Antibiotic Prescribing Practices and Antimicrobial Stewardship Among Obstetrician-Gynecologists in Tertiary Maternity Care

Background: Rational antibiotic use is essential in maternity care because inappropriate prescribing may contribute to antimicrobial resistance. This study assessed antibiotic prescribing practices, self-reported knowledge, and training needs among obstetrician-gynecologists. Methods: A cross-sectional descriptive survey was conducted among 60 obstetrician-gynecologists working in two tertiary-level maternity facilities in Almaty, Kazakhstan, from June to August 2026. Data were collected using an anonymous structured questionnaire and analyzed using descriptive statistics, chi-square tests, and Fisher’s exact tests. Results: Most respondents reported always following clinical protocols (86.7%) and using antibiotic susceptibility results to guide antibiotic selection (63.3%). Cephalosporins were the predominant antibiotic group (93.3%). Microbiological testing was reported as always or frequently performed by 73.3% of respondents, while empirical therapy was reported as always or frequently used by 53.3%. Cesarean delivery was the main reported indication for prophylaxis (60.0%), and 90.0% reported using a single prophylactic dose. Only 40.0% had received antibiotic-related training during the previous three years, while all respondents reported a need for additional training. Recent training was significantly associated with higher self-rated knowledge (91.7% vs. 5.6%, p<0.001), frequent/routine microbiological testing (100.0% vs. 55.6%, p<0.001), and empirical therapy (75.0% vs. 38.9%, p=0.008). Conclusion: The findings indicate generally high reported adherence to protocols but persistent gaps in microbiological testing, empirical antibiotic use, and professional education. Strengthening antimicrobial stewardship training, microbiological diagnostic capacity, and evidence-based prescribing protocols may support more rational antibiotic use in tertiary maternity care.