This World Antimicrobial Awareness Week (18-24 November), Boots is highlighting its work in raising awareness, supporting research and taking action in tackling the threat of antibiotic-resistant strains of diseases.
Antimicrobial resistance (AMR) occurs when a virus, bacteria, fungus or parasite evolves over time and no longer responds to medicines. These resistant strains are known as ‘superbugs’ and can make infections harder to treat, more severe and increase the risk of disease spread. Left unchecked, superbugs have the potential to reduce the effectiveness of modern medicines, such as some antibiotics for bacterial infections, put pressure on health services, and cause more deaths.
The World Health Organisation lists AMR as one of the 10 greatest threats to public health worldwide. As medicines experts, pharmacists have a huge role to play in responsible antimicrobial stewardship – supporting appropriate use of antibiotics by staying up-to-date on the latest training, providing advice to patients, raising awareness and educating the wider public on the issue.
Vaccines and AMR
Vaccinations are among the most recognisable and effective preventative measures we can all take in the fight against superbugs.
During the COVID-19 pandemic, many people will have become very familiar with vaccinations and how they work. We know that vaccination help in protecting bacterial or viral infections. Boots has administered over one million flu vaccines this year* and supported the NHS by delivering more than 1.7 million COVID-19 vaccines since January 2021. As we head into the flu season’s peak, it’s more important than ever to protect yourself including getting vaccinated.
Boots also offers further vaccination services such as the Travel Health & Advice Vaccination Service, Pneumonia Vaccination Service and Shingles Vaccination Service.**
But how does this have an impact on AMR? Claire Nevinson, Superintendent Pharmacist at Boots UK explains: “Widespread use of vaccines means that more people are protected from specific diseases, reducing the likelihood of developing serious illness and the virus or bacteria associated with the vaccine being spread from person to person.
“With fewer serious infections comes a drop in the amount of medicines needed to treat patients that develop these. Less use – or less inappropriate use – of medicines such as antibiotics means diseases have fewer opportunities to develop into superbugs.
“Vaccines are a key part of what we do at Boots to support the fight against AMR.”
Antimicrobial Stewardship
With more than 2,000 stores in the heart of communities up and down the country, Boots can play an important role to inform, support and encourage good practice in patients as well as our pharmacy teams. The tailored advice pharmacists provide to patients around their medicines should also always consider AMR. It’s all part of Antimicrobial Stewardship.
As part of the NHS pharmacy contract, all Boots community pharmacies also encourage antibiotic amnesty, with stores acting as hubs to safely return and dispose of old or unused antibiotics left over from prescriptions. It is important that any unwanted or unused medicines should be taken to a pharmacy so they can be disposed of safely.
“AMR can develop for a number of reasons, but a huge driver can be the misuse of antibiotics away from prescribed use,” says Claire. “Sharing left over antibiotics as a way of treating minor infections may contribute to the development of superbugs.
“It makes the work our community pharmacists do to educate the public about good practices and also to take back unused antibiotics so important.”
Another key part of antimicrobial stewardship is for Boots pharmacists to work with patients to stop unnecessary use of antibiotics. Pharmacy teams talk with patients, offering advice on self-care and treating symptoms for minor infections so that the use of antibiotic treatment is reserved for only when it’s needed.
When antibiotics are required, Boots pharmacists offer important advice on how to take them in a responsible and effective way, limiting any potential contribution to AMR. Antibiotics should be taken as prescribed and the course completed in full, unless a patient is unable to due to side effects or other reasons.
Training our teams
Boots supports national and local campaigns around AMR training and awareness, including those required within the Pharmacy Quality Scheme in England (the national results of the PQS will be published in the ESPAUR report this week). Every Boots pharmacy in England took part in the scheme ensuring they:
- Review their current antibiotics practices
- Use the TARGET antibiotic checklist with patients to ensure safe and effective use
- Update their AMR action plan
- Complete AMR e-learning and assessment
Our pharmacy teams are also encouraged to make pledges as Antibiotics Guardians, committing to upholding antimicrobial stewardship and recognising the importance of their roles.
“Aside from large national campaigns on AMR and antimicrobial stewardship, Boots teams often get involved in locally-led campaigns which are key to getting the message out there in the communities we serve,” says Claire.
“We always encourage our pharmacists to be as active and engaged as they can in their proud roles as Antibiotics Guardians.”
Research and innovation
The fight against superbugs doesn’t stop with our pharmacy teams in stores. Boots also gets involved in research and innovation in the AMS space, collaborating with the healthcare, scientific and pharmaceutical communities to help us all understand more about AMR and find new ways for pharmacy teams to get involved and tackle the issues.
Boots worked in collaboration with colleagues at the UK Health Services Agency (UKHSA) and NHS England to support the development of TARGET materials, including piloting the Antibiotic Checklist designed to support tailored advice to each patient and help to limit unnecessary use of antibiotics.
Boots also collaborated with UKHSA and NHS England to develop an AMR audit in care homes, helping to analyse antibiotic prescribing for elderly residents in UK care facilities. What was largest data collection of its kind showed half of residents were prescribed at least one antibiotic a year and helped identify opportunities to reduce the risk of AMR.
Claire adds: “We are incredibly proud of Boots’ involvement in research and innovation to support the scientific community in tackling AMR and improving antimicrobial stewardship.
“Our collaborations with UKHSA and the NHS have contributed to improved use of antibiotics in care homes as well as the development of the TARGET antibiotic resources for pharmacists and patients, making antimicrobial stewardship easier to achieve with each patient.
“We are also proud of our role in providing flu vaccinations in pharmacies – showing the value of community pharmacists providing this important service. Not only has this data supported the growth of vaccinations in community pharmacies in the UK, but also abroad, highlighting how community pharmacists can support the scientific community.”
*Boots Winter Flu Jab Service. Subject to availability. Eligibility criteria apply. Charges may apply.
**Subject to availability. Eligibility criteria and charges apply.