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Pharmacist-Led Antimicrobial Stewardship
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Pharmacist-Led Antimicrobial Stewardship

A special issue of Pharmacy (ISSN 2226-4787). This special issue belongs to the section "Pharmacy Practice and Practice-Based Research".

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 22636

Special Issue Editor

Dr. Spencer Durham

E-Mail Website
Guest Editor
Department of Pharmacy Practice, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849-5341, USA
Interests: antimicrobial stewardship; urinary tract infections; HIV infection; skin/skin structure infections; pharmacy practice; continuing education
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The increasing threat of antimicrobial resistance is a worldwide problem. In fact, the World Health Organization considers antimicrobial resistance to be one of the top ten public health threats facing humanity. This is associated with numerous untoward consequences, including prolonged hospital stays, increased healthcare expenditures, and even mortality. Although many different factors may contribute to the emergence of antimicrobial resistance, the overuse and misuse of antimicrobials is the predominant factor. With the slow development of novel antimicrobials, few options exist to combat this deadly problem. The best defense is though appropriate antimicrobial stewardship. The Centers for Disease Control and Prevention define antimicrobial stewardship as “the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients.” Pharmacists are in the unique position to lead antimicrobial stewardship efforts because of their expertise in pharmacotherapy, drug utilization, and adverse effects associated with pharmacologic therapy. Pharmacists provide, among other things, guidance with limiting the use of broad-spectrum agents and promoting the overall judicious use of antibiotics.

For this Special Issue, we welcome original research articles related to pharmacist-led antimicrobial stewardship. Articles may focus on, but are not limited to, novel approaches to the provision of antimicrobial stewardship, programs that have been successfully implemented, and antimicrobial stewardship in the acute care, long-term care, and outpatient settings. We also welcome commentaries, reviews, and editorials.

Dr. Spencer Durham
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pharmacy is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • antimicrobial stewardship
  • antimicrobial resistance
  • pharmacist
  • pharmacy
  • infectious disease
  • antibiotics
  • clinical pharmacy

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Published Papers (5 papers)

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Research

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18 pages, 543 KiB  
Article
Evaluating UK Pharmacy Workers’ Knowledge, Attitudes and Behaviour towards Antimicrobial Stewardship and Assessing the Impact of Training in Community Pharmacy
by Donna Seaton, Diane Ashiru-Oredope, Jordan Charlesworth, Isla Gemmell and Roger Harrison
Pharmacy 2022, 10(4), 98; https://doi.org/10.3390/pharmacy10040098 - 16 Aug 2022
Cited by 7 | Viewed by 2556
Abstract
The Antibiotic Guardian (AG) campaign, developed in 2014 is an online ‘pledge’ approach to engage health workers and the public about antimicrobial resistance. It is underpinned by models of science communication and behaviour change. Since its launch until the end of 2021, more [...] Read more.
The Antibiotic Guardian (AG) campaign, developed in 2014 is an online ‘pledge’ approach to engage health workers and the public about antimicrobial resistance. It is underpinned by models of science communication and behaviour change. Since its launch until the end of 2021, more than 140,000 individuals pledged. A service evaluation was conducted to determine the impact of the campaign upon UK pharmacy workers, in response to national training introduced in 2020. Pledged pharmacy workers were sent an online questionnaire collating demographics, self-reported behaviour and opportunity to support prudent antibiotic use. It also investigated respondents’ daily practice and antimicrobial stewardship (AMS) efforts, and motivations for pledging. Capability was measured with a set of knowledge questions. Awareness of changes to the Community Pharmacy Quality Scheme in England to include incentivized training on antimicrobial resistance (AMR) was explored. Of the 5344 pharmacy workers invited to participate, 783 (14.6%) responded to the survey. There was a statistically significant difference between job roles and capability score. Pharmacists, including Academic and Hospital Pharmacists and Pharmacy Technicians reported higher confidence and capability scores than Dispensers and Pharmacy Assistants (F = 13.776, p = 0.0002). Respondents reported strong knowledge on antimicrobial resistance and high confidence in fulfilling their AG stewardship pledge within daily practices (92.7% of all respondents answered all capability questions, as measured by knowledge, correctly). Two thirds of respondents (61.6% (423/693)) agreed or strongly agreed that they had access to and were able to utilise local antibiotic prescribing guidance and a similar proportion of responding community pharmacists (60%) were aware of the content of their workplace AMS plans. No statistically significant relationships were found between motivations for pledging and subsequent behaviour; pledging due to mandatory requirements of work-place training was the most common answer in both 2019 (42%) and 2020 (54%) cohorts. This evaluation supports the value of the AG pledge-based approach to engage and educate pharmacy workers. Reflections show its impact on increasing evidence-based stewardship for pharmacy workers and their response to mandatory training requirement by employers highlights the effectiveness of the AG campaign to promote AMS within pharmacy teams. Full article
(This article belongs to the Special Issue Pharmacist-Led Antimicrobial Stewardship)
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14 pages, 1212 KiB  
Article
Outcomes of a National, Cross-Sector Antimicrobial Stewardship Training Initiative for Pharmacists in England
by Vincent Ng, Diane Ashiru-Oredope, Helena Rosado and Beth Ward
Pharmacy 2021, 9(4), 165; https://doi.org/10.3390/pharmacy9040165 - 10 Oct 2021
Viewed by 3090
Abstract
(1) Background: Pharmacists play a pivotal role in tackling Antimicrobial resistance through antimicrobial stewardship (AMS) and are well placed to lead behaviour change interventions across the healthcare system; (2) Methods: A cross-sector AMS training initiative for pharmacists was implemented across England, with three [...] Read more.
(1) Background: Pharmacists play a pivotal role in tackling Antimicrobial resistance through antimicrobial stewardship (AMS) and are well placed to lead behaviour change interventions across the healthcare system; (2) Methods: A cross-sector AMS training initiative for pharmacists was implemented across England, with three cohorts between 2019–2021. Each cohort took part in an introductory workshop, followed- by a workplace-based quality improvement project supported by peer-assisted learning sessions. Completion of training was determined by an end of training assessment after three to four months. Outcome data and learner survey results were collated, anonymised, and analysed by the training provider. (3) Results: In total, 118 pharmacists participated in the introductory workshop, 70% of these subsequently undertook an improvement project, and 48% engaged workplace stakeholders in the process. Interventions were designed by 57% of learners and 18% completed a at least one Plan-Do-Study-Act cycle. Approximately a quarter of learners met the requirements for a Certificate of Completion. Knowledge quiz scores were obtained from 115 learners pre-training and 28 learners post-training. Paired t-tests conducted for 28 learners showed a statistically significant improvement in mean score from 67.7% to 81.1% (p < 0.0001). Sixty-two learner survey responses were received during the training and 21 follow-up survey responses 6 to 12 months post training. Of the 21 responses to the follow-up survey, ongoing quality improvement work and improvement outcomes were reported by nine and six learners, respectively. (4) Conclusions: The delivery of workplace-based training at scale can be challenging, however this study demonstrates that coupling learning with workplace implementation and peer support can promote behaviour change in learners. Further study into the impact of providing pharmacists across sectors and geographies with access to this type of training will help inform ongoing workforce development interventions. Full article
(This article belongs to the Special Issue Pharmacist-Led Antimicrobial Stewardship)
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19 pages, 3442 KiB  
Article
Practical Pharmacist-Led Interventions to Improve Antimicrobial Stewardship in Ghana, Tanzania, Uganda and Zambia
by Frances Kerr, Israel Abebrese Sefah, Darius Obeng Essah, Alison Cockburn, Daniel Afriyie, Joyce Mahungu, Mariyam Mirfenderesky, Daniel Ankrah, Asiwome Aggor, Scott Barrett, Joseph Brayson, Eva Muro, Peter Benedict, Reem Santos, Rose Kanturegye, Ronald Onegwa, Musa Sekikubo, Fiona Rees, David Banda, Aubrey Chichonyi Kalungia, Luke Alutuli, Enock Chikatula and Diane Ashiru-Oredopeadd Show full author list remove Hide full author list
Pharmacy 2021, 9(3), 124; https://doi.org/10.3390/pharmacy9030124 - 8 Jul 2021
Cited by 16 | Viewed by 6211
Abstract
The World Health Organisation (WHO) and others have identified, as a priority, the need to improve antimicrobial stewardship (AMS) interventions as part of the effort to tackle antimicrobial resistance (AMR). An international health partnership model, the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme, [...] Read more.
The World Health Organisation (WHO) and others have identified, as a priority, the need to improve antimicrobial stewardship (AMS) interventions as part of the effort to tackle antimicrobial resistance (AMR). An international health partnership model, the Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) programme, was established between selected countries in Africa (Ghana, Tanzania, Zambia and Uganda) and the UK to support AMS. This was funded by UK aid under the Fleming Fund and managed by the Commonwealth Pharmacists Association (CPA) and Tropical Health and Education Trust (THET). The primary aims were to develop local AMS teams and generate antimicrobial consumption surveillance data, quality improvement initiatives, infection prevention and control (IPC) and education/training to reduce AMR. Education and training were key components in achieving this, with pharmacists taking a lead role in developing and leading AMS interventions. Pharmacist-led interventions in Ghana improved access to national antimicrobial prescribing guidelines via the CwPAMS mobile app and improved compliance with policy from 18% to 70% initially for patients with pneumonia in one outpatient clinic. Capacity development on AMS and IPC were achieved in both Tanzania and Zambia, and a train-the-trainer model on the local production of alcohol hand rub in Uganda and Zambia. The model of pharmacy health partnerships has been identified as a model with great potential to be used in other low and middle income countries (LMICs) to support tackling AMR. Full article
(This article belongs to the Special Issue Pharmacist-Led Antimicrobial Stewardship)
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12 pages, 583 KiB  
Article
The Effect of Javanese Language Videos with a Community Based Interactive Approach Method as an Educational Instrument for Knowledge, Perception, and Adherence amongst Tuberculosis Patients
by Fauna Herawati, Yuni Megawati, Aslichah, Retnosari Andrajati and Rika Yulia
Pharmacy 2021, 9(2), 86; https://doi.org/10.3390/pharmacy9020086 - 18 Apr 2021
Cited by 3 | Viewed by 5891
Abstract
The long period of tuberculosis treatment causes patients to have a high risk of forgetting or stopping the medication altogether, which increases the risk of oral anti-tuberculosis drug resistance. The patient’s knowledge and perception of the disease affect the patient’s adherence to treatment. [...] Read more.
The long period of tuberculosis treatment causes patients to have a high risk of forgetting or stopping the medication altogether, which increases the risk of oral anti-tuberculosis drug resistance. The patient’s knowledge and perception of the disease affect the patient’s adherence to treatment. This research objective was to determine the impact of educational videos in the local language on the level of knowledge, perception, and adherence of tuberculosis patients in the Regional General Hospital (RSUD) Bangil. This quasi-experimental study design with a one-month follow-up allocated 62 respondents in the intervention group and 60 in the control group. The pre- and post-experiment levels of knowledge and perception were measured with a validated set of questions. Adherence was measured by pill counts. The results showed that the intervention increases the level of knowledge of the intervention group higher than that of the control group (p-value < 0.05) and remained high after one month of follow-up. The perceptions domains that changed after education using Javanese (Ngoko) language videos with the Community Based Interactive Approach (CBIA) method were the timeline, personal control, illness coherence, and emotional representations (p-value < 0.05). More than 95% of respondents in the intervention group take 95% of their pill compared to 58% of respondents in the control group (p-value < 0.05). Utilization of the local languages for design a community-based interactive approach to educate and communicate is important and effective. Full article
(This article belongs to the Special Issue Pharmacist-Led Antimicrobial Stewardship)
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Review

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8 pages, 432 KiB  
Review
Antimicrobial Resistance Following Prolonged Use of Hand Hygiene Products: A Systematic Review
by Gouri Rani Banik, Bandar Durayb, Catherine King and Harunor Rashid
Pharmacy 2022, 10(1), 9; https://doi.org/10.3390/pharmacy10010009 - 4 Jan 2022
Cited by 3 | Viewed by 3852
Abstract
Background: This systematic review aimed to establish whether antimicrobial resistance (AMR) occurs following prolonged use of antimicrobial hand hygiene (HH) products, and, if so, in what magnitude. Methods: Key bibliographic databases were searched to locate items on HH use and AMR development from [...] Read more.
Background: This systematic review aimed to establish whether antimicrobial resistance (AMR) occurs following prolonged use of antimicrobial hand hygiene (HH) products, and, if so, in what magnitude. Methods: Key bibliographic databases were searched to locate items on HH use and AMR development from database inception to December 2020. Records were screened and full texts of all potentially eligible articles were retrieved and checked for inclusion. The following data from the included studies were abstracted: type of HH product used, including the name of antimicrobial agent, study setting, country, study year, duration of use and development of AMR including the organisms involved. Quality assessment was done using the Newcastle-Ottawa Scale (NOS). Results: Of 339 full-text articles assessed for eligibility, only four heterogeneous United States (US) studies conducted in the period between 1986 and 2015 were found eligible, and included. One hospital-based study showed evidence of AMR following long term use of HH products, two studies conducted in household settings showed no evidence of AMR, and another experimental study showed partial evidence of AMR. The overall certainty of the evidence was moderate. Conclusion: Prolonged use of HH products may cause AMR in health care settings, but perhaps not in other settings. Full article
(This article belongs to the Special Issue Pharmacist-Led Antimicrobial Stewardship)
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