Antibiotic Consumption Patterns in Three Romanian Hospitals: A Five-Year Retrospective Study

Background: Monitoring antibiotic consumption represents an important objective for antimicrobial stewardship programs in hospitals. The aim of this study was to analyze antibiotic consumption patterns in three Romanian hospitals. Methods: A five-year retrospective study was conducted using monthly pharmacy consumption data from three Romanian hospitals for the years 2018, 2019, 2023, 2024, and 2025. Antibiotic consumption was quantified using defined daily doses (DDD) per 100 bed-days. Antibiotics were grouped using the World Health Organization AWaRe (Access, Watch, Reserve) classification. Results: The analysis revealed statistically significant differences in overall antibiotic consumption among the three hospitals (p < 0.001). A significant annual correlation between hospitalization days and antibiotic consumption was observed for some years in two of the facilities. Post hoc analysis confirmed statistically significant differences across all AWaRe category pairwise comparisons. Watch antibiotics had the highest consumption rates (over 60%). By therapeutic classes, the highest overall consumption was for cephalosporins, fluoroquinolones, penicillins, and carbapenems. Cefuroxime accounted for the highest cumulative consumption, followed by ceftriaxone, meropenem, vancomycin, ciprofloxacin, and metronidazole. Conclusions: Antibiotic consumption differed among the participating hospitals and study years. Monitoring antibiotic consumption provides valuable information on hospital antibiotic utilization patterns and can support evidence-based antimicrobial stewardship in hospitals.