O04 UKHSA Start Smart Then Focus antimicrobial stewardship: effective implementation during the COVID-19 pandemic at an NHS Foundation Trust in the UK

Antimicrobial resistance (AMR) is a critical global health threat, causing 1.2 million deaths annually. While antimicrobial stewardship (AMS) promotes responsible antibiotic use, the COVID-19 pandemic led to a 15% rise in AMR. This study investigated AMS implementation before and during the pandemic through a retrospective analysis of 640 patient records using the UK Health Security Agency’s AMS toolkit at an NHS Foundation Trust. Despite stable antibiotic prescription appropriateness, adherence to guidelines dropped from 64% to 36% during the pandemic. The findings emphasize the importance of adaptable AMS practices, such as ‘De-escalation,’ in managing AMR and ensuring effective healthcare post-pandemic.