The emergence and spread of bacteria, viruses, fungi and parasites that no longer respond to medicines due to the development of antimicrobial resistance (AMR) is a significant public health concern as it threatens our ability to treat common infections. The global burden associated with drug-resistant infections in 2019 was an estimated 4.95 million deaths, of which 1.27 million deaths were directly attributable to resistance to medicinesi. Addressing inappropriate antibiotics use and finding targeted and impactful solutions to tackle AMR is essential. Interventions on an EU level, such as the European Action Plan against Antimicrobial Resistance and the objectives of the Chemical Strategy for Sustainability, are important pillars in the fight against AMR.
Under the current proposal to address AMR in the EU Pharmaceutical Law review, however, the role of self-care and the pharmacist who provides important advice and counsel would be diminished. The EU Commission proposes to make all antimicrobial medications that are currently available over-the-counter, prescription-only. Instead of getting advice and access to treatments from their local, qualified community pharmacist, otherwise healthy citizens would have to visit a physician for a prescription to treat minor conditions like athletes’ foot, vaginal thrush, cold sores, or minor eye infections. Making treatments for these infections prescription-only will negatively impact the health and wellbeing of European citizens and have a significant impact on healthcare systems.
According to the Association of the European Self-Care Industry AESGP, in 2022 alone, Germany, The Netherlands and Austria combined sold 8.35 million packs of topical antivirals for treatment of herpes, and 47.3 million packs of topical antifungals for nail, vaginal or oral fungal infections. The number of packs sold represents the potential number of additional physician consultations needed if these medicines were subject to a medical prescriptionii.
“To make healthcare systems sustainable, we need to empower, facilitate, and encourage people to take their health in their own hands for the benefit of all”
Making all antimicrobial medications prescription-only, including antifungal and antiviral treatments where there is no evidence of resistance as a result of self-treatment, would impact how quickly European citizens can treat simple infections and drive significant cost burdens to healthcare systems. Delaying treatment could increase transmission of these infections, further exacerbating the situation. A more targeted and therefore impactful approach may be to restrict the prescription status of antimicrobial products, to those antibiotic products and formats for which an AMR risk has been confirmed as a public health threat. This will empower citizens to self-manage with the guidance of the pharmacist,reducing the burden on the healthcare system.
To make healthcare systems sustainable, we need to empower, facilitate, and encourage people to take their health in their own hands for the benefit of all. A timely example is the cough and cold season: we know that antibiotics are often not the best option for upper respiratory conditions or sinusitis. Over-the-counter medicines can offer an effective treatment option and symptom relief, and pharmacists acting in their role as antibiotic stewards are well-placed to advise patients to help them feel better.
Let us strengthen the role of the pharmacist and empower them in their important contribution as antimicrobial stewards while enabling patients to treat their minor conditions quickly, conveniently and efficiently via self-care. When we empower, facilitate, and encourage people to take their health in their own hands, we all can benefit.
i. Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet. 2022 Feb
ii. AESGP Position Paper Pharma Law Review Proposal 2023
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