Improvements in primary care antibiotic use have not been matched in secondary care. [1,2] Although hospitals account for a minority of human antibiotic use, they are where most broad-spectrum antibiotics are prescribed. [1]

A government report published 20 years ago in the UK highlighted the need to address antibiotic overprescribing. [3] Ten years ago, the Government placed statutory responsibility on National Health Service (NHS) hospitals to ensure appropriate antimicrobial use. [4] Three years ago, financial incentives to reduce hospital antibiotic overuse were introduced. [5] In 2018, hospital dispensing of antibiotics, corrected for clinical activity had increased by 7% since 2013. [1]

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