Which antimicrobial stewardship interventions do pharmacy students resonate with the most?

Pharmacists play a pivotal role in safeguarding antimicrobial use and optimising antimicrobial stewardship. The aim of the study was to assess the antimicrobial stewardship knowledge of undergraduate pharmacy students and to map the student responses to the themes of the World Health Organisation antimicrobial stewardship interventions practical guide, with a view to inform recommendations of further teachings that could be incorporated in future curricula.

Following the conclusion of an infectious diseases academic unit, pharmacy students completed a post-unit reflection. The responses were analysed using summative content analysis and mapped to the World Health Organisation antimicrobial stewardship interventions practical guide, which describes 10 commonly used stewardship interventions ('themes').

Students overall resonated with themes that are applicable prior to or at the time of prescribing more than those applicable after prescribing. Out of 610 Australian-based students and 181 Malaysian-based students, 61.6% and 33.7%, respectively, felt confident to intervene when antimicrobial prescribing is not optimal. The two themes students resonated with the most were Clinician education and Self-directed antibiotic reassessments (antibiotic timeouts). In contrast, the two least represented themes were Prior authorization of restricted antimicrobials and De-labelling of spurious antibiotic allergies.

Reflection responses demonstrated that pharmacy students do feel confident to intervene when antimicrobial prescribing is inappropriate, and resonate with their role being most impactful at the pre-prescribing time point, especially through clinical education. Further incorporation of content related to obtaining approval prior to prescribing restricted antimicrobials and de-labelling of allergies into the curriculum is encouraged, as these interventions were generally underrepresented by students.