Knowledge and Practice of Pharmacists toward Antimicrobial Stewardship in Pakistan

Abstract

Background: The irrational use, “over the counter supply”, and unregulated supply chains of antimicrobials are contributing toward antimicrobial resistance. Antimicrobial stewardship programs regulate antimicrobials usage to prevent resistance and reduce health care burden. Objective: To assess the knowledge and practice of pharmacists’ working in various healthcare settings toward antimicrobial stewardship in Pakistan. Method: A cross-sectional study was conducted among pharmacists working in different sectors between March to June 2017. Results: A total of 181 pharmacists participated, of whom (n = 145, 80.1%) were males. The majority of participants were in the 20–30 age group (n = 147, 81.2%) and hold Doctor of Pharmacy degrees. More than 80% of pharmacists agreed that “antimicrobial stewardship is essential to improve patient care”; while (n = 159, 87.8%) pharmacists agreed that “pharmacist should be trained on the use of antimicrobial”. Close to 90% of pharmacists agreed that “adequate training should be provided to pharmacists on antimicrobial use”. Regarding the practice of antimicrobial stewardship, (n = 72, 39.8%) pharmacists often/always “make efforts to prevent or reduce the transmission of infections within the community”; (n = 58, 32%) pharmacists never “dispense antimicrobials without a prescription”; and (n = 60, 32%) pharmacist often/always “communicate with prescribers if unsure about the appropriateness of an antibiotic prescription”. Conclusions: Increased antimicrobial stewardship efforts can both optimize the treatment of infections and reduce adverse events associated with antibiotic use. Pharmacists in Pakistan have good knowledge and adopt positive practices toward antimicrobial stewardship. Pharmacist and other health care professionals should collaborate within multi-disciplinary teams to reduce the problem of antimicrobial resistance and improve the quality of life of patients.

Knowledge, Perceptions and Practices of Community Pharmacists Towards Antimicrobial Stewardship: A Systematic Scoping Review

“…Table 1 describes the characteristics of survey studies and validity of survey tools. Ten studies [29][30][31][32][33][34][35][36][37][38] were conducted in six countries in the years ranging from 2015 to 2018. Survey studies were conducted in: two each from Australia, UK and Pakistan, and one from each of Malaysia, Qatar, Canada, and Ethiopia.…”

“…Breadth of survey studies152We identified 1860 articles, of which 68 were full text reviewed after the screening of titles and 153 abstracts. Ten surveys[29][30][31][32][33][34][35][36][37][38] were included in this review(Figure 1).…”

Pharmacist-led Antimicrobial Stewardship

“…The issue of antimicrobial obstruction is more regrettable in low and center pay nations (LMIC), as the frequency of irresistible infections is high contrasted with high-pay nations. In low and center pay nations, the death rates because of antimicrobial-safe microscopic organisms are under-announced, in any case, accessible information in India, Nigeria, Pakistan, and Congo show that countless neonatal passings came about because of drug-safe sepsis [19]. Every year, in excess of 50,000 infants are evaluated to bite the dust from sepsis because of pathogens impervious to first-line anti-toxins [20].…”

“…Antimicrobial pharmacists have been instrumental in affecting changes at a hierarchical and national level [24]. A pharmacist apportioning antimicrobials without a remedy is 83-100% of the time unconscious of a patient's hypersensitivities status [19]. Erroneous sensitivity marking results in wrong antimicrobial administration of the patient, which may influence clinical result, increment the danger of unfavorable occasions and increment costs.…”

Impact of Medical Professionals on Carbapenem-Resistant Pseudomonas Aeruginosa: Moderation Effect of Workload Based on the Panel Data in China

“…Many countries are facing the challenge of antimicrobial resistance (AMR). About 25,000 people die from AMR a year in European countries [1], and data from India, Nigeria, Pakistan and the democratic republic of Congo indicate that a large number of newborn deaths are caused by drug-resistant sepsis [2].AMR in particular carbapenem-resistant Pseudomonas aeruginosa (CRPA) threatens global public health security [3]. Since Pseudomonas aeruginosa is the main pathogens of healthcare-associated infection (HAI) [4], and Pseudomonas aeruginosa infections are often challenging to treat because of its intrinsic nonsusceptibility to many antimicrobials.…”