The role of the community pharmacy in the fight against antimicrobial resistance: A Survey in Italy

Background: In the last decades, the inappropriate use of anti-microbials has accelerated the spread of AntiMicrobial Resistances (AMR). Italy has been among the countries in Europe with the highest percentages of resistance to the principal classes of antibiotics. Objective. in 2024 we developed a nationwide project in Italy titled “Antimicrobial resistance: it’s time to act”. The main objectives were: to increase the knowledge among community pharmacists of the phenomenon of AMR and Group A Streptococcus (GAS) infections; to investigate, among the population attending community pharmacies, the knowledge of the risks associated with the incorrect use of antibiotics (Phase 1), and the prevalence of GAS infections (Phase 2). Methods. The study was conducted in Italian in community pharmacies. Phase 1 was subdivided into two phases: in Phase 1A, the investigation was carried out by using a self- administered questionnaire, whereas in Phase1B, the same questionnaire was administered to users by the community pharmacist. In Phase 2, data were gathered recording the results of rapid tests to detect GAS infections. Results. During Phase 1, data was collected in 778 pharmacies. 14.507 subjects were interviewed. During phase 2, 218 pharmacies participated and 1.914 subjects were enrolled. The Phase 1 investigation showed that there was a significant lack of awareness of AMR among the study population. The data collected enable us to highlight the need for health care professionals to provide the education of the Italian population on the issue of AMR. Regarding Phase 2, it is possible to affirm that the presence of general symptoms consistent with a GAS infection was not at all predictive of a positive result to the rapid test with the exception of the 0-10-year-old age group. Considering, however, more specifically those who declared a set of symptoms affecting the throat, the likelihood that a subject has a positive test rises significantly with age. Conclusions. In light of these results, and the fact that community pharmacies are among the health services most easily accessible to the general public, their active involvement in any campaign to raise awareness and educate the population on the topic of AMR should be considered.