Antimicrobial resistance is a major public health problem, and the rational use of antimicrobials is a fundamental strategy to address it. Antimicrobial stewardship programs have proven effective in optimizing antimicrobial therapy, especially in intensive care units (ICUs), where consumption is high (1-3).

To evaluate the trend in antimicrobial consumption in an adult ICU of a private tertiary hospital in Brazil with an active stewardship program.

This was a retrospective descriptive study that assessed monthly antimicrobial consumption data, measured by defined daily dose (DDD), in a 22-bed adult ICU over one year (April 2024 to March 2025) (4). Data were extracted from an automated electronic health record system and organized in spreadsheets. Eight antimicrobials (ceftriaxone, meropenem, piperacillin-tazobactam, polymyxin B sulfate, and ceftazidime-avibactam) were selected based on total DDD during the period, as well as cost and spectrum. A descriptive analysis of monthly trends was performed, along with statistical comparison between the first semester (April to September 2024) and the second semester (October 2024 to March 2025), using the Mann-Whitney test.

A general downward trend was observed in mean monthly DDD from the first to the second semester for all antimicrobials analyzed (ceftriaxone: 187.5–134.4; meropenem: 220.9–159.6; piperacillin-tazobactam: 121.7–102.5; ceftazidime-avibactam: 36.0–13.1; polymyxin B: 15.2–9.5). Despite consistent reductions in means, statistical comparison between semesters did not demonstrate significant differences for any of the antimicrobials (p > 0.05). STATA v17 software was used.

There was a trend of reduced antimicrobial consumption over time, reinforcing the positive impact of an active stewardship program. The lack of statistical significance may be related to monthly variability and the limited number of sampling points. These findings highlight the importance of continuous monitoring of antimicrobial use in intensive care settings.