Abstract

Relevance. Antimicrobial stewardship (AMS) programmes have become an important strategy for optimising antibiotic use and combating antimicrobial resistance in surgical practice.

Aim. To evaluate the impact of implementing an AMS on antibiotic consumption in an inpatient surgical department.

Materials and methods. A retrospective analysis of antimicrobial consumption was conducted in the surgical department of a university hospital between 2023 and 2025. Consumption was assessed using the defined daily dose (DDD) and DDD per 100 bed-days, with analysis of the prescribing structure according to the WHO AWaRe classification.

Results. Despite an almost fivefold increase in the total volume of antibiotics used, from 558.1 to 2,387.0 DDD, due to a substantial expansion of surgical services, including the treatment of patients with combat-related injuries, the intensity of antibiotic consumption decreased from 33.5 to 6.8 DDD per 100 bed-days. The proportion of Access group antibiotics increased from 5.8% to 57.3%, whereas the proportion of Reserve group antibiotics declined from 82.6% to 4.7%, indicating a more appropriate pattern of use. A marked reduction was observed in the prescribing of third-generation cephalosporins (particularly ceftriaxone, which is classified as a Reserve antibiotic according to the national healthcare standard), as well as other Reserve antibiotics, including colistin and tigecycline. The use of carbapenems and fluoroquinolones also decreased, while the use of aminoglycosides, metronidazole, and clindamycin, all of which belong to the Access group, increased.

Practical significance. The implementation of a comprehensive AMS resulted in more rational antibiotic use, optimisation of prescribing patterns in accordance with the AWaRe classification, and a reduction in the intensity of antibiotic consumption, confirming the effectiveness of a multidisciplinary approach involving a clinical pharmacist in the inpatient surgical setting.