APMHC

Abstract

Background: Antimicrobial resistance (AMR) is a growing public health threat, undermining the effectiveness of existing treatments and increasing risks of morbidity, mortality, and healthcare costs. In the United Kingdom, antimicrobial stewardship (AMS) has been prioritised as a key strategy to optimise antibiotic use and combat resistance across healthcare settings.  Aim: This dissertation aimed to evaluate the impact of NHS AMS strategies on antibiotic prescribing practices across healthcare settings in the UK. Methods: A narrative literature review was conducted, drawing on twelve peer-reviewed studies published between 2010 and 2024. Searches were performed across five databases (PubMed, Scopus, Google Scholar, CINAHL, and Cochrane Library) using Boolean logic guided by the Population, Intervention, and Outcome (PIO) framework. Eligible studies were critically appraised using the CASP checklists, and data were synthesised thematically following Braun and Clarke’s [12] framework. Results: Five key themes were identified: (1) effectiveness of AMS strategies, (2) influence on prescriber behaviour, (3) implementation challenges, (4) role of education and training, and (5) policy and governance support. AMS interventions were found to improve prescribing quality and reduce inappropriate antibiotic use, but their effectiveness depended heavily on institutional support, leadership, professional training, and national policy integration. Barriers included resource constraints, inconsistent local implementation, and the impact of the COVID-19 pandemic on stewardship delivery. Conclusion: NHS AMS strategies have delivered measurable improvements in antibiotic prescribing practices across UK healthcare settings, aligning with national and global policy objectives. However, sustained success requires robust governance, adequate resourcing, continuous education, and stronger integration into clinical practice. Strengthening AMS remains essential to preserving antimicrobial effectiveness and safeguarding public health against the threat of resistance.

Keywords: Antimicrobial stewardship; Antimicrobial resistance; Antibiotic prescribing; NHS; public health; United Kingdom