A call to action for outpatient antibiotic stewardship

Klepser, Michael E.; Dobson, Erica; Pogue, Jason M.; Labreche, Matthew J.; Adams, Alex J.; Gauthier, Timothy P.; Turner, R. Brigg; Su, Christy P.; Jacobs, David M.; Suda, Katie J.

doi:10.1016/j.japh.2017.03.013

Cited by 37 publications

(30 citation statements)

References 53 publications

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“…Klepser et al highlighted that a strong GP-CP collaboration is a fundamental strategy to develop sustainable stewardship interventions in the community [39]. The lack of GP-CP communication hindered CPs to provide interventions on antibiotic prescriptions.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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The scope of antimicrobial stewardship (AMS) surveys on community pharmacists (CPs) is uncertain. This study examines the breadth and quality of AMS survey tools measuring the stewardship knowledge, perceptions and practices (KPP) of CPs and analyse survey outcomes. Following PRISMA-ScR checklist and Arksey and O'Malley's methodological framework seven medical databases were searched. Two reviewers independently screened the literatures, assessed quality of surveys and KPP outcomes were analysed and described. Ten surveys were identified that assessed CPs' AMS perceptions (n = 7) and practices (n = 8) but none that assessed AMS knowledge. Three survey tools had been formally validated. Most CPs perceived that AMS improved patient care (median 86.0%, IQR, 83.3-93.5%, n = 6), and reduced inappropriate antibiotic use (84.0%, IQR, 83-85%, n = 2). CPs collaborated with prescribers for infection control (54.7%, IQR 34.8-63.2%, n = 4) and for uncertain antibiotic treatment (77.0%, IQR 55.2-77.8%, n = 5). CPs educated patients (53.0%, IQR, 43.2-67.4%, n = 5) and screened guideline-compliance of antimicrobial prescriptions (47.5%, IQR, 25.2-58.3%, n = 3). Guidelines, training, interactions with prescribers, and reimbursement models were major barriers to CP-led AMS implementation. A limited number of validated survey tools are available to assess AMS perceptions and practices of CPs. AMS survey tools require further development to assess stewardship knowledge, stewardship targets, and implementation by CPs.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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“…19 The importance and need for antibiotic stewardship in the outpatient setting have previously been noted. 20 Community pharmacists are obvious candidate antibiotic stewards, and this commentary explores this further, focusing on upper respiratory tract infection (URTI).…”

Section: What Is Known and Objectivementioning

confidence: 99%

Community pharmacists—Leaders for antibiotic stewardship in respiratory tract infection

2017

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Summary What is known and objective Hospital‐based pharmacists are established antibiotic stewards, but the potential for community pharmacists is largely untapped. This commentary explores the potential leadership role of the community pharmacist in antibiotic stewardship using upper respiratory tract infection (URTI) as an example. Comment Community pharmacists are well placed for antibiotic stewardship, possessing the capability (knowledge of medicines), opportunity (contact with prescribers and patients) and inherent commitment. Providing further motivation with information on patient education has great potential to change patient behaviour with respect to consulting a healthcare professional for an antibiotic prescription. A Global Respiratory Infection Partnership pharmacy‐led educational initiative was shown to have a positive impact and can promote appropriate self‐management of URTI and reduce levels of inappropriate antibiotic use. What is new and conclusion Community pharmacists are ideally placed as antibiotic stewards to lead the quest to contain the threat of antibiotic resistance.

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“…Pharmacists have a history of successfully engaging in outpatient antimicrobial stewardship initiatives . Surveys of pharmacists regarding nonprescription oseltamivir demonstrate a sensitivity to the issue of resistance …”

Section: Key Areas Of Concern From Stakeholdersmentioning

confidence: 99%

Pharmacy-based management of influenza: lessons learned from research

Klepser

Adams

2018

International Journal of Pharmacy Practice

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Recently, several jurisdictions have pursued legislative and regulatory changes to allow pharmacy‐based influenza management models in which pharmacists can initiate appropriate antiviral therapy in community pharmacy settings. While studies have been published in Canada, Japan, New Zealand, Norway and the United States, concerns have been expressed over pharmacist training, the accuracy of rapid influenza diagnostic tests, and the potential impact on antimicrobial resistance, among others. Studies have demonstrated that pharmacists provide safe and effective influenza management, with high rates of patient satisfaction, while maintaining or improving antimicrobial stewardship.

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A call to action for outpatient antibiotic stewardship

Cited by 37 publications

References 53 publications

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

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

Community pharmacists—Leaders for antibiotic stewardship in respiratory tract infection

Pharmacy-based management of influenza: lessons learned from research

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