A national standard that will influence global efforts to protect antibiotics

Abstract

Though the infectious diseases (ID) pharmacy specialty has been in existence for many years, recent issues have raised the profile of ID pharmacists within the healthcare system. First, antimicrobial resistance rates have reached a crisis point and gained the attention of international organisations.1 Second, and in large part due to antimicrobial resistance, recognition of the suboptimal use of antimicrobial agents has led to the rapid expansion of antimicrobial stewardship programs (ASPs) in many parts of the world.2-4 Finally, the COVID-19 pandemic has highlighted the importance of leadership that understands that practical aspects of antimicrobial pharmacotherapy can rapidly synthesise emerging literature and gain consensus through collaboration to produce local standards. All of these require expertise in antimicrobial therapies, and consequently the need for ID pharmacists has grown. The SHPA Standard of Practice (SOP) in Infectious Diseases for Pharmacy Services sets important national expectations and guidance for pharmacist practitioners wishing to practice ID. We believe that this document espouses the mission of the Society of Infectious Diseases Pharmacists (SIDP), which is to advance infectious diseases pharmacotherapy and lead antimicrobial stewardship to optimise the care of patients with infections. Both of us have served as President of SIDP and we see parallels between this SOP and the mission of SIDP. The SOP highlights the important contributions (in both depth and breadth) to direct patient care by ID pharmacists in varied practice settings including inpatient hospital care, people living with HIV, antimicrobial stewardship, rural and regional health services, community-based parenteral antibiotic therapy and emerging practices in primary care and aged care facilities. The standard also emphasises essential components of ID pharmacy practice beyond front-line patient care and operations: education quality and safety improvement, policy and protocol development, and research. This includes the importance of regional, national, and international collaborations to advance the science and to act as a mechanism that shares knowledge and best practices. The latter is especially pertinent for pharmacists practicing in settings without the benefit of colleagues in the specialty, including ID physicians. Perhaps more important is that this SOP also sets a standard for ID practice to include pharmacist practitioners in key clinical and administrative roles. The latter is not a standalone section but rather woven into all aspects of ID pharmacy practice. The standard also highlights the collaborative nature of infectious diseases practice and specifically mentions the important role of microbiology and infection prevention working together with the ID team to achieve optimal patient care. Highlighting the role of ID pharmacists in hospital leadership throughout the antimicrobial use process is key. Although written for Australia, this SOP has the potential for international impact. Pharmacy practice in other countries may come to mirror best practices described in documents such as this one. At the invitation of the authors, the two of us reviewed and provided input on a draft of this standard with this in mind. They are congruent with positions on pharmacist roles in the leadership of ASPs taken by the Board of Pharmacy Specialties and by SIDP.5-7 The SOP takes a big step forward and sets a standard that acts as a set of goals for pharmacists practicing in ID. These goals will likely change as practices evolve and ID pharmacists find new and innovative ways to improve the care of patients. With these standards as the starting point, ID pharmacists can further the vision of ensuring safe and effective antibiotics for now and the future. The authors have no conflicts of interests to declare.