Pharmacy key as antibiotic-resistant superbug found

new antibiotics: gloved hands holding two antibiotic capsules

A woman from Pennsylvania in the US has been found to be carrying bacteria resistant to the last-ditch antibiotic colistin, according to the journal Antimicrobial Agents and Chemotherapy.

Researchers reported that E. coli bacteria from the woman’s urinary tract infection contained the mcr-1 gene, first discovered in China in 2015, which confers resistance to colistin.

NPS MedicineWise CEO Dr Lynn Weekes told the AJP that the case underlines the importance of strategies to combat antimicrobial resistance, and urged pharmacists to use their role to help.

“Pharmacists can have a really positive role to play in being part of the solution,” she says.

“This case is just another sign that antibiotic resistance is real, and has an effect on people that means we are moving towards being able to treat less infections. It’s part of the continuum, that we’re moving in this direction.

“For pharmacists, there’s three really important things they can do: the first is to provide symptomatic management for people when they have respiratory infections. Respiratory infections are still the most common reason for people to take antibiotics, and most don’t need them.

“They can provide support and reassurance, and provide sick certificates if they can.”

Obtaining a sick certificate from a pharmacy, not a GP, may reduce the likelihood of a patient being sent away with an antibiotic prescription to go with it, she says.

2012 NPS data showed that one in five Australians expect their doctor to prescribe antibiotics for themselves and/or their child when they have a cough or cold. Four in five also said they expect a prescription from their GP when they have an ear, nose, throat or chest infection, with more than half (51%) saying they would ask their GP for one.

However, last month NPS reported that the percentage of consumers who report asking doctors for antibiotics dropped from 17% in 2014 to 13% in 2015, showing that efforts to improve antibiotic prescribing were working.

Dr Weekes told the AJP that pharmacists should also be alert to the date on prescriptions for antbiotics, as some consumers may use repeats to treat subsequent respiratory infections without consulting a doctor first.

“Pharmacists can also help with appropriate destruction of antibiotics when they’re unwanted, unneeded or not used – rather than keeping them in the fridge or in a cupboard, people should be encouraged to bring them back to the pharmacy for disposal under the Return Unwanted Medicines program.”

She says that improper disposal – such as throwing unused antibiotics in the bin – is a factor in the appearance of antibiotics in waterways, and of antimicrobial resistant bugs in wildlife.

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