Experts develop a list of competencies in antimicrobial prescribing and stewardship

Experts from across Europe have developed a set of competencies in antimicrobial prescribing and stewardship, using a structured consensus procedure. This ESCMID-led study has resulted in a list of competencies that represent the minimum standards that all independent prescribers of antimicrobials should reach to practice according to principles of responsible antibiotic use. The list of competencies is highly relevant for educators, regulators and professional bodies throughout Europe, as well as for individual prescribers.

The competencies set comprises 35 competency points divided into three sections: Core concepts in microbiology, pathogenesis and diagnosing infections; Antimicrobial prescribing; and Antimicrobial stewardship.

"Despite widespread agreement that we need to use antibiotics responsibly, until now, there has been no consensus on what the minimum standards for responsible use are according to which prescribers in Europe should practice", explains Dr. Oliver Dyar, a researcher in public health at Karolinska Institutet, Stockholm, Sweden, who led the study and is treasurer of the ESCMID Study Group for Antimicrobial StewardshiP (ESGAP).

"We hope that this work will help guide those who train doctors, nurses and pharmacists to prescribe antibiotics, and at the same time support the regulators and professional societies that are responsible for setting and maintaining standards" Dr Oliver Dyar said, adding "These competencies could play an important role in harmonizing approaches in antimicrobial stewardship in Europe. We also believe that most of the competencies are relevant for prescribers in other contexts, and it is essential that on a global basis we invest in ways to improve on how we use antibiotics."

The study used a RAND-modified Delphi consensus procedure and involved 65 experts from 24 European countries, most of whom were infectious diseases specialists, clinical microbiologists, or pharmacists. This expert panel reviewed a draft set of competencies which was originally developed by a multidisciplinary panel in the UK, and had since been adapted to the broader European context through consultation with ESCMID Study Groups. Each competency point was assessed for relevance for all independent prescribers in Europe, and the expert panel was able to suggest additional competencies. After three assessment rounds and a face-to-face meeting, there was very high agreement (98%) with the final competencies set.

Over the coming years ESCMID and ESGAP will support efforts to implement these ESCMID generic competencies in antimicrobial prescribing and stewardship.