Decreasing the Peril of Antimicrobial Resistance Through Enhanced Health Literacy in Outpatient Settings: An Underrecognized Approach to Advance Antimicrobial Stewardship

Abstract

Globally, antimicrobial resistance (AMR) is a serious problem causing 700,000 deaths annually. By 2050, AMR is expected to cause approximately 10 million deaths globally each year if allowed to increase at the present rate. Many individuals have limited knowledge regarding appropriate antibiotic use and AMR. Most antibiotic use occurs in the outpatient setting, with approximately 30% of antibiotics prescribed deemed unnecessary. Antimicrobial stewardship (AMS) is a means to reduce inappropriate antibiotic use and AMR. While existing AMS efforts generally focus on the inpatient setting, a significant gap is present in the outpatient setting. A common theme across various national action plans to reduce AMR is the need for education and awareness. The importance of communicating information in a manner easily comprehended by the patient in addition to productive clinician-patient dialogue cannot be overestimated. Enhancing the public's and patients' AMS health literacy is an underrecognized approach to help address AMR. We describe Four Core Elements of Enhancing AMS Health Literacy in the Outpatient Setting, utilizing the Centers for Disease Control and Prevention's framework: (1) leadership commitment, (2) intervention/action, (3) tracking/ reporting, and (4) education/expertise. We call upon leaders in outpatient settings to embrace this approach to curb inappropriate antimicrobial use.

Divergent and Convergent Attitudes and Views of General Practitioners and Community Pharmacists to Collaboratively Implement Antimicrobial Stewardship Programs in Australia: A Nationwide Study

“…According to a Cochrane review [39], use of interprofessional checklists can improve the compliance to recommended stewardship practice. To date, there are many misunderstandings and misperceptions in relation to AMR and AMS exist with the tools used to facilitate interprofessional communication, communication with the patients, and the standard care [40]. This is where GP and pharmacy professional organisations in Australia should come forward with a research agenda of how to develop a clear consensus guidelines defining interprofessional activities including checklists to improve the routine AMS practice by GPs and CPs.…”

Self‐prescribing of antibiotics by patients seeking care in Indian emergency departments

“…36,37 Improving consumer health literacy about antibiotics is an important component to curtail misuse. 38 Our study demonstrates that the ED offers a potential opportunity to reach patients for such efforts. Educational toolkits, videos, and information sheets are all potential mechanisms that can be used for patients in the ED appropriately and have been used successfully as part of outpatient ASPs.…”

Knowledge about infections is associated with antibiotic use: cross-sectional evidence from the health survey Northern Ireland

“…Therefore, knowledge may be insufficient to influence antibiotic overuse. Good, multi-faceted health literacy is required to make the critical decisions necessary to reduce antibiotic overuse [ 33 ]. As reported previously, people with high knowledge about antibiotics reported higher antibiotic use, whereas people with good health literacy used an antibiotic significantly less frequently compared with people with insufficient health literacy [ 19 ].…”