Introduction The COVID-19 pandemic has highlighted the critical need for resilient healthcare systems capable of swift response and adaptation, particularly in light of the ongoing global threat of antibiotic resistance. Hospitals in Abu Dhabi, UAE, are not exempted and must establish robust antibiotic stewardship programs capable of navigating any pandemic, ensuring judicious antibiotic use while maintaining high standards of care and optimal patient outcomes. This study seeks to evaluate the maturity levels of antibiotic stewardship programs in a general hospital to assess preparedness for such health crises. By analyzing data from non-surgical hospitalized patients in a specific age bracket, the study examines prescribing practices, program efficacy, and the hospital's overall readiness to manage infectious disease outbreaks. The findings will guide efforts to strengthen antibiotic stewardship and improve pandemic readiness across healthcare settings. Methods The retrospective observational study focused on non-surgical hospitalized patients aged 25-40 from January to December 2019. Data were collected from electronic medical records between March 2023 and February 2024, using a predefined set of International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes related to respiratory tract infections, urinary tract infections, ventilator-associated pneumonia, and nosocomial infections. The study evaluated clinicians' prescribing habits, antibiotic consumption, stewardship interventions, and the overall impact on the healthcare system to assess the implementation and maturity levels of the antibiotic stewardship program. Results A study of 240 cases involving 229 patients revealed significant findings in antibiotic use and resistance patterns based on predefined criteria. The average duration of antibiotic use per patient was 6.23 days. Duplicate anaerobic therapy was identified in 4.58% of cases.Escherichia coli,Klebsiella pneumoniae,Enterobacter spp., andProteus spp. showed reduced susceptibility to multiple antibiotics.Citrobacter spp. were fully resistant to one antibiotic and had low susceptibility to another.Haemophilus influenzae,Salmonella spp.,Staphylococcus spp.,Streptococcusspp., andEnterococcus spp.displayed varying degrees of reduced susceptibility. Of the cases, 91.66% (n = 220) received antibiotics within 24 hours of admission, with 98.63% (n = 217) receiving empirical therapy. Inaccurate empirical decisions correlated with longer hospital stays (4.45 versus 3.36 days). Appropriate antibiotic stewardship was observed in only 2.35% of cases during stays exceeding three days and 16.47% at discharge. Recommendation A further longitudinal study is recommended to compare how these results contribute to our understanding of the impact of the COVID-19 pandemic on antibiotic stewardship practices, resistance trends, and clinicians' prescribing habits in non-surgical hospitals in Abu Dhabi. Conclusion The review highlighted key aspects of existing stewardship practices. While most patients received empirical therapy, issues such as duplicate anaerobic therapy and a concerning decline in antibiotic susceptibility were identified. Inaccurate empirical decisions were associated with longer hospital stays. The limited instances of appropriate stewardship conduct suggest a need for better adherence to antibiotic management practices and enhanced preparedness for future healthcare challenges.

Human subjects: Consent was obtained or waived by all participants in this study. The Institutional Review Board of Burjeel Holdings and the Department of Health Abu Dhabi Health Research and Technology Ethics Committee issued approval BH/REC/039/22 and DOH/CVDC/2023/512, respectively. Approval was issued by the Institutional Review Board of Burjeel Holdings on 20/01/2023 and by the Department of Health Abu Dhabi Health Research and Technology Ethics Committee on 02/03/2023. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.