Antibiotic prescribing in an English secondary care setting before and during the COVID-19 pandemic.

Antimicrobial resistance (AMR) is a global crisis that requires urgent attention and action. More than 1.2 million people died worldwide in 2019 from infections caused by bacteria resistant to antibiotics, according to the last most extensive study on the issue to date. This is more than the annual death toll from malaria or Aids. The COVID-19 pandemic challenges all aspects of healthcare, especially the management of serious acute bacterial infections and effective delivery of antimicrobial stewardship. The World Health Organisation (WHO) have declared AMR one of the biggest threats to global health and one of the biggest health challenges. Antimicrobial stewardship (AMS) is a set of actions to promote the effective use of antimicrobials. Public Health England AMS and NICE AMS guidelines urge the AMS implementation in acute care settings to maintain the appropriate use of antibiotics and maintain the safety and quality of patient care. The proposed study will investigate the factors affecting antimicrobial stewardship (AMS) implementation before and during the COVID-19 pandemic.