Pharmacists who specialize in infectious diseases have training in antibiotic use and work with healthcare teams to ensure antibiotics are used safely and effectively.
Sara DiTursi, Pharm.D., BCPS, BCIDP
Public Outreach Committee, Society of Infectious Diseases Pharmacists
Madeline King, Pharm.D., BCIDP
Co-Director of Outpatient Antimicrobial Stewardship, Cooper University Healthcare, Public Outreach Committee, Society of Infectious Diseases Pharmacists
The CDC reports that nearly 30% of antibiotic use in the United States is unnecessary. This overuse contributes to the growing problem of antibiotic resistance, making infections harder to treat. Addressing this issue requires a collaborative effort among patients, pharmacists, and healthcare professionals to combat antibiotic resistance.
Infections occur when germs such as bacteria and viruses invade the body and make us ill. Antibiotics are medications used to kill bacteria that cause infections. Antibiotic resistance happens when bacteria learn to resist the antibiotics through different mechanisms leading to ineffectiveness, which allows the bacteria to continue to grow and spread through the body. This leaves patients with fewer treatment options — and, sometimes, no options at all. Most important is recognizing when antibiotics are not needed or when they are used inappropriately. By preventing antibiotic resistance, we can continue to have effective medications that treat infections caused by bacteria.
Trained pharmacists lead the change
Infectious diseases-trained pharmacists (ID pharmacists) are experts on antibiotic use and work with healthcare teams to make sure antibiotics are used safely, effectively, and only when needed. These pharmacists practice antibiotic stewardship, which is the process of assessing the use of antibiotics for appropriateness. ID pharmacists work hard to protect the effectiveness of antibiotics and prevent resistance to protect the health of the public.
Many ID pharmacists work in hospital settings taking care of the sickest patients. These pharmacists serve as a part of the hospital’s antibiotic stewardship program to ensure that the patient is receiving the correct antibiotic for their infection, at the correct dose, and for the appropriate duration. They ensure the chosen antibiotic is safe for the patient based on many factors, including other conditions the patient may have, drug interactions, and antibiotic allergies. ID pharmacists may also recommend stopping antibiotics for patients with viral infections, for which antibiotics will not be effective, and in cases of colonization, where bacteria are present but not causing infection and treatment is not beneficial. They monitor how the patient responds to antibiotic treatment, review culture data, and recommend changes as necessary.
The growing need for outpatient stewardship
An estimated 60% of antibiotic use occurs in outpatient settings (CDC). Ensuring appropriate antibiotic use in the outpatient setting is crucial. Not only can inappropriate use lead to resistance, but it can also lead to unwanted side effects, such as Clostridioides difficile (C. diff) diarrhea, which can cause significant illness. The core elements of outpatient antibiotic stewardship include commitment, expertise, action for policy and practice, reporting, and education. ID pharmacists can facilitate communication between providers (i.e., physicians, physician assistants, and nurse practitioners) and stakeholders, track antibiotic prescribing data, implement policies, and provide education to providers and patients. Outpatient initiatives often focus on educating providers and the public on avoiding antibiotics for viral infections, especially during cold and flu season. Additionally, resources like the CDC’s “symptom relief prescriptions for viral illnesses” help providers recommend over-the-counter products to help patients feel better when antibiotics are not the answer.
Antibiotic stewardship requires a multidisciplinary approach to be effective. Pharmacists, providers, nurses, and other healthcare workers can work together to ensure patients receive the best information in the fight against antibiotic resistance.
For further learning, visit SIDP – ID Pharmacists and Antibiotics. Pharmacists and healthcare workers can enroll in a certificate program about the appropriate use of antibiotics at https://sidp.org/Stewardship-Certificate. Growing interest has also inspired the creation of an educational curriculum for teachers to use with high school students.
