Antimicrobial resistance (AMR) is a major health threat and there is increasing recognition that contamination of the environment by the unsafe disposal of antibiotics via domestic waste streams is a risk for driving the further development of resistance.
In the UK, over 60% of medicines are disposed of in household waste (OECD report 2022), suggesting that public awareness of the importance of safe medicines disposal is low. Evidence also shows that people hoard unused antibiotics for use later, or share them with others, which can also increase the risk of AMR.
Our project promoted the safe disposal of unused and unwanted antibiotics via community pharmacies and encouraged these pharmacy teams to have conversations with patients and the public about the appropriate use of antibiotics. As part of World Antibiotic Awareness Week 2021, we ran an antibiotic amnesty across the NHS England Midlands region.
We invited community pharmacy teams to participate and supported them with a webinar and resources to use. We asked them to have 'amnesty conversations' with patients, highlighting the risks of using leftover antibiotics and encouraging them to return unused or unwanted antibiotics to the pharmacy for safe disposal.
The pharmacy teams recorded the number of conversations they had with patients and the number of full or part packs of antibiotics returned over a two-week period (15-30th November 2021) and submitted their results on the PharmOutcomes platform.
The amnesty ran alongside the pharmacy quality scheme (PQS) incentive to use the TARGET antibiotic checklist with patients when dealing with prescriptions for antibiotics, and was complementary to the scheme. The amnesty was advertised to the public via the CCGs involved, GP practices and participating community pharmacies using social media, website content and posters.
A resource pack, including the digital resources in 13 languages, was made available for use across the Midlands. The Local Pharmaceutical Committee and Local Authority also collaborated to provide communication with pharmacies and to facilitate collection of results.
Overall, 239 community pharmacies took part in the amnesty – they held over 7800 amnesty conversations with members of the public and recorded the return of 369 part-packs and 126 full packs of antibiotics. They also used the TARGET antibiotic checklist 4600 times in the two-week period.
