A national survey of antimicrobial stewardship content in Canadian entry-to-practice pharmacy programs

Objective

To describe the current landscape of antimicrobial stewardship (AMS) instruction in Canadian entry-to-practice pharmacy programs and the perceived barriers and facilitators to optimizing teaching and learning.

Design

Electronic survey.

Participants

Faculty representatives from the 10 Canadian entry-to-practice pharmacy programs, including content experts and faculty leadership.

Methods

A review of international literature pertaining to AMS in pharmacy curricula informed a 24-item survey, which was open for completion from March to May of 2021. Curriculum content questions were developed using AMS topics recommended by pharmacy educators in the United States, and professional roles described by the Association of Faculties of Pharmacy of Canada.

Results

All 10 Canadian faculties returned a completed survey. All programs reported teaching AMS principles in their core curricula. Content coverage varied, with programs teaching, on average, 68% of the recommended AMS topics from the United States. Potential gaps were identified within the professional roles of "communicator" and "collaborator." Didactic methods of content delivery and student assessment, such as lectures and multiple-choice questions, were most frequently used. Three programs offered additional AMS content in their elective curricula. Experiential rotations in AMS were commonly offered, though teaching AMS in formalized interprofessional settings was rare. Curricular time constraints were identified by all programs as a barrier to enhancing AMS instruction. A course to teach AMS, a curriculum framework, and prioritization by the faculty's curriculum committee were perceived as facilitators.

Conclusions

Our findings highlight potential gaps and areas of opportunity within Canadian pharmacy AMS instruction.

[Influence of dental amalgams on the concentration of mercury and silver in biological fluids and hair (author's transl)]

The influence of the extraction and fixing of dental amalgams on the metallic concentrations of different biological samples was studied by atomic absorption spectrometry on a subject. The levels of mercury obviously increased in urine, saliva and slightly in blood, with a maximum on the second or third day after the intervention; on the other hand, in the hair, the increase was very low even at the end of 40 days. The urinary and salivary kinetics of silver were practically similar to the ones of mercury. The determination of silver in these fluids could reveal with more specificity the part of dental amalgams on the increase of the metallic biological concentrations. A study with 25 other subjects carrying amalgams permitted to put in evidence some factors facilitating a slight increase of the mercury contents of the saliva, urine and blood.