Table 1.

Key points to include in clinical AMS curricula [adapted from [20, 22]

	Learning objective(s)	Topics
Effect of AMS initiatives on clinical outcome	The participant learns about how AMS contributes to accurate and safer prescribing of antimicrobials, resulting in improved clinical outcomes	Effective treatment
		Clinical outcomes (mortality and morbidity)
		Reduction of side effects
		Population specific approaches
Effect of AMS initiatives on bacterial resistance	The participant learns about antibiotic resistance mechanisms, including causes and extent	Epidemiology (global)
		Genetics and mechanisms
		Relationship to antibiotic use
		Discussion of AMS initiatives like prospective audit with feedback and formulary restriction
	The participant learns how AMS reduces the spread of antimicrobial resistance
Diagnosis of infection	The participant learns how to accurately interpret laboratory reports in order to make clinical treatment decisions in neonates, infants, children and adolescents;	Proper use and interpretation of bacterial Gram stain/culture, rapid and point-of-care tests, serology, and biomarkers of infection
		Establishment of standardised diagnostic criteria for specific infections
	The participant learns how to diagnose an infection in a standardised manner;
Principles of infection management in children	The participant learns how to make informed treatment decisions early in the course of disease in order to positively influence treatment outcomes;	Promptly identify patients who require antibiotics
		Timely and appropriate initiation of antibiotics
		Obtain cultures before starting antibiotics
		Do not give antibiotics with overlapping activity or combinations not supported by evidence or guidelines
	The participant learns how to de-escalate antibiotic use in order to more effectively treat an infection while limiting exposure to broad-spectrum antimicrobials
		Determine and verify antibiotic allergies
		Consider local antibiotic susceptibility
		Specify expected duration of therapy based on evidence and national and hospital guidelines
		Ensure appropriate administration (intravenous versus oral)
		Give antibiotics at the right dose and interval
		Stop or de-escalate therapy promptly based on the culture and sensitivity results or establishment of an alternative diagnosis
		Reconcile and adjust antibiotics at all transitions and changes in patient’s condition
		Monitor for toxicity reliably and adjust agent and dose promptly
Prescribing of antibiotics	The participant learns the basics needed to prescribe antibiotics for infections caused by susceptible and resistant organisms	Pharmacokinetics and mechanism of action of different classes of antibiotics (‘bug-drug’ coverage)
		Pharmacology and adverse effects, including risk of C. difficile infection
		Principles of empirical versus directed therapy
		Drug purchasing and dispensing costs
Guidelines for diagnosis and management of most frequent infections in children		Specific instruction for these common infections using principles outlined above
		Use of national and local guidelines and public health guidance
Prevention of infection	The participant learns about the importance of preventive measures to limit the development of antimicrobial resistance	Hand hygiene
		Prudent use of catheters and devices
		Principles and duration of surgical prophylaxis
Communication skills	The participant learns how to apply communication techniques to talk with patients and families about prudent antibiotic use