Evaluation of Antibiotic Prescribing Practices in Infection Management: A Retrospective Observational Audit in a UK District General Hospital

Vollständiger Abstract

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Antimicrobial resistance (AMR) is a significant global health threat driven largely by inappropriate antibiotic use. Optimising prescribing practices through antimicrobial stewardship is essential to reduce resistance and improve patient outcomes. To evaluate antibiotic prescribing practices in infection management within a UK district general hospital general internal medicine ward, focusing on compliance with guidelines, antibiotic consumption, microbiological investigation, and treatment outcomes. A retrospective observational audit was conducted between March and May 2025 on a general internal medicine ward at Eastbourne District General Hospital. Data from 65 antibiotic prescriptions were analysed and compared against NICE guideline NG15, the UKHSA “Start Smart - Then Focus” framework, and local antimicrobial guidelines. Co-amoxiclav accounted for 77% (50/65) of prescriptions, followed by levofloxacin (15%), meropenem (15%), and vancomycin (2%). Respiratory infections and sepsis were the most common indications. Repeat antibiotic courses were required in 68–70% of patients. Blood cultures were not performed in up to 18% of cases. The audit highlights several important challenges in antibiotic prescribing, including a high reliance on empirical therapy, frequent repeat prescribing, and inconsistent microbiological testing. Strengthening antimicrobial stewardship interventions, particularly 48–72-hour antibiotic review, improved biological investigation, and enhanced documentation, is necessary to improve prescribing practices and reduce AMR risk.