Antimicrobial Stewardship Curriculum and Training among Health Professional Schools and Residency Training Programs in California

BACKGROUND: Improving antimicrobial use is the single most important action to slow development and spread of antimicrobial resistance. Antimicrobial prescribing habits are likely developed early in education or clinical training, but information about curricula is lacking. METHODS: In November 2016, the California Department of Public Health Healthcare-Associated Infections Program distributed a 19-item survey to 65 health professional schools (dentistry, medicine, nurse practitioner, pharmacy, physician assistant) and 287 residency and fellowship training programs (dentistry, emergency medicine, family medicine, internal medicine, pediatrics, pharmacy, infectious disease). The survey assessed knowledge, attitudes, and practices related to antimicrobial stewardship (AS) and antimicrobial resistance (AR) as well as antimicrobial stewardship curriculum and training activities. RESULTS: We received data from 23 health professional schools and 78 residency training programs for response rates of 35% and 27%, respectively. Among 101 respondents, 89 (88%) agreed or strongly agreed that “AR is a major issue at my hospital” and 56 (55%) were satisfied with their current AS curriculum. Ninety-four (93%) respondents were interested in learning about successful strategies for implementing AS curricula or training from other schools or programs. Respondents incorporated a median of 7 of 8 specific AS principles and practices into their curricula and training [range, 0–8] (Figure 1) and used a median of 4 of 9 different teaching methods [range, 0–9] (Figure 2). The most cited barriers to incorporating AS curriculum and training were limited training infrastructure or resources (n = 58, 63%) and competing training priorities (n = 50, 54%). The least cited barrier was lack of interest or concern about AR and AS (n = 10, 11%) (Figure 3). CONCLUSION: Health professional schools and residency training programs recognize that antimicrobial resistance is a major public health issue and acknowledge the need to strengthen antimicrobial stewardship curricula. Public health agencies can facilitate sharing antimicrobial stewardship resources and materials as a strategy to enhance curricula in health professional schools and training programs. DISCLOSURES: All authors: No reported disclosures.