社区药剂师作为抗菌药耐药性管理者:关于他们在中低收入国家的贡献和挑战的叙述性综述

Rosy Raju, Sunitha Chandrashekar Srinivas, Srikanth Malavalli Siddalingegowda, Raj Vaidya, M. Gharat, T. M. P. Kumar
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摘要

抗菌药耐药性(AMR)是一个全球性的公共卫生危机,它阻碍了现有抗菌药的治疗效果。由于传染病负担沉重、资源有限,尤其是受过培训的医疗保健专业人员有限,中低收入国家(LMICs)尤其容易受到抗菌药物耐药性的不利影响。有时,社区药剂师作为寻求感染治疗的患者的第一个和最后一个接触点,可以在 AMR 所需的管理方面发挥关键作用。本综述旨在强调低收入国家的社区药剂师作为 AMR 管理员所做出的贡献。综述从资源有限、培训不足、缺乏政策法规以及与患者行为相关的问题等角度探讨了所面临的挑战。低收入国家和地区的社区药剂师可以通过关注 "一体健康 "AMR 管理来优化他们的宣传贡献。如果政策制定者和其他医疗服务提供者能够协同实施抗菌药物管理(AMS)政策和计划,支持社区药剂师努力促进抗菌药物的合理使用,那么以患者和人群为中心的具有变革性和可操作性的抗菌药物管理(AMS)是可行的。
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Community pharmacists as antimicrobial resistance stewards: a narrative review on their contributions and challenges in low- and middle-income countries
Antimicrobial resistance (AMR) is a global public health crisis that impedes the therapeutic effectiveness of available antimicrobial agents. Due to the high burden of infectious diseases and limited resources, especially trained healthcare professionals, low- and middle-income countries (LMICs) are particularly susceptible to the detrimental effects of AMR. Sometimes, as the first and last point of contact for patients seeking treatment for infections, community pharmacists can play a pivotal role in the stewardship required for AMR. This review aims to highlight the contributions made by community pharmacists in LMICs as AMR stewards. The review considers the challenges from the perspectives of limited resources, inadequate training, a lack of policies and regulations, and issues related to patient behavior. Community pharmacists in LMICs could optimize their advocacy contributions by focusing on One Health AMR stewardship. Transformational and actionable patient and population-centric antimicrobial stewardship (AMS) is feasible with the synergy of policymakers and other healthcare providers in the implementation of AMS policies and programs that support community pharmacists in their efforts to promote rational antimicrobial use.
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