Opinion Piece: Sakeena Hameem
The need to improve Antimicrobial Stewardship among Pharmacists in Sri Lanka
Antimicrobial Stewardship (AMS) is a coordinated approach among diverse healthcare stakeholders that promotes the judicious use of antimicrobials (e.g. antibiotics) to improve patient health outcomes, decrease the risk and spread of antimicrobial-resistant microorganisms (bacteria, viruses, parasites and fungi) and infections caused by multidrug resistance.
In addition, antimicrobial stewardship aims to reduce unnecessary costs related to the overuse and misuse of antibiotics which impact not only at a human health level, but also in farming practice, food production, veterinary medicine, the environment, and the economy at large which is why it is regarded as important to Sustainable Development and achieving the Sustainable Development Goals (SDGs).
AMS programmes are vital to optimising antimicrobial therapy, ensuring best patient outcomes, reducing un-intended use of antimicrobial medicines and enhancing appropriate prescribing practices.
Many countries have achieved success through implementing antimicrobial stewardship programmes including some developing countries. Further to this, antimicrobial stewardship programmes have shown to be an effective intervention to reduce non-prescription sales of antimicrobial drugs in developing countries. Unfortunately, Sri Lanka still lags in terms of the implementation of antimicrobial stewardship programmes. One of the areas of antimicrobial stewardship which could impact our local systems is the empowerment and education of healthcare professionals, including pharmacists. Additionally, antimicrobial stewardship can play a substantial role in encouraging personnel to follow prescribing guidelines and diagnosis recommendations based on local antibiotic susceptibility data.
Antimicrobial stewardship programmes can also assist physicians to prescribe the right antimicrobial (e.g. antibiotic) at the right time and for the right duration. AMS programmes can also help pharmacists in Sri Lanka to dispense antibiotics according to the local therapeutic guidelines. This will promote appropriate treatment for antibiotic-responsive infections in combination with confirmatory microbiological diagnostics in community and hospital settings. The collaboration between different healthcare professionals such as physicians, microbiologists, nurses and pharmacists that AMS programmes require to be most effective also facilitates better patient outcomes.
Antimicrobial resistance is a global health crisis and when it comes to tackling it, every country matters. Countries like Sri Lanka are important to ensuring the judicious use of these precious drugs. This is especially true when it comes to travel as these dangerous superbugs which are adapting to resist their antimicrobial effects can cross our borders, not only in the case of tourism which Sri Lanka is well-renowned for but also in trade which inevitably impacts our local and global economy at large.
When it comes to tackling antimicrobial resistance, no country is an island.
We all have an equal role to play.
Sakeena Hameem is a qualified pharmacist and received her doctoral degree in Pharmacy from The University of Sydney, Australia. She is a Senior Lecturer in Pharmacy at Department of Pharmacy, Faculty of Allied Health Sciences, University of Peradeniya, Sri Lanka. She is also a Council member of Pharmaceutical Society of Sri Lanka (PSSL).
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