ArticleJournal of pharmaceutical policy and practice2026
Early antibiotic review and AWaRe prescribing in respiratory infections before vs during COVID-19: a two-hospital retrospective cohort study.
Article in Journal of pharmaceutical policy and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Antimicrobial stewardship (AMS) is essential for optimising antibiotic use and limiting antimicrobial resistance. The COVID-19 pandemic disrupted healthcare delivery, but its effect on early antibiotic review remains unclear. This study compared antibiotic review practices and prescribing patterns among hospitalised patients with respiratory tract infections before and during the pandemic. Methods: A retrospective cohort study was conducted across two acute hospitals within an NHS Foundation Trust in England. Adults aged 25 years or older admitted with respiratory tract infections and prescribed systemic antibiotics were included from 2019 (pre-pandemic) and 2020 (pandemic). Data covered review timing, stewardship interventions based on the CARES framework, and prescribing patterns according to the WHO AWaRe classification. Stratified systematic random sampling identified 640 patients: 320 per year and 160 per hospital annually. Results: Median age was 78 years in 2019 and 79 years in 2020. Mortality was comparable (15.0% versus 15.6%; Conclusions: Early antibiotic review remained resilient during COVID-19 despite operational pressures. Nevertheless, increased Watch prescribing highlights the need for enhanced diagnostic stewardship and pandemic-resilient AMS infrastructure. Embedded review processes, multidisciplinary collaboration, workforce development, and digital stewardship tools may strengthen antibiotic optimisation during future healthcare disruptions. The contribution of pharmacists requires further investigation. These findings demonstrate that maintaining review frequency alone may not prevent broader-spectrum prescribing and support targeted strategies to improve documentation, promote Access antibiotics, and preserve stewardship quality during periods of pressure.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.