthemes. All of the respondents had sound knowledge about the irrational use of antibiotics; however, they were oblivious about the ASP. After explaining the term, the respondents were of the opinion that these strategies could not be implemented in the current healthcare system of the country. According to the findings of the study, prescribing and dispensing practices were not followed. Only a few patients were educated about the antibiotics they were purchasing. Most of the study participants were unaware of any ASP being offered in the community pharmacy settings. The study participants agreed to be the antibiotic stewards, but a number of obstacles were reported. The training of pharmacists, medication reconciliation, the implementation of the good pharmacy practice guidelines and assurance of pharmacist availability at drug retail outlets were few suggestions given by the study participants to incorporate the ASP in the community settings.

Atif M ，Asghar S ，Mushtaq I ，Malik I ... -  《-》