Strengthening Antimicrobial Stewardship Through Regular Interventions: A Two-Cycle Clinical Audit in a District General Hospital in the United Kingdom
Authors: Pushpa Saajan , Shayi Shali , Ashica Joshy , Mahboba Muhib , Anusha Krunasagar , Sandra Shali , Shikandhini Visuvanthan
Abstract
Background:
Antimicrobial resistance (AMR) is a growing global health crisis driven by inappropriate antibiotic use, prolonged treatment, and inadequate documentation of prescribing rationale. Optimizing antimicrobial use through hospital-based stewardship interventions is a clinical priority to improve outcomes and curb resistance. This audit evaluated whether structured pharmacist–microbiologist interventions could enhance compliance with local antimicrobial-prescribing standards on a busy medical ward in a United Kingdom district general hospital.
Aim: To measure compliance with Trust antimicrobial-prescribing standards and assess the effect of pharmacist–microbiologist interventions on prescribing quality.
Methods: Two nine-week audit cycles were undertaken on medical ward. Each cycle included a four-week baseline review, a four-week stewardship intervention, and a one-week post-intervention re-audit. Data were extracted from the electronic prescribing system.
Results: In Cycle 1, baseline compliance was 63 % (guideline), 79 % (indication), and 83 % (duration), rising post-intervention to 83 %, 92 %, and 94 %. In Cycle 2, baseline rates were 63 %, 25 %, and 90 %, improving to 85 %, 69 %, and 92 % after intervention.
Action Plan: Daily pharmacist–microbiologist antimicrobial-stewardship ward rounds and integrated electronic prescribing prompts have been embedded into routine clinical practice. Regular re-audits and targeted induction training for new prescribers will help sustain ≥ 90 % compliance with guideline standards and support ongoing patient-safety improvement.
Keywords: Antimicrobial resistance ,Antimicrobial stewardship ,Quality improvement
Pubmed Style
Pushpa Saajan, Shayi Shali, Ashica Joshy, Mahboba Muhib, Anusha Krunasagar, Sandra Shali, Shikandhini Visuvanthan. Strengthening Antimicrobial Stewardship Through Regular Interventions: A Two-Cycle Clinical Audit in a District General Hospital in the United Kingdom. EJMCR. 2026; 25 (February 2026): 87-90. doi:10.24911/ejmcr.9-2418
Publication History
Received: December 01, 2025
Revised: January 08, 2026
Accepted: January 12, 2026
Published: February 25, 2026
Authors
Pushpa Saajan
Department of Microbiology, The Princess Alexandra Hospital NHS Trust Harlow, United Kingdom.
Shayi Shali
Department of Pharmacy, The Princess Alexandra Hospital NHS Trust Harlow, United Kingdom.
Ashica Joshy
Department of Pharmacy, The Princess Alexandra Hospital NHS Trust Harlow, United Kingdom.
Mahboba Muhib
Department of Pharmacy, The Princess Alexandra Hospital NHS Trust Harlow, United Kingdom.
Anusha Krunasagar
Department of Microbiology, The Princess Alexandra Hospital NHS Trust Harlow, United Kingdom.
Sandra Shali
Department of Acute Medicine, The Princess Alexandra Hospital NHS Trust Harlow, United Kingdom.
Shikandhini Visuvanthan
Department of Microbiology, The Princess Alexandra Hospital NHS Trust Harlow, United Kingdom.