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De-escalation concept and MIC literacy among medical students and clinical residents
  1. Hideharu Hagiya,
  2. Kazuki Tokumasu,
  3. Mikako Obika,
  4. Fumio Otsuka
  1. Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
  1. Correspondence to Dr Hideharu Hagiya, Department of General Medicine, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan; hagiya{at}

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The emergence of antimicrobial resistance (AMR) is a threat to public health worldwide.1 2 In 2015, WHO called for every country to introduce active countermeasures against this pressing healthcare menace. Shortly thereafter, the European nations, the USA and other countries formulated 10-year action plans,3 4 which included the promotion of antimicrobial stewardship (AMS) as one of the major principles. For instance, the UK government aims to reduce antibiotic prescriptions in primary care settings by 10% by 2020.5 Based on the Japanese National Action Plan on AMR launched in 2016,6 the Japanese government set goals to achieve 33%, 50% and 20% reductions in total antimicrobial use; use of oral cephalosporins, fluoroquinolones and macrolides; and intravenous drug use in 2020, respectively, in comparison with their uses in 2013. Oral antimicrobial uses of cephalosporins, quinolones and macrolides have decreased by 14.2%, 9.7%, and 12.7%, respectively, which, however, did not achieve the national goals.7 Conversely, the use of intravenous agents increased by 3.9% across the country.

AMS is the cornerstone of mitigating the emergence of AMR pathogens. Learning opportunities for AMS are more easily available than they were earlier. However, it is unclear whether young doctors have currently reached a clinically sound level of understanding of appropriate antimicrobial therapy. In this study, we aimed to reveal the degree of understanding of the basic concept of infectious disease treatment among medical students and clinical residents.

Initially, we recruited student doctors (4–6th year pregraduate students) of Okayama University School of Medicine, who were on rotation to the Department of General Medicine from June 2019 to September 2020 as part of their clinical internship curriculum. We subsequently included …

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  • Correction notice This article has been corrected since it first published. The provenance and peer review statement has been included.

  • Contributors HH was responsible for the study design, data collection, data analysis and writing of the final manuscript. KT, MO and FO supervised and approved the study protocol.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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