Background and objective:
Antibiotic resistance has been identified by the European Center for Disease Prevention and Control (ECDC) as a public health emergency and by the World Health Organization in 2019 as one of the ten threats to global health. The aim of our research was to assess the use of antibiotics in surgical wards.

Methods:
The study was conducted in November 2022 in the Azienda Ospedaliera Universitaria delle Marche, according to the protocol proposed by the ECDC (PPS3). All patients admitted to the wards at or before 8 a.m. and not discharged at the time of the survey have been included. For the surgical area all following departments have been included: Cardiac Surgery, Neurosurgery, Otorhinolaryngology, Breast Surgery, Transplant Surgery, Maxillofacial Surgery, Hand Surgery, Thoracic Surgery, Plastic Surgery, Vascular Surgery, General and Emergency Surgery, Orthopedics, Urology, Gynecology and Pediatric Surgery.

Results:
Of the 239 patients included, 53.6% were females and 46.4% males. The 60.7% (N=145) of the total, had already undergone invasive surgery and 45.2% (N=108) were taking antibiotics. The most commonly used antibiotics were cefazolin (25.4%, N=34), amoxicillin/clavulanic acid (13.4%, N=18) and piperacillin/tazobactam (11.9%, N=16). Among the patients on antibiotic therapy, 22.2% (N=24) were being treated for a hospital acquired infection, 11.1% (N=12) for a community infection, 11.1% (N=12) for medical prophylaxis and 55.6% (N=60) for surgical prophylaxis; in 58.3% (N=35) of these patients, prophylaxis had been prolonged for more than one day.

Conclusions:
Overall, the significant use of antibiotics is consistent, as 45.2% (N=108) of patients were taking at least one antibiotic at the time of the survey. Although surgical prophylaxis depends on the type of surgery, given the high percentage of prophylaxis lasting for more than one day, we can conclude that further development is necessary to implement additional strategies to promote surgical antibiotic stewardship at hospitals.