Abstract
Background. Rational use of antibacterial agents is a key component of healthcare quality and an essential strategy to mitigate antimicrobial resistance, which is recognized as one of the leading global threats to public health.
Aim: to assess the quality of antibiotic therapy in a hospital setting through a retrospective clinical audit, with a focus on compliance with clinical recommendations, appropriateness of treatment parameters, and the practice of 48-hour antibiotic review in 2024, as well as adherence to key quality indicators defined by the national standard of the Ministry of Health of Ukraine No. 823.
Materials and methods. A single-center retrospective descriptive study was conducted in the format of a clinical audit. A total of 177 episodes of antibiotic therapy administered in a hospital setting between January and December 2024 were analyzed. The assessment included documentation of prescribing indications, compliance of antibiotic selection with clinical recommendations, appropriateness of dose, route of administration, and treatment duration, as well as the presence and outcomes of the 48-hour antibiotic review. Statistical analysis was descriptive, and results were presented as n/N (%) with corresponding 95% confidence intervals.
Results. A standardized antibiotic prescription form was present in 93.2% of clinical episodes, and documented indications were recorded in 74.6%. Antibiotic selection was consistent with applicable clinical recommendations in 94.1% of cases. A documented 48-hour antibiotic review was performed in 88.7% of clinical episodes; among these, antibiotic therapy was discontinued in 49.0% and de-escalated in 38.2% of cases. Combination therapy was used as an empirical initial strategy in 67.2% of clinical episodes; however, in most cases it was subsequently de-escalated or discontinued following reassessment. Microbiological sampling was performed in 92.0% of cases, although microbiological results influenced antibiotic selection in only 40.0% of episodes with available data. Conclusions. The clinical audit demonstrated a high level of adherence to the principles of rational antibiotic use and effective implementation of documented reassessment at 48 hours as a standardized time point within the recommended 48-72-hour review interval. At the same time, areas with potential for further improvement were identified, including enhancing completeness of documentation of prescribing indications and strengthening the systematic use of microbiological findings to optimize antibiotic therapy in accordance with national quality indicators defined by the Ministry of Health of Ukraine No. 823. A structured approach to antibiotic prescribing and reassessment represents an effective mechanism for improving the quality of medical care