Antimicrobial resistance – Are we losing the battle against bacteria?

By Dr Claire Thompson, RPS Deputy Chief Scientist

Meeting with world health officials in October, Prof Dame Sally Davies, England’s Chief Medical Officer, repeated her warning that if antibiotics lose their effectiveness it would spell the end of modern medicine.

It has been 18 months since Jim O’Neill made his final recommendations on how we can tackle antimicrobial resistance (AMR) globally.  These included the need to:

– Increase public awareness of AMR;
– Reduce the over/inappropriate use of antibiotics;
– Prevent the spread of infections;
– Increase research into new antibiotics by generating a $2bn Global Innovation Fund.

Since then, little has changed within the UK.

At the BioInfect 2017 event Jo Pisani, Pharma & Life Sciences Partner at PwC, gave her state of the nation address on antibiotics and was disappointed to see that little has changed in the pipeline of new antibiotics since the O’Neill reports. “The UK has opportunity to be world leader in antibiotic development, but with so few companies involved in antibiotic R&D, how do we advance the pipelines?” she said.

Source: Antimicrobial resistance: The state of the nation report on UK R&D. PwC. https://www.pwc.co.uk/industries/healthcare/insights/antimicrobial-resistance.html

Where are the new antibiotics?

At the moment, there are less than 100 scientists in the Pharma Industry who are working on new antibiotics. This is mainly due to the lack of reimbursement models for antibiotics.

There have been calls for new models and incentives for developing antibiotics, such as exclusivities on market entry akin to those which are in place for orphan drugs or paediatric medicines, but these are yet to come to fruition.

This means that organisations such as the AMR Centre, charities such as Antibiotics Research, and small companies like Auspherix are leading the charge in developing new antibiotic medicines.
In order to progress the development of new antibiotics, we need to stop focussing on what they are going to cost and start thinking of cost of not having them.

What are we doing to combat AMR?

The key to overcoming AMR is not just about new antibiotics; improving stewardship and raising awareness are imperative. As a profession, these are some of the activities we are involved in.

Public engagement and awareness
With 1.6 million pharmacy visits per day, pharmacists are perfectly positioned to talk with patients and the public about what antimicrobial resistance is, when antibiotics are required, and how to take them. The Test and Treat service at pharmacies is under-utilised. Currently, people aren’t aware of it and don’t know they can talk to their pharmacist.

Antimicrobial Stewardship Programme
In September, the RPS launched the Antimicrobial Stewardship programme  which contains reference, guidelines and support tools for pharmacists.

What impact can we have?

In 2016, Government set a challenge of reducing inappropriate antibiotic prescribing by 50% by 2020. Pharmacists are integral to this. As a profession, we still have some work to do to ensure that the public know that they can talk to pharmacists about health concerns and to get advice on medicines. But the impact we can have as pharmacists (on raising awareness and providing stewardship) and as pharmaceutical scientists (in developing new antibiotics) is enormous.

A tweet from the BioInfect 2017 summarised this perfectly “Great way to cut queues at your GP. Talk to your pharmacist and conserve our antibiotics”.

Contrary to the saying, resistance is not futile – it is rife. But the war on bacteria is not over! Please play your part.

Mother was right!

“Wash your hands when you come in”, “Make sure you wash before dinner”, “Show me your hands” – just some of the echos of my childhood which I’m sure many of you recognise.
Ahead of World Antibiotic Awareness Week  and European Antibiotic Awareness Day  I spent much of my time at the RPS researching, collating and checking resources to support antimicrobial stewardship for the RPS AMS Portal.
I learnt a lot and guess what – our mothers were right!  One of the simplest ways to reduce the use of antimicrobials is hand washing (or hand hygiene as it is referred to in healthcare settings).  Not just to remove visible dirt but to remove bacteria and viruses which could cause infections such as upset stomachs, coughs, colds or pneumonia. Washing your hands properly should take 20 seconds, as long as it takes to sing “Happy Birthday to you” twice.
Simple you think – but wait – the RPS Handwashing essential guide states that 84% of British adults don’t wash their hands for long enough and 65% of people don’t always wash their hands before eating. The infographic below has other figures which make uncomfortable reading.

I mentioned these gruesome figures one evening at home and an unexpected consequence was that my daughter, who teaches a Year 2 class, was interested in using this information at school in some way.  I suggested having a look at the e-bug resource (another resource found during my AMS research) and together with the ‘handwashing and mouldy bread experiment’ (look it up on youtube!) she formulated a lesson plan.  The children loved it – and it became a feature of their end of term assembly.
So, what started as a literature review style research project on antimicrobial stewardship and resistance ended up as a theme for a school assembly.  It illustrates that antimicrobial stewardship belongs to us all – organisations, health professionals and all ages of members of the public.  Now, during World Antibiotic Awareness Week, take some time to have a look at the AMS Portal.  This is essentially a signposting resource linking to antimicrobial stewardship resources under six key categories: strategy, policy and guidance; clinical and technical guidance, initiatives and campaigns, training and educations resources, journals; and organisations.  The AMS Portal focuses on GB resources for pharmacists and pharmacy teams although we recognise the need to signpost to worldwide information and resources from outside GB are also included.
Have a browse – you might even find yourself influencing another school lesson or even humming ‘Happy Birthday to you, Happy Birthday to you………………….’!

Grant application success!

Kristina Medlinskiene, previous course attendee

Writing a grant application for the first time is not easy to say the least (or maybe it never gets easy). I recall my very early start on this endeavour with very rough knowledge of what it may entail. The RPS two-day research proposal workshop gave me clarity but it also raised many more questions about issues I hadn’t even thought about!

Patient public involvement group? Advisory group? Before the workshop I had not thought about forming these groups or had any idea how to do it. Methodology? Theoretical framework? Detailed costs of the project? Just a few things that I needed to find answers to.

The format of the two days stimulated thinking about your project and the grant application. Most importantly it gave me a direction, a sense of ‘right, this is clearer now’. By the end of the two days I had a preliminary action plan with identified crucial tasks that I needed to address first.

The two days consisted of presentations and workshops covering various topics from how to build a case for the funding application, to the data processing and analysis. Whilst some topics were covered briefly, I read more about it in the book provided and referred back to it for some quick pointers.

Personally, the biggest benefit of attending the two-day workshop alongside the workshops was networking. You not only get a chance to meet and hear experiences of pharmacists who have gone through the process but also ask them for advice later when you are writing your application and get stuck! They were incredibly helpful.

As I have learnt writing a grant application requires a lot of commitment, persistence and some sleepless nights. Get all the help you can, even if it means pushing barriers of your confidence!

If you don’t know how to start writing an application, these workshops could be what you need. They helped me with my application writing.

The RPS will be running a research proposal writing workshop on the 6-7th March 2018. See our events page for more information and to book your place. This course has very limited numbers so please don’t hesitate and secure yours now. We want to ensure you get the grant funding you deserve by writing a successful grant application.

Community pharmacists against common infections

Jonathan BurtonArticle by Jonathan Burton, Community pharmacist, Vice Chair of the Scottish Pharmacy Board

I work in a community pharmacy setting and as you might imagine I see many people through the day who present with various symptoms, wanting advice about their ailments and how to treat them. As winter closes in, these symptoms are for the most part those associated with seasonal coughs and colds, sore throats and ear ache. Read more Community pharmacists against common infections

Get all the support you need for your time at university

By Laura Bushell, Marketing and Communications Coordinator

We offer our student members an extensive range of resources to facilitate your learning and to help you to achieve your best in your studies. Because we offer so many resources, we understand that it can be difficult to know where to start!

That’s why we’ve created a ‘Student Hub’ dedicated to the resources that will be essential in your studies.

Read more Get all the support you need for your time at university

Creating a profession where you feel comfortable to be yourselves

by Robbie Turner, RPS Director for England

Recently I wrote a blog about  LGBTQ Pride celebrations describing how upset I was that LGBTQ young people were still suffering high levels of abuse, discrimination and mental health issues as a result of their identity. I promised to reflect on what more the RPS could do to support pharmacists to help young LGBTQ people and we are exploring how our future RPS campaigns can deliver this. Read more Creating a profession where you feel comfortable to be yourselves

What do pharmacists need to know about heartburn?

By Dr Pulak Sahay, Consultant Gastroenterologist and Senior Lecturer of Medicine, Leeds University

What is reflux?

It is estimated that there are over 10 million adults in the UK who suffer from heartburn (sometimes known as reflux disease or Gastro-Oesophageal Reflux Disease (GORD)).  If left untreated or poorly controlled, this can cause considerable discomfort and lead to a poor quality of life. In extreme situations, untreated heartburn can cause a host of both gastrointestinal (GI) and non-GI complications, including severe complications such as Oesophageal Adenocarcinoma (OA) – known as Oesophageal Cancer. Read more What do pharmacists need to know about heartburn?

Pharmacy’s future is digital

By Sibby Buckle, Chair of the RPS Digital Forum

 

What is the RPS Pharmacy Digital Forum?

It’s where the profession comes together to forge the future.  We are an enthusiastic and committed group of 30+ members who agree that digital literacy across the profession needs urgent attention.

With representation from across the UK, and from all sectors of pharmacy – community, primary care and hospital, PMR suppliers, NHS Digital, DH, PSNC, PRSB, and NHS Improvement –  there is a real appetite to create the change needed to enable pharmacy to be truly integrated into the NHS and healthcare. Read more Pharmacy’s future is digital

Strengthening Pharmacy in Scotland

Rose Marie ParrArticle by Rose Marie Parr, Chief Pharmaceutical Officer, Scottish Government

On 21 August 2017, I launched the new pharmacy strategy for Scotland: Achieving Excellence in Pharmaceutical Care which sets out the priorities, commitments and actions for improving and integrating pharmacy services in Scotland.

During the launch I had the pleasure of visiting both a community pharmacy and a GP practice in Port Glasgow to meet health and social care practitioners to talk about the way pharmacy services are adapting and enhancing care in the NHS. Read more Strengthening Pharmacy in Scotland

My week at RPS

Roshnee Patel, MPharms Student at King’s College London

What’s happening behind the scenes? As a pharmacy student it is very difficult to understand and know what is being done for us outside the four walls of our university. My week at RPS demonstrated to me how much support there is available after we graduate but also during our studies. Fortunately, I was able to spend some time within the marketing team and I got to see it all.

From just about knowing how to use Google calendar to now being able to structure, format and schedule social media posts, my time at RPS has enabled me to develop a wide range of my skill sets. In the RPS, opportunities are always knocking on your door. I was given the opportunity to write an email to students in Birmingham. Having had no previous experience in writing emails to such a large number of recipients, I was taught the do’s and don’ts and how to template my email. Within the marketing team, I also got to witness the amount of hard work which goes into planning and preparing for anything to be sent out to the public and making sure that whatever is being sent out is for the correct audience with the most useful information. Before anything is sent to the public it is prepared and checked way in advance. The FIP World Congress next year is being held in Glasgow and is being hosted by the RPS. Even though the event is over a year away, a tremendous amount of work is currently being done to make sure the event is the best. Having also got the chance to sit in on a meeting, I saw how the RPS have and are still developing programmes to help pharmacy students from their first day till their last and beyond that as well. When we’ve just finished our pre-reg year or we’re over 10 years into our career it is comforting to know that the RPS will be there to support and guide us if we need them. It was also great to see how the RPS are always highlighting the importance of pharmacists in the community and are continuously changing themselves to make our journeys easier.

Read more My week at RPS