How to educate prescribers in antimicrobial stewardship practices

Abstract

Widespread antimicrobial use has compromised its value, leading to a crisis of antimicrobial resistance. A major cause of misuse is insufficient knowledge of prescribing of antimicrobials in many categories of professionals. An important principle of antimicrobial stewardship is avoiding selection pressure in the patient, both on pathogen and commensal by avoiding unnecessary use, choosing the least broad-spectrum antibiotic, adequate doses, a good timing and the shortest possible duration. Up to now, most educational efforts have been targeted at professionals (mostly medical doctors) after their training and at the adult public. In the past few years, progress has been made in educating children. It is now crucial that academia and ministries of Health and Education jointly focus on an adapted undergraduate medical/professional curriculum that teaches all necessary principles of microbiology, infectious diseases and clinical pharmacology, with emphasis on the principles of prudent prescribing.

Do final‐year medical students have sufficient prescribing competencies? A systematic literature review

“…defined 12 competencies for prudent antimicrobial prescribing, based on a consensus between two UK working groups 67. This study served as a basis for the 34 learning outcomes for antimicrobial stewardship defined by Pulcini and Gyssens 68. Turner and Weiner used a Delphi study among pain specialists to develop 39 competencies for a chronic pain curriculum 56.…”

South African medical students’ perceptions and knowledge about antibiotic resistance and appropriate prescribing: Are we providing adequate training to future prescribers?

“…There were three major find ings, which are consistent with observa tions from highincome countries: [1113,15] (i) a perceived lack of preparedness and confidence to prescribe antibiotics; (ii) a desire for more education in this area; and (iii) inadequate knowledge of basic antibiotic prescribing practice. The bulk of antibiotic prescribing is done by junior doctors and nonspecial ists, [4,16] and there are limited opportuni ties for postgraduate training in antibiotic steward ship, particularly in out patient prac tice and nonacademic settings. [5,6] Inadequate preparation at medical school may translate into widespread antibiotic misuse and per petuate antibiotic resistance.…”

“…Even though most students remembered having attended lectures on key topics, and found these useful, this did not reflect in their knowledge scores. Although passive education, such as class lectures, has a limited impact on improving antibiotic use on its own, [6,16] it is an important method to teach fundamental stewardship principles. [21] Formal lectures were among the least popular suggested methods to improve preparedness for antibiotic prescription, suggesting that other, more active, educational approaches are required to complement traditional passive learning.…”

Misuse of Antibiotic Therapy among University Community in South Jordan

“…In addition, some infections require no antibiotic use, including viral infections, which can be similar in symptoms to bacterial infections to many individuals with limited knowledge in this area [23,29]. Issues like type of bacteria of the second infection and bacterial resistance upon subsequent use of the same antibiotic pose a challenge that needs to be addressed when educating those individuals.…”