Antimicrobial resistance is one of the major threats to global public health, driven by the indiscriminate use of antibiotics and worsened during the COVID-19 pandemic. This scenario compromises therapeutic effectiveness and increases morbidity, mortality, and hospital costs. Antimicrobial Stewardship Programs (ASP) are recommended by national and international health authorities as a key strategy to promote rational antibiotic use. To implement an electronic tool for auditing and monitoring the consumption of broad-spectrum antimicrobials, focusing on the use of meropenem, polymyxin B, vancomycin, and teicoplanin, as well as to describe the interventions carried out by the hospital infection control service. A retrospective observational study was conducted between July 2024 and January 2025, analyzing 256 prescriptions from hospitalized patients. Data were obtained from the electronic medical record and hospital antimicrobial dispensing reports. The applied metrics were Defined Daily Dose (DDD) and Days of Therapy (DOT). Clinical interventions were classified and their acceptance rate analyzed. Power BI was used to develop interactive dashboards and perform visual data analysis. Among the prescriptions analyzed, 82.8% were empirical. Clinical interventions were performed in 39.4% of cases, with a 98% acceptance rate. The main actions were therapy discontinuation and culture-guided adjustment. Meropenem was the most frequently used agent. The predominant infection focus was respiratory (52.3%), and most audits were performed in intensive care units (84.8%). Temporal variations in DOT and DDD were expressed in graphical format. The implementation of the electronic tool enabled qualified monitoring of antimicrobial use and guided timely clinical interventions, strengthening the institutional stewardship program. Prospective auditing demonstrated a positive impact on prescription rationalization, particularly in ICUs, revealing high consumption rates and frequent need for adjustment. The predominance of empirical therapy, combined with a high acceptance of the recommendations, indicates opportunities for continuous improvement and consolidation of safe prescribing practices in the face of growing microbial resistance.
Correia et al. (Sun,) studied this question.