Carey's Policy Paper

Baczwaski 22 September, 2008
Med-Town Pharmacy Policy

Antibiotic resistance not only affects scientists and doctors, it has now become a problem of the world. People don’t realize that every time they take antibiotics, resistant germs may be left to grow and multiply while the sensitive bacteria are the only ones killed (2). When antibiotics are misused, the now resistant bacteria created can cause new and harder to treat infections (1). It’s important to understand that the decisions made about antibiotic use, unlike any other medicine, the possible consequences extend far beyond your reach. When antibiotics are taken responsibly, it protects the health of our families, communities, and nations against the resistance that may occur (1).
One of the main issues dealing with antibiotic resistance is the misuse of the antibiotics, which can be taken care of with help from our pharmacy. Over 25% of Americans keep their leftover medications in their homes today (3). Leftover medications include saving the medication for later use, taking an antibiotic without a doctor’s prescription, having leftovers, and sharing your medication (5). Our population as a whole does not understand that if you discontinue an antibiotic early, the bacteria can grow faster than they had been growing before. Also, people believe if they stop the medication early, they can go back on to the medication when they begin to feel ill again. This however is not the case, because antibiotics treat specific bacteria only. When people begin to feel sick later on, they do not realize that it could just be a virus; therefore they take the antibiotic for no reason at all. Only 15% of sore throats are caused by the strep throat bacterium, Streptococcus Pyogenes, therefore the other 85% are viruses not needing antibiotics (6). Besides taking the antibiotics at a later time, people often misuse antibiotics in general. Overuse of specific drugs, like narcotics or over the counter, may harm only the specific patient who consumed them, but overuse of antibiotics and the antibiotic resistance that has emerged affects you and everyone else that you may or may not come in contact with (4).
Our small pharmacy can only make small changes in hopes to decrease antibiotic resistance. We have made this policy in order to make a difference in the misuse of antibiotics in hopes to reduce antibiotic resistance in our town. This policy sets the guidelines used by Med-Town, a pharmacy, on how individuals within the company interact and communicate with one another, with our clients, and with others in the medical field.

I. POLICY
A. Med-Town pharmacists must use the computers provided to determine the last time clients have filled their medication at the time of their order. Clients will not be allowed to refill their prescription until the last pill has been taken according to the date the medication was picked up originally. By restricting the date of refilling prescriptions it will help reduce antibiotic resistance by decreasing over dosing and sharing of prescriptions.

B. Med-Town employees will require clients to show a personal identification card when they pick up their prescriptions, along with their signature. The name on the prescription must be the person who picks up the medication, unless they are not an adult or the doctor states why they are incapable of picking up their medication. This will help reduce antibiotic resistance by lowering the chance of prescription drugs taken by someone who is not prescribed them.

C. Med-Town employees must check up on clients when they have stopped the course of antibiotics or if a client is overdue in refilling a medication. This will not only keep clients on top of things when taking their medication, but will make sure the client has taken the medication properly and that there are no leftovers in the home. The employee “check-ups” will reduce resistance to antibiotics by ensuring the client has taken the medicine properly, and that there will be no leftover antibiotics in our environment.

While our policy is working well here at Med-Town, others may argue against our strategies. Some may argue that clients should be able to renew prescriptions early because of vacation or if they accidentally dropped a pill down the sink. However, the most innocent-looking people with these excuses may be the ones who instead are selling their medicine. Also, some may believe that requiring those who are prescribed the antibiotics must pick up their own pills seems very inconvenient in a world of high gas prices and inflation. But, how does the pharmacy know that an appointed individual will really bring the prescribed medicine to the correct individual without taking any of the pills for them self? Finally, it may be too time consuming to have the employees “check up” on every patient with a phone call asking if they are done with the course of the medication. However, this is what voice message systems are for when the computer system does everything. The main problem with this policy, however, is in trusting the patients. We have no way of telling whether or not that patient actually took all of their medication and isn’t keeping them for the next time their sick. But we can only do the best that we know how to do, and if we have done everything else it’s up to the client whether or not they want to be healthy or not.

1. Mayo Clinic Foundation for Medical Education and Research. “Antibiotics: Use Them Wisely”. Feb 13, 2008. http://www.mayoclinic.com/health/antibiotics/FL00075
2. Centers for Disease Control. “Get Smart: Know When Antibiotics Work”. August 22, 2008. http://www.cdc.gov/drugresistance/community/anitbiotic-resistance-faqs.htm
3. International Journal of Antimicrobial Agents. “A Global Survey of Antibiotic Leftovers in the Outpatient Setting”. December 2007, Volume 30, Issue 6. p530-536
4. The Society for Healthcare Epidemiology of America. “Controlling Use of Antimicrobials in a Community Teaching Hospital”. March 2006, Volume 27, Issue 3. p239-244
5. International Journal of Antimicrobial Agents. “A Systematic Review and Meta-Analysis of Misuse of Antibiotic Therapies in the Community”. August 2005, Volume 26, Issue 2, p106-113
6. FDA Consumer Magazine- From Test Tube to Patient. “Battle of the Bugs: Fighting Antibiotic Resistance”. January 2006, 4th Edition.

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