Evaluation of the Rational Use of Broad-Spectrum Antibiotics According to Regulatory Guidelines in Hospitalized Patients: A Descriptive Study

Abstract

Background: Antimicrobial resistance (AMR) is becoming a serious issue for global health, with predictions of up to 10 million deaths each year by 2050. Antimicrobial stewardship programs (ASPs), supported by WHO, CDC, and various health organizations, are designed to improve antibiotic use through guidelines and reviews. Objectives: The present study examined adherence to national guidelines for broad-spectrum antibiotics in patients at Baqiyatallah Hospital in Tehran. Methods: Between November 2024 and March 2025, researchers analyzed 120 hospitalized patients at Baqiyatallah Hospital who were prescribed specific broad-spectrum antibiotics, such as meropenem and vancomycin. They collected information about the patients, lab results, culture findings, and their antibiotic prescriptions. Results: We found that only 33.3% of patients had a consult from infectious diseases (ID) specialists, and just 30% had their prescriptions reviewed by a pharmacist. Cultures were taken from 87.5% of patients. The ID specialists made continuation/discontinuation decisions in only 4 of 184 cases (2.2%). Conclusions: Overall, the use of broad-spectrum antibiotics at this hospital often deviates from the recommended guidelines. Involvement from ID teams and routine checks by pharmacists were not utilized as much as needed. These results indicate a clear need to improve ASPs and increase the involvement of clinical pharmacists to encourage better antibiotic use.