Assessing antifungal stewardship competency among pharmacy students: key findings and implications for clinical...

Antifungal resistance (AFR) is a significant public health concern. It restricts the available treatments for fungal infections, making them more difficult to possibility of treatment and increasing the risk of serious consequences. Pharmacists could significantly promote the rational use of antifungals, lessen their overuse, and support public health initiatives to stop the spread of resistant fungal infections by participating in antifungal stewardship (AFS) programs. Hence, the current study aimed to evaluate undergraduate pharmacy students' knowledge, attitudes and practices toward AFR.

A cross-sectional study was conducted on undergraduate pharmacy students studying their fourth and final year in various public and private universities of Karachi. The study questionnaire consisted of demographic details of students, 10 questions about knowledge, 10 questions about attitude and 10 questions regarding practice. The significance of each variable was evaluated, and the model fit was assessed with -2 Log Likelihood and Nagelkerke R Square. Data was analyzed using IBM SPSS version 20.

Out of 1763 students from the 4^th year and final year in different universities, 1,325 students responded to the questionnaire, which makes the response rate 75.1%. The students, 75.6% (n = 1,002), revealed good knowledge, which improved as the years of education progressed and was statistically significant (χ ² = 21.06, p < 0.001). A positive attitude was observed in 76.1% (n = 1,008) students toward AFR and AFS, with statistically significant improvement (χ ² = 6.94, p < 0.001) in incremental study years, being highest in the 5th year (78.4%, n = 661/843). Practice score was good in 49% (n = 652) students, which was better in the final year (50.1%, n = 422/843) compared to the 4^th year (47.7%, n = 230/482), which was statistically non-significant.

The presented research indicated that most students had an understanding of AFR and AFS, which is encouraging because AFR and AFSs are under- and poorly-researched fields in Pakistan. However, there is still a need to improve the lacking areas where students have low scores regarding AFR and AFS by providing educational interventions. Furthermore, strategies should be implemented to reduce the misuse and overuse of antifungals, especially without a prescription, to reduce AFR in Pakistan.