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Guest article by Stephanie Kohl, Policy & Advocacy Officer at the European Association of Hospital Pharmacists (EAHP) 

The theme of this year’s European Antibiotic Awareness Day (EAAD) focused on continuing to keep antibiotics working also in times of a global pandemic. For EAHP and its members, prudent use of antibiotics plays a key role in combatting the rising problem of antimicrobial resistance. The clinical patient-facing role for hospital pharmacists has gained a prominent position in many countries. One of the most recognised roles is that of the hospital antimicrobial pharmacist. Working as part of the multidisciplinary stewardship team, the hospital antimicrobial pharmacist is the secret weapon of every healthcare system that helps manage the use of antimicrobials, together with other specialists such as the treating physician, the infectologist, the microbiologist and infection control nurses.

Hospital pharmacists are ideally placed to positively contribute to the effective and appropriate use of antimicrobials, as part of the antibiotic stewardship team. With many years of study focused on the medications (such as pharmacodynamics, pharmacokinetics, adequate use, adverse reactions, interactions, etc.) and with the management of the supply chain and supply to each speciality under the control of the pharmacy department, the hospital pharmacist can contribute to the development of prescribing guidelines, and manage their implementation by an agreed access programme supported by subsequent clinical use audits. The hospital antimicrobial pharmacist identifies areas for improvement for the antimicrobial/infection control team, to ensure the availability of effective antimicrobial therapy into the future, and to support hospital and health system governance by providing data for key hospital performance indicators on antimicrobial consumption.

Some European countries have already acknowledged the important role that antibiotic stewardship teams play, in combatting the escalating threat of antimicrobial resistance that seriously jeopardises the effectiveness of standard treatments, rendering some ineffective for their approved indications. To ensure that all European patients and citizens alike benefit from these interventions, EAHP advocates for the utilisation of the specialised background and knowledge of the hospital pharmacists, in multi-professional antibiotic stewardship teams. This includes:

1. enabling and promoting the profession to make direct interventions within multidisciplinary care teams, such as reviewing antibiotic duration;
2. advising on the cessation of inappropriate antibiotic treatments;
3. suggesting the switching from intravenous to oral antibiotics;
4. overcoming antibiotic shortages through stewardship-lead substitution;
5. and educating other healthcare professionals on the restricted use of certain antibiotics.

Antibiotic stewardship teams should become routine throughout Europe: they help reduce antibiotic overuse, positively contribute to lowering resistance development, and have formed an integral part of the treatment of patients during the COVID-19 pandemic.