Your contribution to antimicrobial resistance

red and white antibiotics in blister pack with blue and white antibiotics loose in front

Your trash—someone else’s treasure? Not necessarily, write Judith A Singleton, Esther TL Lau and Lisa M Nissen

What if we told you the antibiotics your patients threw in the garbage bin last week are killing off all the bacteria in the environment? Don’t care? Not your problem?

Well, congratulations. You have just contributed directly to the global antimicrobial resistance problem.

Why? Because these antibiotics have killed off the “good” bacteria in the environment as well as the “bad”, and aided the transference of antimicrobial resistance genes in the bacterial gene pool.

Welcome to a post-antimicrobial future—we aren’t quite there yet, but don’t worry, we are getting there. That bacterial cough you have today?—it could kill you tomorrow.

So, what can you as a pharmacist do about it?

The Lancet Infectious Diseases Commission (2013) reported that comprehensive national strategies such as surveillance of antibiotic use, and infection control policies with antimicrobial stewardship programmes in hospitals, have proven to be the most successful at controlling antimicrobial resistance.

Current initiatives in Australia, such as the National Prescribing Service (NPS) MedicineWise media campaign, and the General Practitioner Antimicrobial Stewardship Programme Study (GAPS), have tended to focus on prescribers.

However, these strategies have yet to reduce Australia’s antibiotic usage.

Australia has one of the highest antibiotic prescribing rates of Organisation for Economic Co-operation and Development (OECD) countries with 24 daily doses prescribed for every thousand people per day compared with the OECD average of 18 daily doses for every thousand people.1

Global antimicrobial resistance is everyone’s problem, and pharmacists also have a responsibility to help combat this public health issue. The International Pharmaceutical Federation has highlighted the need for pharmacists to play an important role in reducing prescribing rates of antibiotics.

Pharmacists must also take a leadership role in ‘end-of-pipe’ strategies such as the environmentally responsible disposal of pharmaceutical waste,2 particularly since the inappropriate disposal of antibiotics contributes significantly to the dissemination of antimicrobial resistant genes in the environment.

The Return of Unwanted Medicines (RUM) project is one such initiative to reduce inappropriate disposal of medicines, and other countries are beginning to follow suit.

It is the role of all pharmacists to address these issues, and stand up and be counted in the global fight against antimicrobial resistance!



  1. Organisation for Economic Co-Operation and Development (OECD). OECD.Stat. 2015 1.2.2016]; Available from:

  1. Singleton, J.A., et al., The global public health issue of pharmaceutical waste: what role for pharmacists? Journal of Global Responsibility, 2014. 5(1): p. 126.



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