Antibiotic Awareness Week 2024

Combating Antimicrobial Resistance: The Role of ID Pharmacists and a One Health Approach 

Efforts to understand and reduce the spread of antimicrobial resistance (AMR) have elucidated a complex interplay between agricultural practices, climate change, waste contamination and water treatment, and environmental or healthcare-related exposure to antimicrobials.¹ Globally, human activity now more than ever accelerates the incidence and acquisition of resistant organisms. The ubiquitous and unyielding nature of AMR, including the myriad of contributing factors, therefore requires a multipronged, team-based solution. Many governing bodies like the Centers for Disease Control and Prevention (CDC) as well as the World Health Organization (WHO) have adopted a One Health approach to tackling AMR. One Health unites several disciplines, including experts on human and animal health, epidemiology and ecology, and coordinates with policymakers to better monitor and combat AMR threats.^2,3

ID pharmacists, acknowledged as experts in therapeutics, are uniquely positioned to provide guidance on antimicrobial utilization to ultimately mitigate the emergence of resistance. ^4,5 By incorporating evidence-based recommendations, significant interventions can be made to shorten treatment durations or narrow antimicrobial spectrum where appropriate.⁶ ID pharmacists in turn contribute to the literature as researchers publishing pharmacokinetic and pharmacodynamic studies, clinical outcomes data, and cutting-edge in vitro studies analyzing the interplay between antimicrobials and the microbiome. These efforts work to directly reduce unnecessary antimicrobial exposure and better understand the multifaceted impact of pharmacotherapy on drug resistance.

In addition to therapeutics, ID pharmacists also must recognize current and emerging AMR threats and work with laboratory staff and infection preventionists to identify, contain, and prevent the acquisition of these pathogens. This multidisciplinary approach is what makes ID pharmacists and antimicrobial stewardship programs (ASPs) vital contributors to a One Health solution to tackle AMR. ASPs can engage several other key stakeholders including medical and nursing staff, hospital leadership, and policymakers to enact change not only at the bedside but on a large scale.^7,8 The global environment may be changing in accessibility, temperature, and ecology however ID pharmacists and ASPs remain steadfastly well-aligned as part of the team based, One Health fight against AMR.