What are you planning to learn?
There has been much information generated around the increase in AMR. However, I wanted to learn about this first-hand rather than based on hearsay. I wished to gain the following information:
- Why is AMR happening?
- What can be done by Pharmacists like myself?
How are you planning to learn it?
I plan to start at the source of this news, the newspaper articles that have increased the hysteria around this topic and have touted it as a ‘doom and gloom’ scenario almost creating a sense of apocalypse. The news paper of my choosing was by the Telegraph, ‘Antibiotic-resistant superbugs creating deadly risks for hip and knee operations’. The article stated, ‘More than 2,500 people are now dying each year following a surge in once-treatable bloodstream infections for which antibiotics no longer work.’ And, had commentary from leading expert such as:
Professor Dame Sally Davies, the Chief Medical Officer for England, said: “The evidence is clear that without swift action to reduce infections, we are at risk of putting medicine back in the dark ages, to an age where common procedures we take for granted could become too dangerous to perform and treatable conditions become life-threatening.”
But, whilst this was a good basis to steer up my appetite for learning. It didn’t answer my first question, why are antibiotics developing resistance or rather how are they doing this? These clever little buggers have somehow found a way to beat a drug that we have spent decades developing. I started with a TEDex talk, this was interesting as it based the rational on the long known Darwin’s theory of evolution (Natural selection). Here are the different ways:
- Micro-organisms mutate which can thus lead to resistance, as antibiotics are used they kill-off the bacteria that has not mutated thus allowing the mutated antibiotics to proliferate. This term is known as survival of the fittest, as they reproduce.
- Another way in which this occurs is due to conjugation, bacteria sharing their mutated gene, thus giving the other bacteria advantage against antibiotics.
Now, I wanted to answer the question, what can be done by pharmacist?
The Royal Pharmaceutical Society guide, ‘The Pharmacy Contribution to antimicrobial stewardship’ was a fantastic way to gain idea into what we are doing and perhaps what I could be doing. There were various examples such:
- Providing simple diagnostic tests to identify bacterial infection. i.e. strep test in community pharmacy
- Delivering public health campaigns and opportunistic patient advice and counselling such as hygiene, appropriate use of antimicrobials and self-care.
Give an example of how this learning has benefited the people using your services.
This learning has been useful, as when I am locuming I can now advice patients confidently, particularly those who may be suffering from a cough and their defacto is to take an antibiotic. I now inform them that this may not be the case and encourage them to describe their symptoms, probing it further and when they are keen to obtain antibiotics I can refer them first to a local pharmacy carrying out the strep-test. I give them education around AMR and the importance to ensure we use antibiotics when it is necessary.
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