by | December 11, 2018 | Opinion

Hospital pharmacists in the frontline against AMR

Stephanie Kohl Policy & Advocacy Officer, European Association of Hospital Pharmacists

Antimicrobial Resistance threatens to endanger many patients’ lives.  The loss of effective antimicrobials is pushing modern medicine back into the pre-antibiotic area. Hospital pharmacists are aware of this threat and are taking action in hospitals where pharmacists are available, to keep antibiotics working. In this vein, , in June 2018, the General Assembly of the European Association of Hospital Pharmacists (EAHP) adopted a revised position paper on antimicrobial resistance (AMR focusing  on the prudent use of antimicrobial drugs through antibiotic stewardship to ensure efficient therapy for patients with life threatening infections.

To maintain the efficacy of antimicrobial drugs and to prevent AMR from spreading further, EAHP is demanding stronger uptake of the multi-professional approach. Antibiotic stewardship teams, which are still far away from being routine in European hospitals, could help to alleviate the situation. Patients are not yet actively asking for the use of antibiotic stewardship teams in hospitals, however scientific results show their contribution to resistance development, the efficient reduction of antibiotic overuse and even cost savings. Therefore, EAHP calls on national governments and health system managers to use the specialised background and knowledge of the hospital pharmacists in multi-professional antibiotic stewardship teams.

However, it’s not only stewardship teams that are needed to combat AMR, but the universal application of infection prevention and control measures as well as vaccination programmes is also necessary. Toolkits such as the one for healthcare professionals in hospitals and other healthcare settings produced by  the European Centre for Disease Prevention and Control (ECDC) should be used by hospital pharmacists to augment the uptake of prophylactic measures.

Increased investment to support the development of innovative proposals as well as arrangements for the maintenance of essential antibiotics are vital. EU Member States are consequently encouraged to make the necessary arrangements to combat medicines shortages of existing antibiotics and offer incentives for practice-based research projects to investigate new fields of infectious disease control such as immunotherapy; and to optimise the cost-effectiveness of systems for surveillance on antibiotic use and resistance.  The ‘One Health’ approach of the European Commission’s action plan against AMR is a step in the right direction which also highlights the importance of the fact that measures in the human and veterinary sector as well as in the environmental field should complement each other.  However, further commitment is needed to keep antibiotics working. Therefore, EAHP’s position paper highlights the need for governments to make arrangements to maintain essential antibiotics on the market with contingency stock level arrangements and alternative production by hospital pharmacists enabled where necessary. In relation to animal health, EAHP strongly supports regulatory oversight and proper implementation of measures in the veterinary and agriculture sectors at European, national and local level.

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