Publication date: Jul 02, 2025
Introduction: Antimicrobial resistance (AMR) poses a critical global health threat, with projections of 10 million annual deaths by 2050 if left unaddressed. Antimicrobial stewardship (AMS) initiatives, such as the UKHSA Start Smart – Then Focus (SSTF) framework, are vital for optimising antibiotic use. However, the COVID-19 pandemic significantly disrupted AMS practices, leading to increased empirical prescribing and reduced opportunities for timely antibiotic review. Methods: This retrospective cohort study analysed antibiotic review practices among 640 adult inpatients treated for respiratory tract infections (RTIs) at two secondary care hospitals within an English NHS Trust during 2019 (pre-pandemic) and 2020 (pandemic). Data included demographics, comorbidities, antibiotic classification (WHO AWaRe), review timing (Days 2-3, 4, 7), and AMS interventions aligned with SSTF-CARES outcomes. Statistical analysis was performed using SPSS v22.0. Results: Patients were predominantly elderly (median age: 78-81), with a high prevalence of comorbidities including hypertension (45%) and diabetes (20%). Overall mortality was 15%. Watch antibiotics were most frequently prescribed (46.3%-65.0%), especially during the pandemic, while Reserve antibiotic use remained appropriately low (
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 Pandemic |
| disease | MESH | respiratory tract infections |
| disease | MESH | hypertension |