TRENDS IN ANTIBIOTIC USAGE AT A SPECIALIZED OBSTETRICS AND GYNECOLOGY HOSPITAL IN VARNA, BULGARIA (2017–2023): A RETROSPECTIVE ANALYSIS

Objective: Antimicrobial resistance (AMR) poses one of the greatest global health challenges, with inappropriate antibiotic prescribing in hospitals recognized as a major driver. This study aimed to evaluate antibiotic consumption trends in the Specialized Hospital for Obstetrics and Gynecology for Active Treatment “Prof. Dr. Dimitar Stamatov” (SHOGAT), Varna, Bulgaria, over a seven-year period (2017–2023), including the COVID-19 pandemic years. Material and Method: A retrospective observational analysis was performed using the hospital’s complete antimicrobial usage database. Antibiotics were classified according to the WHO ATC/DDD methodology and expressed as defined daily doses (DDD) per 100 bed-days across four wards: Intensive Care Unit, Gynecology Ward, Maternity Ward, and High-Risk Pregnancy Ward. Classification of antibiotic use followed the WHO AWaRe framework into Access, Watch, and Reserve groups. Result and Discussion: The results demonstrate that cephalosporins, fluoroquinolones, and metronidazole were the most commonly prescribed agents, with a peak in total antibiotic use during 2020, coinciding with the onset of the COVID-19 pandemic, followed by a gradual decline. Overall, 58.37% of antibiotics belonged to the Access group, while 41.63% were from the Watch group; no use of Reserve antibiotics was recorded. The consistently low and well-regulated consumption underscores the importance of surveillance, strict protocols, and institutional commitment to rational antibiotic use.