M.A. van Agtmael

Essential competencies in prescribing: A first european cross‐sectional study among 895 final‐year medical students

European medical students should have acquired adequate prescribing competencies before graduation, but it is not known whether this is the case. In this international multicenter study, we evaluated the essential knowledge, skills, and attitudes in clinical pharmacology and therapeutics (CPT) of final‐year medical students across Europe. In a cross‐sectional design, 26 medical schools from 17 European countries were asked to administer a standardized assessment and questionnaire to 50 final‐year students. Although there were differences between schools, our results show an overall lack of essential prescribing competencies among final‐year students in Europe. Students had a poor knowledge of drug interactions and contraindications, and chose inappropriate therapies for common diseases or made prescribing errors. Our results suggest that undergraduate teaching in CPT is inadequate in many European schools, leading to incompetent prescribers and potentially unsafe patient care. A European core curriculum with clear learning outcomes and assessments should be urgently developed.

The Prescribing Performance and Confidence of Final-Year Medical Students

It is widely believed that medical students are not as well prepared or as sufficiently skilled in prescribing as they should be at the outset of their careers. However, a preclinical context‐learning pharmacotherapy program has been found to improve students’ therapeutic skills during an ensuing clinical clerkship in internal medicine. 1 In this Commentary, we argue that a similar approach during a clinical clerkship may further enhance therapeutic skills at the end of the clerkship.

Successful treatment of a disseminated Nocardia brasiliensis infection

Systemic nocardiosis is most often caused by Nocardia asteroides, but it can also be caused by other Nocardia spp. with different antimicrobial susceptibility patterns. Difficulties in species determination and susceptibility testing can hamper the implementation of appropriate antibiotic therapy, as illustrated by the case reported here. In August 2003, a 48-year-old man was referred to our Department of Internal Medicine with chest pain that was aggravated by breathing and coughing. Except for being a heavy smoker, his medical history was unremarkable until June 2002, when he lost his sight in his left eye after it was injured by a penetrating iron splinter. In February 2003, he was diagnosed with sympathic ophthalmia, an autoimmune uveitis that can occur after ocular trauma and often causes blindness of both eyes (injured and not injured). After this diagnosis was made, his left eye was enucleated and his right eye was treated with prednisone and ciclosporin. Two months before admission, he had been on a short holiday to the subtropical island of Madeira. At admission, the patient’s temperature was 37.0◦C but it soon rose to 38.4◦C. His right eye showed no sign of uveitis and its vision was normal. Auscultation of the heart and lungs was normal. Laboratory tests showed a markedly raised C-reactive protein level of 101 mg/l and leucocytosis of 20.0×109/l. Chest radiograph and computed

Essential diseases in prescribing: A national Delphi study towards a core curriculum in pharmacotherapy education

Prescribing is a core skill for junior doctors, yet 8–10% of their prescriptions contain errors. To ensure adequate training in prescribing, it is important to define the diseases for which junior doctors should be competent to prescribe. The aim of the present study was therefore to identify the essential diseases in prescribing for junior doctors.

Toxic intracellular anabolite levels of tenofovir and didanosine causing a steep CD4-cell decline.

7‐11 November 2010, Tenth International Congress on Drug Therapy in HIV Infection, Glasgow, UK

Koorts bij volwassenen

De Vries H, Van Agtmael MA, Bastiaans JF. Koorts bij volwassenen. Huisarts Wet 2004;47(8):374-8.