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Pharmacists: Antibiotic Gatekeepers and So Much More

October 18, 2020

Pharmacy has come a long way since the 17th century, when the first pharmacy guild was formed. Over the years, apothecaries, druggists or chemists, as pharmacists were known then, began building their profession and requiring more rigorous educational requirements.

Producing medications also changed over the years. In the beginning, pharmacists often diagnosed patients and made up their own medicinal products. It was a pharmacist who invented the ever popular Coca Cola, in 1886. Druggist John Stith Pemberton, who had served in the Civil War, devised a drink that would help ease his pain, but did not have the addictive qualities of morphine.

Pemberton settled on a drink that used coca leaves and kola nuts, first with alcohol. When prohibition struck, he removed the alcohol and named his drink, Coca Cola. He promoted this new drink as a tonic, a cure-all for whatever ailed a person. The cocaine (from the coca leaves) was removed from the recipe around 1903. The drink became a treat or an indulgence.

Eventually, diagnosing patients became part of the physicians’ domain, and the pharmacists stuck with compounding medicines the doctors prescribed. Although the pharmacists no longer prescribed drugs, they remained an important part of the healthcare system and their responsibilities grew.

Pharmacist education

Since 2004, pharmacists in the United States have to earn a Doctor of Pharmacy (PharmD) degree, a three-year program following an undergraduate degree. Once they have the degree, they must pass an exam from the National Association of Boards of Pharmacy and apply for licensing in the state they wish to practice.

As with any other health field, pharmacists need to keep up-to-date with regular education activities. Pharmacists can specialize in certain areas, like intensive care, for example. But what makes pharmacists unique in healthcare is their public-facing position. Community pharmacists are the most commonly encountered front-line healthcare professionals. They play an active and valuable role  detecting and helping manage illnesses in the community, including sepsis.

Pharmacists can give vaccines

Vaccines against infectious illnesses are a vital part of preventing sepsis. If you prevent infection, you prevent sepsis. Almost all states allow pharmacists to give any vaccine, including one for the seasonal flu. However, a few states limit what type of vaccine pharmacists may administer or limit the age of the patients they may tend to. This map can show which states allow different vaccines, but it is from 2015, so check with your pharmacist to be sure.

In 2020, in response to the COVID-19 pandemic, the U.S. Department of Health & Human Services expanded what pharmacists are allowed to do regarding childhood vaccines. The HHS acknowledged that many children are not receiving timely childhood vaccines because of the pandemic. The community pharmacy was a good place to encourage parents to follow through with the scheduled vaccinations.

Pharmacists can screen for drug safety

While doctors and nurse practitioners know a lot about medications so they can prescribe them, pharmacists are the medication experts. They also have files of other medications their patients may take or have taken, along with information about allergies. So when a patient brings in a new prescription or asks about an over-the-counter product, the pharmacist can check to ensure that the new drug doesn’t work against any other medications, and that it is safe for the patient to take.

This role is particularly important if a patient sees several specialists for various ailments. It’s not unusual for one patient to see several specialists in addition to their primary care physician.

Each specialist should be aware of their patients’ medical history. But mistakes happen and they may prescribe a medication that could cause harm if combined with other medications or treatments.

Pharmacists can be antibiotic gate keepers

Antibiotics are overused and misused in our society. Some people push their doctors to prescribe antibiotics for viral illnesses or for bacterial illnesses that would likely go away on their own. Patients might not follow the directions properly. They may stop taking them before the prescription is finished or take someone else’s medications.

Antibiotics were  wonder drugs when they were first discovered. But with the overuse and misuse, some bacteria have mutated to the point that they are now resistant to the very drug that used to stop them in their tracks.

Community pharmacists play an important role by educating patients about antibiotic use – and when not to use them.

 In-hospital pharmacists

Hospital and healthcare systems are recognizing the important role that pharmacists have in providing patient care. Pharmacists who work in hospitals review prescriptions, consult with doctors about medication use, and help develop different treatment plans when needed. You also might find a pharmacist on the ICU or emergency room team, giving the staff the benefit of their medication expertise.

If you have any medication questions, from how to take them or dealing with side effects, to which type of over-the-counter products are best for you, your local pharmacist is your source for information. They have the information at their fingertips and are happy to share it with you. They do so much more than just dispense medications – they can save lives.

For more information on sepsis and antimicrobial resistance (AMR), visit the Sepsis and Antimicrobial/Antibiotic Resistance page, part of the Sepsis Alliance Sepsis and… library.