ESCMID Publications

ESCMID Panorama

ESCMID has developed a set of generic competencies in antimicrobial prescribing and stewardship, through a structured Europe-wide consensus procedure. These competencies represent the minimum standards that all independent prescribers of antimicrobials should reach to practise according to the principles of responsible antimicrobial use, and are intended to be relevant for all independent prescribers in Europe.

The list of generic competencies can be downloaded here. The set includes 35 competency points, in three sections: Core concepts in microbiology, pathogenesis and diagnosing infections; Antimicrobial prescribing; and Antimicrobial stewardship.

 

The manuscript describing the study has been published in Clinical Microbiology and Infection.

The press release can be downloaded here.

 

How can these competencies be used?

These competencies can immediately be used by:

  • Educators: To assess coverage of antimicrobial prescribing and stewardship principles in curricula; to design teaching materials; to assess if outcomes are reached by trainees

  • Regulators, professional bodies: To inform the setting of standards

  • Individual prescribers: To monitor their own competency

What are generic competencies? Can the competencies set be adapted?

In their current form they are intended to be relevant for all independent prescribers in Europe. The term "generic competencies" is used to indicate that these are general competencies which can also be used as a starting point by all prescribing professional groups for developing their own more specialized competencies. For example, additional competencies may be considered to be relevant for certain prescriber groups (e.g. members of an antimicrobial stewardship team).

 

What is an independent prescriber?

Prescribing rights vary from country to country. In developing these competencies we used the term "independent prescriber" to represent an unsupervised and unrestricted prescriber. This would include a primary care doctor, even if they can only prescribe oral antimicrobials; a trainee doctor, for example in respiratory medicine; a first year graduate from medical school who can write and sign antimicrobial prescriptions, even if they usually do so under guidance from their clinical team; a nurse or pharmacist prescriber who can prescribe a range of antimicrobials for a range of clinical conditions, without supervision. The following were not considered to be independent prescribers: final year medical students who are able to write prescriptions, but need a qualified doctor to sign the prescription; nurse or pharmacist prescribers who can only prescribe specific antimicrobials (e.g. trimethoprim) in specific circumstances (e.g. urinary tract infections).

 

How was the competency set developed?

A full description of the method is available in the manuscript describing the study, together with the list of expert panel members. In brief, a RAND-modified Delphi procedure was used, consisting of two online questionnaire rounds, a face-to-face meeting, and a final review. The draft set of competencies used in the study was originally developed by a multidisciplinary panel in the UK (https://doi.org/10.1093/jac/dku350), and was then revised through consultation with ESCMID Study Group representatives. The draft competencies set was reviewed by an expert panel consisting of 65 representatives from 24 European countries. Most expert panel members were specialists in infectious diseases or clinical microbiology, or pharmacists. Each competency point was assessed for relevance for all independent prescribers using a Likert scale, and the expert panel were able to suggest additional competencies. There was very high agreement (98%) with the final competencies set.