Antibiotic Use and Stewardship in Settings Outside of Acute Hospitals

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: 30 January 2026 | Viewed by 424

Special Issue Editors


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Guest Editor
NHS England, London, UK
Interests: antimicrobial stewardship; behaviour change; antimicrobial resistance; antimicrobial prescribing

E-Mail Website
Guest Editor Assistant
NHS England, London, UK
Interests: antimicrobial stewardship; behaviour change; antimicrobial resistance; antimicrobial prescribing

Special Issue Information

Dear Colleagues,

Antimicrobial resistance (AMR) is a threat to everyone, including citizens, patients, and healthcare workers. AMR presents a critical and escalating global health challenge, contributing to 1.27 million deaths worldwide in 2019, including 87,500 deaths in the UK. By 2050, AMR is projected to cause 38.5 million global deaths, with severe implications for public health and economic stability, with the projected cost reaching GBP 79 trillion (USD 100 trillion) globally by 2050 if mitigation measures, including AMS, are not implemented.

In response, the UK AMR National Action Plan (NAP) 2024-2029 sets out a framework to prevent increases in drug-resistant infections, improve AMR knowledge by 10%, reduce antibiotic use by 5%, and ensure that 70% of antibiotics used in healthcare fall within the access category.

The ESPAUR report shows that over 80% of antibiotics are prescribed outside of the hospital setting; however, AMS expertise is concentrated in secondary care settings. In publishing this Special Issue, we aim to highlight AMS activities that can reduce the overuse of antibiotics and improve their implementation in settings other than acute hospitals in order to highlight AMS interventions in these settings and share best practices.

For this Special Issue, the submission of original research articles and reviews is welcome. Research areas may include (but are not limited to) the following: antimicrobial use, antimicrobial stewardship interventions, and interventions based on NAP commitments, all in settings outside of acute hospitals alongside AMS implementation and behaviour change research.

Dr. Monsey McLeod
Guest Editor

Dr. Naomi Fleming
Guest Editor Assistant

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • antimicrobial stewardship
  • antibiotic use
  • community
  • primary care
  • mental health
  • local authority
  • care home
  • public
  • health and justice
  • dental

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Published Papers (1 paper)

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Research

8 pages, 413 KB  
Article
Preserving Health Beyond Infection Control: Frailty, Weight, and Cognition in OPAT Patients
by Giacomo Ciusa, Giuseppe Pipitone, Bianca Catania, Giulia Coniglione, Claudia Imburgia, Maria Grazia Laura Marsala, Preziosa Scordo, Antonio Albanese, Antonio Cascio, Giovanni Guaraldi and Chiara Iaria
Antibiotics 2025, 14(11), 1173; https://doi.org/10.3390/antibiotics14111173 - 20 Nov 2025
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Abstract
Background: Outpatient Parenteral Antimicrobial Therapy (OPAT) is a validated alternative to inpatient care for complicated infections, ensuring clinical efficacy, safety, and cost-effectiveness. However, its impact on patient-centered outcomes such as nutritional status, frailty, and cognitive well-being has rarely been studied. Methods: We conducted [...] Read more.
Background: Outpatient Parenteral Antimicrobial Therapy (OPAT) is a validated alternative to inpatient care for complicated infections, ensuring clinical efficacy, safety, and cost-effectiveness. However, its impact on patient-centered outcomes such as nutritional status, frailty, and cognitive well-being has rarely been studied. Methods: We conducted a multicentric retrospective observational study of patients treated with OPAT between April 2024 and July 2025 in two tertiary care hospitals. Baseline demographics, comorbidities, weight, frailty status (Rockwood Clinical Frailty Scale (CFI)), and infection-related variables were collected. Follow-up assessments evaluated body weight, frailty, and subjective cognitive status. Clinical outcomes, adverse events, and hospital readmissions were recorded. Results: Of 139 patients treated with OPAT, 119 were included in the analysis (56% male, median age 67 years). Common comorbidities were ischemic heart disease (33%), diabetes mellitus (29%), chronic pulmonary disease (22%), and solid tumors (19%). The most frequent infections were urinary tract infections (UTIs) (29%), osteomyelitis (25%), and pneumonia (17%). Multidrug-resistant (MDR) organisms were isolated in 66% of cases. Clinical recovery occurred in 82,5% of patients, while 16% required readmission in the next 30 days; no deaths were reported. Body weight (median 73 vs. 73.0 kg at baseline, p = 0.43) and frailty index (median 2.5 vs. 2.4, p = 0.16) remained stable. Cognitive status was unchanged in 85.6%, declined in 5.9%, and improved in 8.5%. Conclusions: OPAT was confirmed to be clinically robust and well tolerated, with additional potential benefits in preserving weight, frailty status, and cognitive well-being. These findings suggest that OPAT not only ensures infection control but may also protect against hospitalization-related functional decline. Prospective studies incorporating standardized geriatric and cognitive assessments are needed to confirm these preliminary findings and define OPAT’s broader role in holistic patient care. Full article
(This article belongs to the Special Issue Antibiotic Use and Stewardship in Settings Outside of Acute Hospitals)
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