| Abstract [eng] |
SUMMARY Objective. To evaluate the extent of inappropriate antimicrobial use, common prescribing errors, their causes and clinical consequences based on literature review and clinical case analysis. Methods. A literature review was conducted to analyze scientific publications on rational and irrational antibiotic use, common prescribing errors, their determinants and consequences. In addition, a retrospective analysis of 5 clinical cases was performed, assessing antibiotic prescribing indications, adequacy of diagnostic workup, empirical therapy selection, use of microbiological testing, and treatment adjustments. Results. Literature data indicate that inappropriate antibiotic use remains a widespread problem, particularly in primary care, where a substantial proportion of prescriptions are unjustified. The most common errors include prescribing antibiotics without a clear indication of bacterial infection, inappropriate drug selection, excessive use of broad-spectrum antibiotics, prolonged treatment duration, and insufficient use of microbiological diagnostics. Key contributing factors include diagnostic uncertainty, physician-related decision-making factors, patient expectations, and healthcare system characteristics. Inappropriate antibiotic use is associated with adverse outcomes such as side effects, disruption of the microbiota, Clostridioides difficile infection, and the spread of antimicrobial resistance. The analysis of clinical cases demonstrated that antibiotics were frequently prescribed without adequate assessment of infection etiology, without appropriate diagnostic testing, or based on overinterpretation of non-specific inflammatory markers. Unjustified treatment escalation and insufficient integration of microbiological test results into clinical decision-making were also observed. These errors were associated with clinically significant complications, including Clostridioides difficile infection and severe infectious outcomes. Conclusions. Inappropriate antibiotic use remains a common and clinically significant problem. Effective antimicrobial stewardship requires a comprehensive and systematic approach, including rational prescribing, improved diagnostics, and timely adjustment of therapy. Keywords: Antimicrobial use; Antibiotic prescribing errors; Antimicrobial resistance; Rational antibiotic use; Antimicrobial stewardship. |
