E-DRUG: Rational Use of antibiotics (2)
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Dear Anibal,
Thank you for your comment. Certainly it is an interesting matter, both
ethical and professional. I agree with you enforcement is the way.
However in developing countries several steps must precede:
- Unless governments provide health care systems that include its entire
people (of course that is dependable on governments budgets, and here the
role of international organizations is important).
- Educate the public about the dangers of inappropriate use of antibiotics
through various established educational methods that involve intensive
multimedia campaigns and face-to-face communication with the people at
their common places of gatherings for example markets, everyday places of
business and trade, mothers at pregnancy and vaccination clinics or
womens unions, youth sports clubs, schools and colleges.
-Re-educate health care providers about the dangers of inappropriate use
of antibiotics as part of a continuous education and learning scheme on
health and rational use of medicines. In addition to updating their
knowledge, ensure that those dispensing the medicines are decently paid.
After all the above:
-Introduce strict enforcement measures like performing frequent random
simulated client visits to pharmacies by health or drug department
inspectors and imposing costly fines on offenders as well as disciplinary
procedures like for example striping of their licenses and suspending them
from practicing or shut down their pharmacy for a certain period of time.
As for addressing inappropriate use of antibiotics by health professionals
(doctors and other prescribers) including pharmacists [refer: Balbisi E.
& Ambisas E. (2005) Self-prescribing of noncontrolled substances among
pharmacists. Am J Health-Syst Pharm. 62:2508-11] continuous professional
development is important. Providing prescribers with continuous education
about rational antibiotic prescribing in accordance with the recommended
guidelines, performing regular resistance surveillance at hospitals,
addressing communication issues such as perceived demand between patients
and doctors, reiterating the harms of unnecessary antibiotic prescribing
and introducing the concept of delayed-prescriptions are important
measures to be implemented.
On the other hand the magnitude of
inappropriate use (self-prescribing) by pharmacists needs to be
investigated. Open dialogue with pharmacists focusing on the negative
impacts of self-prescribing as harmful, illegal and unprofessional is
essential to address this issue.
Kind regards,
Majd
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Majd Dameh
BSc (Micro), BPharm, MHealSci, PhD Candidate
RegPharmNZ, MPS
Professional Pharmacy Practice
School of Pharmacy
University of Otago
P.O. Box: 913
Dunedin 9054
NEW ZEALAND
M D <damma696@student.otago.ac.nz>