The expanding role of the antibiotic pharmacist

Abstract

Widespread inappropriate prescribing of antibiotics in UK hospitals has led to the introduction of specialist antibiotic pharmacists. Their role is to monitor antibiotic use, advise clinicians, educate all grades of healthcare workers and help to develop policy. Antibiotic pharmacists have been shown to be effective in many situations. As these practitioners become more accomplished it will be possible to expand their role to include direct intervention in patient treatment. Simple measures, such as modification of intravenous treatment to oral and automatic stop orders, could greatly enhance patient care.

Antimicrobial Stewardship Programs in Health Care Systems

“…Furthermore, patients whose physicians received recommendations from the pharmacist were significantly more likely to achieve clinical or microbiological cure (49%) than those who received recommendations from the infectious diseases fellows (35%). Because of the need for midlevel practitioners to enforce antimicrobial stewardship policies, the next decades will likely see clinical pharmacists as increasingly important partners to infectious diseases physicians in implementation of antimicrobial stewardship programs (159).…”

An Elective Course in Differential Diagnostics

“…[1][2][3][4][5][6][7][8] Instruction in the basic principles of differential diagnostics prepares nonphysician health care providers with the fundamental abilities and critical inquiry skills to ensure they understand their patients and the underlying cause of a disorder or complaint before "prescribing" the best drug regimen to manage the patient's symptoms. [9][10][11][12][13] The complex thought process needed to provide effective patient care is becoming part of the daily demands for pharmacists [12][13][14][15][16][17] and requires competence, patience, empathy, and tenacity, among other attributes. Development of these attributes in future pharmacists is the mission and charge of pharmacy education.…”

“…[19][20][21][22][23][24][25][26] While not trained to be diagnosticians, throughout the curricula, PharmD students are introduced to didactic information and given assignments that require them to be familiar with the diagnostic tests ordered to diagnose many disease states. 18 In professional practice settings, pharmacist clinicians often must decide whether they should recommend prescription and/or nonprescription medications based on their patients' complaints 5,6,[11][12][13][14][15]17 Thus, pharmacists must be able to accurately assess a patient's presenting complaint and recommend the most appropriate course of action, a responsibility that places the pharmacist in a pivotal role with respect to the patient's health care. To this end, some may argue that PharmD students should be formally exposed to and instructed in the principles of differential diagnostics to effectively prepare them to assess medication problems and understand the needs of their patients prior to recommending or assigning any medication intervention.…”

“…[1][2][3][4][5][6][7][8]11,15,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] Programs training physicians, physician assistants, dentists, and other prescribers use similar educational methods as those used with PharmD students (ie, problem-based learning), yet there is less emphasis on the use of the principles of differential diagnostics in PharmD curricula, perhaps because pharmacists do not formally diagnose patients' ailments as part of their daily practice. To better prepare PharmD students to effectively interact with other healthcare providers and provide quality patient care, an elective course was developed focusing on problem-solving using the basic principles of differential diagnostics.…”

Clinical Pharmacy and Pediatrics: Why Focus on Antibiotics?

“…The role of the 'antibiotic pharmacist' is expanding [3]. Many reports describe it's role in an adult population [3,4].…”