Pharmacists can play a major role in infection control

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Infection control and getting rid of troublesome minor ailments such as coughs and cold often boil down to one thing for many Australians – antibiotics.

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In the past antibiotics have been very effective for infection control but the day of reckoning is close.
Antibiotics are medicines used to treat infections caused by bacteria. However, many bacteria are now resistant to commonly used antibiotics with the result that some infections caused by these antibiotic-resistant bacteria are difficult to treat. Wise use of antibiotics can help slow antibiotic resistance.
Many people do not recognise that colds and many other upper respiratory infections, as well as some ear infections, are caused by viruses, not bacteria.
If antibiotics are used too often for things they can’t treat — like colds or other viral infections — they can stop working effectively against bacteria when they are really needed. This is what is known as antibiotic resistance — when antibiotics can no longer cure bacterial infections. For some years this has been a concern and is considered one of the world’s most critical public health threats.
The problem of antibiotic resistance is so serious that the World Health Organization (WHO) has predicted a return towards the health problems of the pre-antibiotic era within a decade. This was a horrendous time when safe surgical procedures were almost impossible, when minor wounds could lead to amputations, and mild respiratory infections could result in death.

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“Pharmacists and pharmacy assistants can play a major role in infection control by raising awareness of the importance of immunisation and to make sure immunisation regimens are up to date (and particularly by allaying consumer fears about perceived immunisation risks).”  
GRANT KARDACHI

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In a report released earlier this year, WHO presented a sobering scenario.
“Antimicrobial resistance (AMR) threatens the effective prevention and treatment of an ever- increasing range of infections caused by bacteria, parasites, viruses and fungi . . .   A post-antibiotic era – in which common infections and minor injuries can kill – far from being an apocalyptic fantasy, is instead a very real possibility for the 21st Century,” the report, Antimicrobial resistance: global report on surveillance 2014, stated.
The report makes a clear case that resistance to common bacteria has reached alarming levels in many parts of the world and that in some settings, few, if any, of the available treatments options remain effective for common infections. Another important finding of the report is that surveillance of antibacterial resistance is neither coordinated nor harmonised and there are many gaps in information on bacteria of major public health importance.
Action is being taken and international efforts over the past few years have resulted in fewer children receiving unnecessary antibiotics, but over-use or inappropriate use remains a problem which continues to fuel an increase in antibiotic-resistant bacteria.
Antibiotic resistance is also an economic burden on the entire healthcare system. Resistant infections cost more to treat and can prolong healthcare use.
As a nation, we need to get smart about when antibiotics are appropriate — to fight bacterial infections. Taking them for viral infections, such as a cold, most sore throats, acute bronchitis and many sinus or ear infections will not cure the infection, will not keep other people from getting sick, will not help you or your child feel better and in fact may cause unnecessary and harmful side effects.
In the past, there was a feeling that unless a person left a doctor’s office with an antibiotic prescription they had not been attended to properly. That has all changed and consumers today are urged not to demand antibiotics when a doctor says they are not needed, and not to take an antibiotic for a viral infection like a cold or most sore throats.
Critically they should never take antibiotics prescribed for someone else. The antibiotic may not be right for your or your child’s illness and taking the wrong medicine may delay correct treatment and allow bacteria to increase.
Consumers need to avoid antibiotics if they are not needed. For instance, effective treatment of symptoms is usually all that’s necessary for respiratory tract infections such as the common cold. Consumers should choose products which are specific for their needs. Pharmacists can recommend what’s most appropriate.
Of course, consumers can also minimise the need for antibiotics with some simple and sensible lifestyle and behaviour strategies, and making sure their, and their children’s, immunisation schedule is up to date.
They should also be aware that resistance occurs not just in the wider population but individually to themselves. People prescribed antibiotics are twice as likely to develop their own resistance to that drug.
Pharmacists and pharmacy assistants can play a major role in infection control by raising awareness of the importance of immunisation and to make sure immunisation regimens are up to date (and particularly by allaying consumer fears about perceived immunisation risks).
We also need to be promoting transmission prevention strategies. Regular hand washing is important, especially before preparing food, and the use of alcohol gels cleansers can be further promoted - as should be the need to cough and sneeze not into the hand but into a disposable tissue or the bend in the elbow.

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Grand Kardachi
Grand Kardachi was recently re-elected president of the Pharmaceutical Society of Australia for a fourth term. He is a community pharmacist who recently sold his business interests but is still accredited to undertake medication reviews and sits on the Australian Association of Consultant Pharmacy.