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Antimikrobna rezistencija sve je veći problem kojim se trebaju baviti svi uključeni u zdravstveni sustav pa tako i ljekarnici. Zadnjih se godina objavljuje sve više radova na temu antimikrobne rezistencije i programa upravljanja antimikrobnom terapijom. Cilj istraživanja: pregled postojećih dostupnih programa upravljanja antimikrobnom terapijom, ocjenjivanje uloge ljekarnika te ukazivanje na mogućnosti koje oni pružaju ili bi mogli pružati u unaprjeđenju zdravstvene zaštite u smislu optimiziranja uporabe antibiotika. Materijal i metode: pri izradi je napravljen pregled znanstvene i stručne literature, publikacija stručnih udruga i institucija te drugih raspoloživih izvora za ključne riječi: antimikrobna rezistencija, rezistencija na antibiotike, smjernice, uloga ljekarnika, antimicrobial stewardship, antimicrobial resistance, guidelines, pharmacist role. Rezultati: Ljekarnik može sudjelovati u programima upravljanja antimikrobnom terapijom na svim razinama zdravstvene zaštite i važan je član tima u brojnim intervencijama. Tako u bolničkoj sredini, osim što brine o pravovremenoj nabavi antibiotika, može sudjelovati u izradi smjernica i praćenju pridržavanja istih, praćenju interakcija, određivanju doza te sudjelovati u izradi računalnih intervencija i njihovu praćenju. U javnoj ljekarni savjetuje bolesnika o pravilnom uzimanju propisanih antimikrobnih lijekova kao i o samoliječenju virusnih infekcija. Ljekarnik može i sudjelovati u javnozdravstvenim kampanjama usmjerenima na racionalnu uporabu antibiotika. Zaključak: Uloga ljekarnika nije jednaka u svim zemljama. Ona ovisi o obrazovnom sustavu, ovlastima koje ljekarnik ima te o mjestu rada ljekarnika. Značajnija uloga ljekarnika u programima upravljanja antimikrobnom terapijom velikim se dijelom veže uz visokorazvijene zemlje. Ljekarnici kao najdostupniji zdravstveni djelatnici imaju potencijal preuzimanja mnogo veće i značajnije uloge u programima upravljanja antimikrobnom terapijom, a u Hrvatskoj i na svim razinama zdravstvenoga sustava. Aktivnosti ljekarnika u programima upravljanja antimikrobnom terapijom u Republici Hrvatskoj predviđene su i Nacionalnim programom za kontrolu otpornosti bakterija, što je važan preduvjet za aktivnije sudjelovanje ljekarnika u programima upravljanja antimikrobnom terapijom. Zato je važno dobro i kontinuirano obrazovanje koje bi se u tom području trebalo provoditi kroz preddiplomsku, diplomsku i poslijediplomsku nastavu, u programima specijalizacija te u programima trajnog usavršavanja ljekarnika. Antimicrobial resistance is a growing problem that needs to be addressed by everyone involved in the health care system, including pharmacists. In recent years, more and more papers have been published on antimicrobial resistance and antimicrobial stewardship (AS) programs. The aim of the research: Reviewing the existing available AS programs, assessing the role of pharmacists and determining the opportunities they provide or could provide in improving health care in terms of optimizing the use of antibiotics. Material and methods: During the course of this research, a review of scientific and professional literature, texts published by professional associations and institutions, as well as other available resources has been performed for the following keywords: antimikrobna rezistencija, rezistencija na antibiotike, smjernice, uloga ljekarnika, antimicrobial stewardship, antimicrobial resistance, guidelines, pharmacist role. Results: Pharmacists can participate in antimicrobial stewardship programs at all levels of health care and are important team members in numerous interventions. For example, in the hospital environment, in addition to taking care of the timely procurement of antibiotics, they can participate in the development of guidelines and monitoring the compliance therewith, monitoring the interactions, determining the doses, developing computer interventions, their monitoring, etc. In public pharmacies, they advise patients on the proper use of prescribed antimicrobial drugs as well as on the self-treatment of viral infections. Pharmacists can also participate in public health campaigns aimed at the rational use of antibiotics. Conclusion: The role of pharmacists is not the same in every country. It depends on the education system, and the powers that the pharmacists have, as well as on the pharmacist’s place of work. A more significant role of pharmacists in AS programs is largely related to highly developed countries. Pharmacists, as the most accessible health care professionals, have the potential for a much greater and more significant role in antimicrobial stewardship in Croatia at all levels of the health care system. The activities of pharmacists in AS programs in the Republic of Croatia are also defined by the National Program for the Control of Bacterial Resistance, which is an important precondition for a more active participation of pharmacists in antimicrobial stewardship programs. This is why quality and continuous education in this field should be organised through undergraduate and postgraduate teaching, in specialization programs as well as in continuing education programs for pharmacists. |
