Non-compliance of the treatment with antibiotics in non-severe acute infections. Med Clin Barc , , pp. Llor, N. Sierra, S. Bayona, M. Moragas, et al. Compliance rate of antibiotic therapy in patients with acute pharyngitis is very low, mainly when thrice-daily antibiotics are given. Rev Esp Quimioter, 22 , pp. Branthwaite, J. Pan-European survey of patients attitudes to antibiotics and use. J Int Med Res, 24 , pp. Goossens, R. Ferech, R. Vander, M. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study.
Lancet, , pp. Robles, V. Antimicrobial resistance among respiratory pathogens in Spain: latest data and changes over 11 years — to — Antimicrob Agents Chemother, 54 , pp. Shehan, P. Patel, A. Srinivasan, D. Emergency department visits for antibiotic-associated adverse events. Clin Infefc Dis, 47 , pp. Van Wijk, B. Van Wijk, O. Klungel, E. Heerdink, A de Boer, et al. Effectiveness of interventions by community pharmacists to improve patient adherence to chronic medication: a systematic review.
Ann Pharmacother, 39 , pp. Machuca, J. Espejo, L. Gutierrez, M. The effect of written information provided by pharmacists on compliance with antibiotherapy. Ars Pharmaceutica, 44 , pp. Assessing pharmacist intervention on antibiotic therapy adherence. Seguim Farmacoter, 2 , pp. Faus, P. Amariles, F. Pharmaceutical care: concepts, processes and practical cases.
Drug utilization guide. Baena Parejo, F. Fisac Lozano, F. Validation of a questionnaire to assess patient knowledge of their medicines. Aten Primaria, 41 , pp. Morisky, L. Green, D.
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Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care, 24 , pp.
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Roth, H. Caron, B. Measuring intake of a prescribed medication: a bottle count and a tracer technique compare. Clin Pharmacol Ther, 11 , pp. Peterson, L. Takiya, R. Meta-analysis of trials of interventions to improve medication adherence. Am J Health Syst Pharm, 60 , pp. Kredo, J. Patient education and counselling for promoting adherence to treatment for tuberculosis.
Cochrane Database Syst Rev, 16 , pp. Clark, T. Karagoz, S. Apikoglu-Rabus, F. Effect of pharmacist-led patient education on adherence to tuberculosis treatment. Am J Health Syst Pharm, 64 , pp. Johnson, J. Gazmararian, K. Jacobson, Y. Pan, B. Schmotzer, S Kripalani, et al. Effect of a pharmacy-based health literacy intervention and patient characteristics on medication refill adherence in an urban health system. Ann Pharmacother, 44 , pp. Morgado, S. Morgado, L. Mendes, L. Pereira, M. Pharmacist interventions to enhance blood pressure control and adherence to antihypertensive therapy: review and meta-analysis.
Am J Health Syst Pharm, 68 , pp. Toro-Chico, M. Pharmaceutical intervention on the therapeutic adherence in patients with chronic renal disease. Rev Calid Asist, 26 , pp. Influence of sociodemographics and clinical characteristics in the adherence of pharmacological treatment of patients with cardiovascular risk. Pharm Care Esp, 14 , pp. Parameters important in short antibiotic courses. J Int Med Res, 28 , pp. Orero, J. Rev Esp Quimioter, 19 , pp. Okuyan, M. Sancar, F. Assessment of medication knowledge and adherence among patients under oral chronic medication treatment in community pharmacy settings.
Pharmacoepidemiol Drug Saf, 22 , pp. All rights reserved. Recomendaciones para el manejo de la faringoamigdalitis Are you a health professional able to prescribe or dispense drugs? Si continua navegando, consideramos que acepta su uso. To improve our services and products, we use "cookies" own or third parties authorized to show advertising related to client preferences through the analyses of navigation customer behavior.
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First dispensing. Download PDF. A qualitative study of hospital pharmacists and antibiotic governance: negotiating interprofessional responsibilities, expertise and resource constraints. Open Access. First Online: 06 February Part of the following topical collections: Organization, structure and delivery of healthcare. Background Antibiotic treatment options for common infections are diminishing due to the proliferation of antimicrobial resistance AMR.
Results Three major themes emerged in the pharmacist interviews including 1 the responsibilities of pharmacy in optimising antibiotic use and the interprofessional challenges therein; 2 the importance of antibiotic streamlining and the constraints placed on pharmacists in achieving this; and 3 the potential, but often under-utilised expertise, pharmacists bring to antibiotic optimisation. Conclusions Pharmacists have a critical role in AMS teams but their capacity to enact change is limited by entrenched interprofessional dynamics. Background Antimicrobial resistance AMR is a prominent public health concern.
The limited impact of antimicrobial stewardship AMS In the past decade a range of clinical governance programs aiming at optimising antimicrobial use in hospitals have been developed under the umbrella term of antimicrobial stewardship AMS [ 11 , 12 , 13 , 14 , 15 , 16 ]. Design This is a qualitative study utilising semi-structured interviews with Australian hospital-based pharmacists involved in antibiotic decision-making.
This translates into communication with doctors, giving and seeking advice, keeping records and establishing links across different departments of the hospital.
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Pharmacists interpreted their role in antibiotic prescribing within the boundaries of their relationship with doctors—i. Increasingly, pharmacy assumes duties beyond the dispensing of drugs, requiring stronger involvement in clinical practice and a physical presence on hospital wards. This perception was voiced across all levels of seniority and areas of clinical focus.
These constraints are made more pertinent by the informal practices pharmacists face when attempting to optimise antibiotic use in line with antibiotic guidelines. Almost all of our participants talked about difficulties to intervene once a prescription was written. Being present at the moment of initiating antibiotic therapy was for most the exception.
This, and the lack of a default mechanism to correct suboptimal antibiotic scripts, exposed pharmacy interventions to a range of inconsistencies in practice. The imprest stock is an onsite supply of medications accessible by nurses and doctors at any time. All antibiotic drugs that need approval from an Infectious Diseases specialist are stocked only in limited quantity. This gives pharmacy the ability to track the use of restricted drugs. Managing and restricting the supply of antibiotic drugs is one of the key antimicrobial stewardship interventions of hospital pharmacy.
Pharmacists justified this enactment of interprofessional control emphasising their responsibility to safeguard the viability of antibiotics for the future. The latter interview excerpt above demonstrates how restrictive management of supply is accompanied by attempts to educate and raise awareness about therapeutic guidelines. Participants also discussed the limitations a restrictive approach to streamlining antibiotic use imposes. The participants doubted that gatekeeping practices alone were the best way to optimise antibiotic use.
This argument relates to the hospital as an organisational setting characterised by hierarchically-structured professional relations. Establishing a dispensing authority in the form of the pharmacist as gatekeeper alongside the prescribing authority manifest in the doctor was perceived as a threat to the integrity of that system. Gatekeeping practices alone are ineffective and may have adverse effects on the choice of antibiotics pushing pharmacy to intervene more directly in the prescribing process.
More precisely they perceived it as a clash between medical judgment and pharmaceutical standards. The pharmacists understood their expertise as unique and highly specialised on drugs as opposed to the broader remit of medical knowledge. They framed this expertise as different from, and more specialised than, the clinical knowledge of the medical profession. Most participants agreed that the value of pharmacy is not to supplant medical judgment but provide practical advice and prompts to complement it, for example, by assisting with precise dosing, raising awareness about AMR and promoting the accessibility of clinical guidelines.
Pharmacists built on their professional education and standards to argue for their potential to make meaningful contributions in the clinical field. DOCX 15 kb. Theuretzbacher U. Accelerating resistance, inadequate antibacterial drug pipelines and international responses. Int J Antimicrob Agents.
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World Health Organization. Antimicrobial resistance. Global report on surveillance. Centers for Disease Prevention and Control. Core elements of hospital antibiotic stewardship programs. The epidemic of antibiotic-resistant infections: A call to action for the medical community from the Infectious Diseases Society of America. Clin Infect Dis. Infectious Diseases Society of America. Promoting antimicrobial stewardship in human medicine.
Zarb P, Goossens H. Fridkin SK, Srinivasan A. Implementing a strategy for monitoring inpatient antimicrobial use among hospitals in the United States. Antimicrobial prescribing practice in Australia. Prescribing trends before and after implementation of an antimicrobial stewardship program. Med J Aust. Point-prevalence study of inappropriate antibiotic use at a tertiary Australian hospital.
Intern Med J. Guarding the goods: An introduction to antimicrobial stewardship. Clin Microbiol Newsl. CrossRef Google Scholar. Paterson DL. Unfortunately, antimicrobials have been used so widely and for so long that those infectious organisms have adapted over time to become resistant to some drugs. At least 2 million Americans become infected with antimicrobial-resistant organisms each year, causing more than 23, deaths. Antibiotic stewardship refers to the careful and responsible management of anti-infective agents.
The goals of ASPs are to limit inappropriate antimicrobial use, optimize antimicrobial selection, and limit unintended consequences. The most important question is not which antibiotic to use but whether to use one at all. Proper selection considerations include dosing, route of administration, and duration of therapy. Finally, unintended consequences to consider are adverse drug events, cost, and resistance. Executives can issue directives, requiring the facility to cooperate with efforts to monitor and improve antibiotic use.
Leaders can delegate stewardship-related duties and place these duties into job descriptions and performance reviews. Sufficient compensation, time, and training should be given to those departments participating in the stewardship program. Accountability Ideally, ASPs would have an infectious-disease specialist physician as the stewardship program leader responsible for program outcomes and a pharmacist with additional training in infectious diseases as the pharmacy leader to colead the group and be responsible for improving antibiotic use.
The Pharmacy and Therapeutics committee should not be considered the ASP unless it expands its role to allow the time and expense to create and maintain the program. The more departments involved, the smaller the workload for each department and the more buy-in staff members in these departments will have. Clinicians and department heads must be fully engaged in the ASP, as they are the prescribers of the antimicrobials. Infection prevention specialists and hospital epidemiologists coordinate monitoring and prevention of infections. These specialists can analyze, audit, and report data.
They can also assist with educating staff members and implementing strategies to optimize antibiotic use. Therefore, the quality improvement staff should be involved to ensure that policies and procedures are being followed. One important policy is documentation of dose, duration, and indication for all courses of antibiotics to ensure that these medications are discontinued or modified as appropriate. One important procedure is the development and implementation of facility-specific treatment recommendations based on formulary options, local susceptibilities, and national guidelines.
Laboratory staff members should guide the appropriate use of tests and expedite results to the proper individuals. They can also create and interpret a site-specific antibiogram Figure. Information technology staff members are imperative for the integration of stewardship protocols into workflow. Some examples include creating prompts to review antibiotics at 48 hours, facilitating the collection and reporting of antibiotic use data, implanting information and protocols at the point of care, and implementing clinical decision support.
They can also assure that cultures are performed before beginning antibiotic treatments.