<![CDATA[Antimicrobial resistance is a persistent threat to hospital care, particularly when empirical therapy relies on broad-spectrum antibiotics without continuous evaluation of local use and susceptibility patterns. This literature review aimed to synthesize evidence from four Indonesian hospital-based studies regarding antibiotic utilization, rationality assessment, and bacterial resistance profiles. A structured narrative review was conducted using four selected articles provided by the author. Data were extracted for study design, setting, population, antibiotic evaluation method, dominant antibiotic classes, rationality indicators, resistance profile, and stewardship implications. The four studies were descriptive and hospital-based, using retrospective records, concurrent observation, ATC/DDD with DU 90%, qualitative rationality criteria, and antibiogram data. The synthesis showed a consistent concentration of antibiotic use in broad-spectrum groups, especially third-generation cephalosporins, penicillins, quinolones, and macrolides. In a Bandung public hospital, total antibiotic consumption reached 95,719.01 DDD, with penicillins, cephalosporins, quinolones, macrolides, and sulfonamides included in the DU 90% segment. In intensive care, ceftriaxone was the most frequently used antibiotic and most rationality indicators were appropriate, although clinically significant drug interactions were still identified. In pediatric acute respiratory infection inpatients, cefotaxime and ceftriaxone dominated empirical therapy. Resistance mapping in Denpasar highlighted relevant Gram-positive and Gram-negative pathogens and recommended antibiotics according to susceptibility levels. Overall, the reviewed evidence supports an integrated antimicrobial stewardship model combining ATC/DDD-DU 90% surveillance, qualitative rationality evaluation, antibiogram-based empirical guidance, and periodic feedback to prescribers.]]>
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