Assessing the appropriateness of antifungal prescribing: key results from the implementation of a novel audit tool in Australian hospitals.

This article focuses on the implementation and findings of the Antifungal National Antimicrobial Prescribing Survey (Antifungal NAPS), a standardized electronic audit tool developed to assess the quality of systemic antifungal prescribing in Australian hospitals. Data from 11 hospitals involving 516 prescriptions showed that 77.1% of antifungal prescriptions were appropriate, with fluconazole being the most commonly prescribed agent but having the lowest appropriateness rate, particularly in empirical use for urinary tract and intra-abdominal infections. The study identified key areas for quality improvement, including optimizing fluconazole use, enhancing invasive fungal infection risk assessment to guide prophylaxis, and increasing infectious diseases (ID) and antimicrobial stewardship (AMS) oversight. The Antifungal NAPS tool, validated through international consensus metrics, supports targeted interventions to improve antifungal stewardship and patient outcomes in hospital settings.