Enhancing Antifungal Stewardship: The Educational and Healthcare Benefits of Involving Pharmacy Students in Audits

Antifungal stewardship is important for promoting quality care and tackling the emergence of drug resistance. Evaluation of the quantity and appropriateness of common antifungal prescriptions like fluconazole is essential in the development of these programs. To perform a clinical audit of fluconazole prescribing and explore whether involvement of pharmacy students in this process was feasible and meaningful from both pharmacy student and health system perspectives. An audit was conducted of all fluconazole prescriptions January 2024 to March 2024 at two Sydney hospitals. Trained pharmacy students, under the supervision of antimicrobial stewardship pharmacists and physicians, completed the audit using the Antifungal National Antimicrobial Prescribing Survey audit tool. Prescriptions were assessed for their compliance to guidelines and appropriateness. Data on pharmacy students' educational experience was collected by a 5-point Likert scale survey. 145 fluconazole prescriptions were audited: 34 for empiric therapy, 56 for directed therapy, and 56 for prophylaxis. Ninety-one (62.8%) prescriptions were assessed as appropriate, 46 (31.7%) were inappropriate and 8 (5.5%) were not assessable. Seventeen patients with fluconazole doses 200 mg or greater had potential drug-drug interactions identified, with three being clinically significant requiring intervention. Students had positive experiences contributing to quality use of medicines, in terms of enjoyment, support, and education. Inappropriate fluconazole use was common. Pharmacy students made a positive contribution to antifungal audit, promoting good stewardship practises for the hospital whilst accessing enhanced learning and development opportunities.