Strengthening Antimicrobial Stewardship Through Regular Interventions: A Two-Cycle Clinical Audit in a District General Hospital in the United Kingdom

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 pharmacistmicrobiologist 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 pharmacistmicrobiologist 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 pharmacistmicrobiologist 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.