All healthcare workers have a role in tackling antimicrobial resistance. Pharmacy teams have both a lead and supportive role in contributing to fight AMR:

• Community pharmacists could discuss with GPs joint plans for handling delayed prescriptions for antibiotics. This strategy is recommended nationally as part of prudent antimicrobial stewardship to reduce antibiotic consumption in primary care for urinary, respiratory and conjunctival infections. Research has shown that the strategy reduces antibiotic use compared with immediate antibiotics, without the increased risk of complications, and reduces future expectations for antibiotics
• Hospital pharmacists and nursing teams can prompt/remind prescribers at 48-72 hours to review those patients prescribed antibiotics and regularly thereafter in order to de-escalate or stop treatment where appropriate
• With >70 per cent of antibiotic prescribing occurring in primary care, community pharmacy teams have a critical role to play in tackling AMR

Preventing infections

Preventing infections will play a major part in tackling antimicrobial resistance because it reduces the need for antibiotics in the first place.

Hand hygiene

Hand hygiene is important in preventing transmission of infection at home and especially in all health and social care settings. Cleaning hands properly is the single most important thing anyone can do to help reduce the spread of infections.

Hands should always be washed with soap and water if they are visibly soiled, or after using the toilet. Alcohol hand rub can be used if hands are visibly clean but is not effective against some infections (e.g. Clostridium difficile), so washing with soap and water is safer.

Washing hands properly takes about 20 seconds (as long as singing “Happy Birthday” twice). A video from the NHS available via YouTube shows the correct way to wash hands, while the WHO’s ‘My five moments for hand hygiene’ guidance, which defines the key moments when healthcare workers should carry out hand hygiene, can be adapted for community pharmacy as follows:

• Before touching a patient/service user (before a consultation)
• Before clean/aseptic procedures (before handling or dispensing medication)
• After body fluid exposure/risk (after consultations/dispensing medication)
• After touching a patient/service user
• After touching a person’s surroundings.

In addition to hand hygiene, personal hygiene is also important. Long hair should be tied back, nails kept short and minimum jewellery worn. Rings with stones in them should not be worn as they are difficult to clean properly. Open wounds should be covered with an occlusive dressing and clinical gloves should only be put on immediately before use and disposed of appropriately afterwards. Glove use is not a substitute for hand hygiene.

Getting the message across

European Antibiotic Awareness Day (EAAD) is a Europe-wide initiative held each year on November 18, while the WHO’s World Antibiotic Awareness Week runs during the same week. Educational materials and resources are available via the Public Health England website.

All pharmacy team members are encouraged to choose their individual pledge and to encourage their customers to do the same at antibioticguardian.com. You can also join the conversation on social media via Facebook or Twitter using the hashtag #AntibioticGuardian