European survey on principles of prudent antibiotic prescribing teaching in undergraduate students

We surveyed European medical schools regarding teaching of prudent antibiotic prescribing in the undergraduate curriculum. We performeda cross-sectional survey in 13 European countries (Belgium, Croatia, Denmark, France, Germany, Italy, Netherlands, Norway, Serbia,Slovenia, Spain, Switzerland, United Kingdom) in 2013. Proportional sampling was used, resulting in the selection of two to four medicalschools per country. A standardized questionnaire based on literature review and validated by a panel of experts was sent to lecturers ininfectious diseases, medical microbiology and clinical pharmacology. In-depth interviews were conducted with four lecturers. Thirty-fiveof 37 medical schools were included in the study. Prudent antibiotic use principles were taught in all but one medical school, but onlyfour of 13 countries had a national programme. Interactive teaching formats were used less frequently than passive formats. The teachingwas mandatory for 53% of the courses and started before clinical training in 71%. We observed wide variations in exposure of studentsto important principles of prudent antibiotic use among countries and within the same country. Some major principles were poorlycovered (e.g. reassessment and duration of antibiotic therapy, communication skills). Whereas 77% of the respondents fully agreed thatthe teaching of these principles should be prioritized, lack of time, mainly due to rigid curriculum policies, was the main reported barrierto implementation. Given the study design, these are probably optimistic results. Teaching of prudent antibiotic prescribing principlesshould be improved. National and European programmes for development of specific learning outcomes or competencies are urgentlyneeded