Six ‘AMR roadmaps’ define and prioritise major milestones for mitigating AMR
Priority actions that pharmacists should take to minimise antimicrobial resistance (AMR) have been described in a publication by the International Pharmaceutical Federation (FIP) recently. The new publication presents six ‘AMR roadmaps’, one for each of the World Health Organisation regions, that define and prioritise major milestones towards mitigating AMR for the period 2024 to 2028.
The roadmaps were developed by FIP in collaboration with its regional pharmaceutical forums and, for the European Region, with FIP member organisations in Europe, as there is no FIP regional pharmaceutical forum in the European region.
The roadmap for the African Region describes eight AMR and antimicrobial stewardship (AMS) priority actions, including encouraging the use of point-of-care diagnostic tools to differentiate between viral and bacterial infections and inform selection of antimicrobials. Six actions for pharmacists across the region of the Americas are prioritised, including educating other healthcare providers about AMR and encouraging interprofessional collaboration within AMS programmes.
The publication also presents various activities that have already been undertaken in countries of each region. For example, in the Eastern Mediterranean region, pharmacists are monitoring and supporting patients who have been exposed to antimicrobial resistant micro-organisms.
Advocacy
A total of 34 responses from 22 countries were obtained from various regions. Since FIP does not have a regional forum in the European Region, it surveyed 68 FIP member organisations from Europe and received 17 answers.
From the responses, they found there is a need for pharmacists to advocate for international, collective and alternative financial models to incentivise the research and development of new antimicrobials. Equitable access to all antimicrobials for those in need should also be a priority.
Pharmacy bodies should also support the discovery and development of new cost-effective antimicrobial medicines, alternatives to antimicrobials, and foster research into improved use of existing antimicrobials, including new combinations.
Pharmacy as a profession should also promote the adaptability of antimicrobial (including fixed-dose combinations) pack sizes according to their course length, and advocate against irrational fixed-dose combinations, said the respondents.
Diagnostic tools
According to the responses, the most well established AMR and AMS actions for pharmacists in the regions included encouraging the use of point-of-care diagnostic tools to screen for early signs of infectious diseases, differentiating between viral and bacterial infections, and informing the choice of empirical antimicrobials, where appropriate, as part of clinical pathways (68%).
European pharmacists also prioritised encouraging the
use of point-of-care diagnostic tools
Also among the most well established AMR and AMS actions for pharmacists included ensuring the right antimicrobial medicine is prescribed to the right person for the right duration at the right dose and dosing interval, while opting for the narrowest-spectrum agents where possible (65%).
Providing appropriate counselling and safety checks for allergies and chronic conditions as well as collaborative work with other healthcare professionals documenting in healthcare records was at 65% among the respondents, while educating other healthcare providers about AMR and encouraging interprofessional co-operation within the AMS programmes in hospitals and in communities was at 62%.
Improvement
However, there was found to be a need for improvement when it comes to promoting evidence-based medicine in antimicrobial treatment that is informed by the current guidelines and by local antibiograms. Monitoring the use of antimicrobials and adherence to treatment regimens by patients is also an area for improvement, as well as ensuring that antimicrobial medicines for animal use are supplied in accordance with country legislation and regulations, according to the responses.
European pharmacists also prioritised encouraging the use of point-of-care diagnostic tools to screen for early signs of infectious diseases, differentiating between viral and bacterial infections, and informing the choice of empirical antimicrobials, where appropriate, as part of clinical pathways. These respondents also said pharmacists should be actively involved in water, sanitation and hygiene (WASH) and infection prevention and control (IPC) programmes in communities and healthcare settings. These pharmacists also said there should be more focus on encouraging competent authorities to involve pharmacists in national and local immunisation programmes and support immunisation generally, and especially for vulnerable populations, to help prevent infections.
“AMR should be a concern for every country, and for pharmacists in every country,” said Manjiri Gharat, co-chair of the FIP AMR Commission (to September 2024) and contributor to the publication. “FIP is supporting the profession to combat AMR in a number of ways, including that one of the 21 FIP Development Goals guiding transformation of the profession is antimicrobial stewardship. These new roadmaps have been developed to follow previous roadmaps for the 2020 to 2024 period, so that we can continue to drive actions on AMR.”
The full report is available to read at https://www.fip.org/file/6112.
