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Updated: Aug 10, 2025
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Antimicrobial stewardship implementation before and during the COVID-19 pandemic in the acute care settings: a
Rasha Abdelsalam Elshenawy1, Nkiruka Umaru2, Amal Bandar Alharbi2
1Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire School of Life and Medical Sciences, Hatfield, AL10 9AB, UK. R.a.elshenawy@herts.ac.uk.
Introduction:
Antibiotics are widely administered for various indications, leading to increased antimicrobial resistance (AMR) in acute care hospitals. Since the onset of the COVID-19 pandemic, Antimicrobial Stewardship (AMS) effective strategies should be used to maintain the rational use of antibiotics and decrease the threat of Antimicrobial Resistance (AMR).
Aim:
This systematic literature review aims to investigate the AMS intervention Before-the-pandemic (BP) and During-the-pandemic (DP) from the literature.
Design And Setting:
Systematic literature review of primary studies on AMS implementation in acute care settings.
Methods:
Relevant studies published between 2000 and March 2021 were obtained from Medline (via PubMed), OVID, CINAHL, International Pharmaceutical Abstracts, Psych Info, Scopus, Web of Science, Cochrane Library, OpenGrey, and Google Scholar, using a comprehensive list of search terms. Public Health England (PHE) toolkit was agreed upon as a gold standard for the AMS implementation.
Results:
There were 8763 articles retrieved from the databases. Out of these, 13 full-text articles met the inclusion criteria for the review. The AMS implementation was identified in the included studies into AMS strategies (Core strategies & Supplemental strategies), and AMS measures BP and DP.
Conclusion:
This Systematic literature review summarises AMS implementation strategies and measures all over the previous 20 years of research. There are many lessons learnt from COVID-19 pandemic. The proper selection of the AMS implementation strategies and measures appeared to be effective in maintaining the appropriate use of antibiotics and decreasing the AMR threat, especially during the COVID-19 pandemic. Further studies are required to provide empirical data to evaluate the AMS implementation and identify which of these strategies and measures were effective BP and DP. In order to be prepared for any emergency/crisis or future pandemics.
Insights
Antimicrobial Stewardship (AMS) strategies are crucial for rational antibiotic use and combating antimicrobial resistance (AMR). This review examines AMS interventions before and during the COVID-19 pandemic, highlighting lessons learned for future preparedness.
Area of Science:
- Infectious Diseases
- Public Health
- Health Policy
Background:
- Rising antimicrobial resistance (AMR) necessitates effective Antimicrobial Stewardship (AMS) strategies in acute care settings.
- The COVID-19 pandemic underscored the need for robust AMS to ensure rational antibiotic use and mitigate AMR.
- Previous research on AMS implementation before and during the pandemic is synthesized to identify effective strategies.
Approach:
- A systematic literature review was conducted, analyzing primary studies on AMS implementation in acute care.
- Studies published between 2000 and March 2021 were sourced from multiple databases using comprehensive search terms.
- The Public Health England (PHE) toolkit served as a benchmark for evaluating AMS implementation.
Key Points:
- 13 full-text articles met the inclusion criteria from 8763 retrieved articles.
- AMS implementation strategies were categorized into core and supplemental approaches.
- Interventions were analyzed based on their effectiveness before the pandemic (BP) and during the pandemic (DP).
Conclusions:
- AMS strategies and measures are effective in promoting appropriate antibiotic use and reducing AMR, particularly during health crises like the COVID-19 pandemic.
- Lessons learned from the pandemic emphasize the importance of selecting appropriate AMS strategies and measures.
- Further research is needed to empirically evaluate AMS implementation and identify specific effective strategies BP and DP for enhanced pandemic preparedness.
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