With 39 outputs spanning peer-reviewed articles, conference presentations, posters, and innovative methodologies. this body of work emphasises the critical importance of interdisciplinary approaches and evidence-based practices in combating AMR.

Key Research Highlights

1. Multi-Phase Methodologies

The comprehensive Three-Phase Methodology: Antimicrobial Stewardship Before and During COVID-19 in Secondary Care integrated data across multiple phases to assess changes in AMS strategies. This approach informed the comparative analysis of antibiotic prescribing patterns pre- and during COVID-19.

2. Trends in Antibiotic Use During the COVID-19 Pandemic

Elshenawy's research highlighted significant shifts in antibiotic use during the COVID-19 pandemic in the UK secondary care setting.

• Poster Presentation: Trends in Antibiotic Use in a UK Secondary Care Prior to and During the COVID-19 Pandemic (11 Nov 2024) presented key findings on how prescribing patterns evolved during the pandemic and their implications for AMR.
• Oral Presentation: Pattern in Antibiotic Use in a UK Secondary Care Prior to and During the COVID-19 Pandemic (8 Nov 2024) delved deeper into comparative data, offering insights into AMS strategies during this critical period.

3. Global and Sustainable AMS Solutions

The research emphasised the need for sustainability in AMS practices.

• The FIP Global Roadmap 2030: A poster titled Sustainable Pharmacy and Antimicrobial Stewardship with a Novel Antibiotic Dashboard (8 Nov 2024) showcased an innovative tool for monitoring antibiotic use, aligning with global sustainability goals.

4. Healthcare Professionals' Perspectives on AMS

Two pivotal studies explored the views of healthcare professionals, capturing frontline insights critical to refining AMS practices:

• Workforce Views on Antibiotic Prescribing and Stewardship During the COVID-19 Pandemic at an NHS Foundation Trust in England (Poster, 8 Nov 2024).
• Healthcare Workers’ Views on Antibiotic Prescribing and Stewardship (Meeting Abstract, 1 Nov 2024, International Journal of Pharmacy Practice).

5. The WHO AWaRe Classification for Antibiotic Prescribing

An oral presentation, Antibiotic Prescribing Trends in a UK Secondary Care Setting: A 2019–2020 Medical Records Review Using the WHO AWaRe Classification (5 Nov 2024), offered a structured approach to evaluating prescribing patterns based on global classification standards.

6. Pharmacists’ Role in AMR Combat

The presentation, How Pharmacists Combat Antimicrobial Resistance: Optimising Practices and Raising Awareness, showcased strategies to empower pharmacists in improving AMS practices. By enhancing their role, the study underlined pharmacists' ability to raise awareness and ensure the responsible use of antibiotics.

7. COVID-19 and AMS Practices

A substantial portion of the research focused on the impact of the COVID-19 pandemic on AMS. Notable outputs included:

• Trends in Antibiotic Use in a UK Secondary Care Setting Prior to and During the COVID-19 Pandemic, which analysed prescribing patterns and their implications on AMR.
• The Impact of COVID-19 on ‘Start Smart, Then Focus’ Antimicrobial Stewardship at One NHS Foundation Trust in England, a detailed exploration of how pandemic conditions reshaped AMS implementation.

8. Innovations in AMR Monitoring

Research such as The FIP Global Roadmap 2030: Sustainable Pharmacy and Antimicrobial Stewardship with a Novel Antibiotic Dashboard highlighted technological advancements for monitoring antibiotic use and resistance trends, aligning with the United Nations Sustainable Development Goals.

Distribution of Research Output by Type

The research output for 2024 demonstrates a strategic mix of publication formats, as shown in the infographic:

Blogs and Research Community  Contributions (14):

• The largest share of outputs, these contributions include protocols, exploratory analyses, and preprints that laid the foundation for innovative approaches in AMS and AMR research. Notable works include Three-Phase Methodology: Antimicrobial Stewardship Before and During COVID-19 in Secondary Care and Think Ethics: Insights from the Health Research Authority Approval Process for AMS Research.

Poster Presentations (7):

• Posters provided visual summaries of key findings at conferences, fostering knowledge dissemination. Examples include The FIP Global Roadmap 2030: Sustainable Pharmacy and Antimicrobial Stewardship and Trends in Antibiotic Use in a UK Secondary Care Setting Prior to and During the COVID-19 Pandemic.

Oral Presentations (5):

• Presentations such as How Pharmacists Combat Antimicrobial Resistance: Optimising Practices and Raising Awareness underscored real-world applications and engaged audiences in critical discussions about AMS.

Peer-Reviewed Journal Articles (5):

• Published in high-impact journals, these articles include Shorter and Longer Antibiotic Durations for Respiratory Infections to Fight AMR, offering evidence-based strategies to optimise antibiotic use.

Meeting Abstracts (5):

• Abstracts like Healthcare Workers’ Views on Antibiotic Prescribing and Stewardship During the COVID-19 Pandemic contributed to international dialogue on AMS practices.

Working Papers (2):

• These papers, including A Pilot Study: Interrupted Time-Series Analysis of the Impact of the COVID-19 Pandemic on AMS, provided in-depth explorations of emerging AMS trends.

Reports (1):

• The standout report, Optimising Antimicrobial Use During the COVID-19 Pandemic in UK Acute Care Settings (2020–2024), synthesised insights from three sequential studies to inform AMS practices.

Figure 1. Distribution of Research Output by Type in 2024

Key Themes and Global Impact

The research outputs collectively address pivotal AMS and AMR challenges, with a focus on advancing global health and sustainability:

• Global Collaboration: Studies such as Enhancing AMR Surveillance in Developing Countries address critical gaps in data collection and surveillance in low-resource settings, fostering international partnerships to combat AMR.
• COVID-19 Insights: A significant portion of the research examines how the pandemic reshaped AMS practices, including adaptive strategies like the Start Smart, Then Focus programmes. These findings provide actionable insights into improving AMS during health crises.
• Sustainability and the United Nations Sustainable Development Goals (SDGs): The FIP Global Roadmap 2030 outlines strategies for sustainable pharmacy practices and the integration of AMS into broader health frameworks.

These efforts align with SDG 3 (Good Health and Well-Being), SDG 12 (Responsible Consumption and Production), and SDG 17 (Partnerships for the Goals), emphasising the need for global collaboration to confront AMR effectively.

This alignment with the United Nations SDGs reinforces the global significance of the research and highlights the role of sustainable stewardship in addressing the growing burden of AMR.

Global and Policy Implications

The research body reflects a commitment to addressing AMR as a global health crisis. By bridging gaps in AMS practices, advocating for sustainable pharmacy approaches, and leveraging multidisciplinary collaboration, these outputs have direct implications for policymakers, healthcare providers, and global health stakeholders.

Future Directions

Elshenawy’s research paves the way for continued innovation in AMR and AMS. Focus areas include:

• Expanding the use of digital tools and dashboards for real-time surveillance.
• Strengthening the integration of AMS into global health systems.
• Addressing challenges in AMS implementation in low-resource settings.

With over 300 downloads across these impactful contributions, the work demonstrates a robust engagement with academic and professional audiences, driving meaningful progress in the fight against AMR. As we move forward, such research underscores the critical need for sustainable solutions to safeguard public health worldwide.

Keywords: Antimicrobial Resistance (AMR), Antimicrobial Stewardship (AMS), Sustainable Pharmacy, COVID-19 Impact, Global Health Collaboration