Combating Antimicrobial Resistance: Insights from Antimicrobial Stewardship Research
Published in Sustainability
I am Rasha Abdelsalam Elshenawy, I am a Clinical Pharmacist by background doing my PhD at the University of Hertfordshire in the UK. I am an Antimicrobial Stewardship Global Lead. I have an American Board of Pharmacy with 20 years of experience, and I am certified in Antimicrobial Stewardship. I have special interests in antimicrobial resistance (AMR) and antimicrobial stewardship (AMS). I led AMS and put measures against antibiotic-resistant bacteria and Five-years AMS strategic plan.
I am a director of FADIC Antimicrobial Stewardship School, which was shortlisted for the Antibiotic Guardian award (2020). This school was shared in the Centre for Disease Control and Prevention (CDC) AMR challenge in 2018. Realising the global burden of AMR has fulfilled my passion for finding possible solutions to AMR through effective implementation of AMS and improving antibiotic prescribing and education
- The World Antibiotic Awareness Week (WAAW) highlights the importance of responsible antibiotic use and education on antimicrobial resistance and antimicrobial stewardship.
- The urgency to combat an AMR has never been greater. With projections of 10 million deaths annually by 2050 due to AMR, the importance of antibiotic awareness is paramount.
- My experience conducting AMR research at Bedfordshire Hospitals NHS Foundation Trust has been pivotal in understanding this crisis.
- I extend heartfelt thanks to the antimicrobial stewardship pharmacists at the Trust. Their collaboration in promoting AMR research has been invaluable. Likewise, the Research and Development (R&D) department within the Trust deserves recognition for their support in my PhD research project, which investigated antimicrobial stewardship before and during the COVID-19 pandemic.
- The invaluable contributions at Bedfordshire Hospitals NHS Foundation Trust have been made by a team of dedicated professionals, including AMS pharmacists (Faisal Khan, Abdul Mohamed, and Suraiya Chandratillake), Chief Pharmacist (Pritesh Bodalia), Head of Pharmacy at Luton & Dunstable University Hospital (Ravi Sharma), Head of Pharmacy at Bedford Hospital (Gemma McGuigan), AMS Lead, and Microbiology Consultant (Dr Mulla Rohinton).
- The Research & Development (R&D) department, with Assistant Director of R&D (Dr. Mohammad Wasil), and Manager of Research and Development (Margaret Louise Tate), have also played a crucial role.
- Acknowledgements extend to the former lead specialist pharmacist in training and development (Patricia Edwards), as well as the Trust's communication team.
- Their support and assistance have been pivotal in maintaining the success of our research. From reviewing retrospective medical records to conducting prospective surveys among healthcare professionals, their contributions have significantly shaped the comprehensive outcomes of our research. This collaboration promotes an integerated antibiotic prescribing and antimicrobial stewardship investigation, thereby fostering antimicrobial stewardship and combating antimicrobial resistance (AMR).
- I am also grateful to the University of Hertfordshire, School of Life and Medical Sciences, for sponsoring this research. The support from university supervisors (Prof Zoe Aslanpour and Dr Nkiruka Umaru) and the statistical support department has maintained the quality and excellence of the research.
Key takeaways from this sustainable research project include:
- A multidisciplinary team is essential for a consistent, integrated research project.
- Collaboration between academia and NHS trusts is crucial for evidence-based research to address AMR.
- Future AMR research is vital for developing integrated tools and understanding the necessary elements for effective AMS implementation.
- Healthcare professionals are committed to proper antibiotic use, but clinical judgment and practice situations can be challenging.
- Antimicrobial stewardship is more than judicious antibiotic use; it's a lifestyle in clinical practice.
- The output of this research is a comprehensive roadmap for AMS implementation, including dynamic dashboards and educational programs.
- The COVID-19 pandemic has highlighted the impact of AMR on mortality.
- The loss due to antibiotic misuse highlights the urgent need for rational antibiotic use.
In conclusion, my gratitude goes to the AMS team at Bedfordshire Hospitals NHS Foundation Trust for their support throughout my academic journey and the University of Hertfordshire. Their dedication has not only aided my research but also contributes significantly to the global fight against AMR.
Dissemination of this Research Project
- An investigation into the effectiveness of antimicrobial stewardship during a pandemic- COVID-19 in acute care setting: Published in Prospero.
- Antimicrobial stewardship before and during the COVID-19 pandemic: Possible solution to antimicrobial resistance: Published ISRCTN Medicine Blog.
- Antimicrobial stewardship implementation before and during the COVID-19 pandemic in the acute care settings: A systematic literature review.
- Antimicrobial Stewardship Implementation Before and During the COVID-19 Pandemic in Acute-care settings: Published in Springer Community related to the United Nations sustainable goals.
- Antimicrobial stewardship implementation before and during the COVID-19 pandemic: Published in WHO AMR Exchange on Antimicrobial Stewardship & COVID-19.
- How did the COVID-19 pandemic impact antibiotic prescribing and antimicrobial stewardship in acute care settings?: Published in Octopus.
- An investigation into factors affecting antibiotic use during the COVID-19 pandemic in two hospitals: Published in ISRCTN related to WHO criteria.
- WHO AWaRe classification for antibiotic stewardship: tackling antimicrobial resistance – a descriptive study from an English NHS Foundation Trust prior to and during the COVID-19 pandemic: Published in Frontiers Microbiology.
- Shorter and Longer Antibiotic Durations for Respiratory Infections: To Fight Antimicrobial Resistance—A Retrospective Cross-Sectional Study in a Secondary Care Setting in the UK: Published in MDPI Pharmaceuticals.
- Impact of COVID-19 on ‘Start Smart, Then Focus’ Antimicrobial Stewardship at One NHS Foundation Trust in England Prior to and during the Pandemic: Published in MDPI COVID. Novel survey distribution methods: impact on antimicrobial resistance research outcomes: Published in JAC-Antimicrobial Resistance.
To read the Final Report of the 'COVID-19 Impact on Antimicrobial Stewardship', contact the Principal Investigator, Rasha Abdelsalam Elshenawy.
Email: r.a.elshenawy@herts.ac.uk
Publication Date: 23 November 2023.
Dr Rasha Abdelsalam Elshenawy is Senior Lecturer in Antimicrobial Resistance and Stewardship, Infection Management, Research, Public Health and Patient Safety at the University of Hertfordshire and Consultant in Antimicrobial Resistance (AMR) and Stewardship (AMS) for the South Centre, Geneva. With over 20 years’ experience in clinical pharmacy and antimicrobial stewardship, she leads research on antibiotic prescribing, patient safety, and health systems strengthening.
Her work has directly informed UK parliamentary policy through written evidence submissions and contributes to global health initiatives aligned with the UN Sustainable Development Goals. She has authored more than 120 publications, served as Associate Editor for JAC–Antimicrobial Resistance, and directs the internationally recognised FADIC Antimicrobial Stewardship School. Her expertise spans AMS implementation, digital health, AI in prescribing, pandemic preparedness, and public engagement in AMR.
Follow the Topic
-
ISRCTN: The UK’s Clinical Study Registry
A primary clinical trial registry recognised by WHO and ICMJE that accepts studies involving human subjects or populations with outcome measures assessing effects on human health and well-being, including studies in healthcare, social care, education, workplace safety and economic development.
-
BMC Public Health
An open access, peer-reviewed journal that considers articles on the epidemiology of disease and the understanding of all aspects of public health.
What are SDG Topics?
An introduction to Sustainable Development Goals (SDGs) Topics and their role in highlighting sustainable development research.
Continue reading announcementRelated Collections
With Collections, you can get published faster and increase your visibility.
Monitoring, preventing, and managing type 2 diabetes
BMC Public Health is calling for submissions to our Collection on Monitoring, preventing, and managing diabetes at the population level. With rates of type 2 diabetes rising globally, especially in low- and middle-income countries and underserved communities, prevention strategies are critical. As the disease progresses people with diabetes are at increased risk of complications such as cardiovascular and kidney diseases, neuropathy and visual loss.
This Collection seeks submissions that explore population-level approaches to monitoring rates of diabetes, preventing or delaying the development of type 2 diabetes, and system-wide efforts to improve the management of the disease and reduce rates of complications, with a focus on improving health outcomes and reducing healthcare burdens.
Submissions are encouraged on primary prevention initiatives and culturally adapted, community-level interventions to reduce the risk of diabetes. Research aimed at improving systems for monitoring rates of diabetes and its complications through routinely-collected health data, or for improving management by enhancing patient engagement with healthcare systems or better identifying those in need, are encouraged. Research on diabetes education and support systems is also welcomed, with a focus on empowering individuals to adopt and sustain healthier lifestyles and avoid known causes of diabetes.
Additional topics of interest include (but are not limited to):
Access to healthcare and diabetes management
The impact of food insecurity on diabetes outcomes
Community-based interventions for low-income populations
Interventions to reduce exposure to environmental causes of diabetes
Financial barriers to diabetes medication and treatment
Housing instability, employment status and type 2 diabetes
Health literacy, poverty, and diabetes management
Policies to reduce poverty-related health disparities in diabetes
This Collection supports and amplifies research related to SDG 3: Good Health & Well-Being.
All manuscripts submitted to this journal, including those submitted to collections and special issues, are assessed in line with our editorial policies and the journal’s peer review process. Reviewers and editors are required to declare competing interests and can be excluded from the peer review process if a competing interest exists.
Publishing Model: Open Access
Deadline: Oct 16, 2026
Digital exclusion and health equity
Digital exclusion poses significant barriers to health equity, particularly in the context of an increasingly technology-driven healthcare landscape. Many individuals, especially from underserved communities face challenges in accessing digital health resources, including telehealth services, electronic health records, and health information online, alongside challenges from other social determinants of health. This Collection seeks to explore the intersection of digital health access and health equity, focusing on the disparities that arise from unequal access to digital tools and resources.
Addressing digital health exclusion is critical for promoting health equity and ensuring that all individuals can benefit from advancements in digital health. Recent strides in telehealth and digital health interventions have demonstrated the potential for technology to improve access to care, yet they also reveal significant disparities that must be acknowledged. By understanding the factors that contribute to eHealth disparities, we can develop targeted digital inclusion strategies that address the unique needs of diverse populations, ultimately fostering a more equitable health system.
Topics for submission include but are not limited to:
- Equitable digital health systems: policy, infrastructure, and community engagement
- Digital health access among underserved communities
- Digital literacy and health outcomes across diverse populations
- Innovations and implementation strategies for bridging digital health gaps in underserved communities
- Measuring and monitoring digital health disparities: metrics and methodologies
This Collection supports and amplifies research related to SDG 3 (Good Health and Well Being) and SDG 10: (Reduced Inequalities).
All manuscripts submitted to this journal, including those submitted to collections and special issues, are assessed in line with our editorial policies and the journal’s peer-review process. Reviewers and editors are required to declare competing interests and can be excluded from the peer review process if a competing interest exists.
Publishing Model: Open Access
Deadline: Dec 11, 2026
