Assessing the relevance of carbapenem prescriptions by an antibiotic stewardship team

•Five-month prospective study of carbapenem prescriptions in a University Hospital, with rapid responsiveness of the antibiotic stewardship team.•An 82% compliance of carbapenem prescriptions with guidelines; better compliance for empirical prescriptions (91%).•An almost systematic collection of microbiological samples in case of empirical prescriptions to promote de-escalation.•Compliance of first prescribers with the infectious disease specialist's advice improving over the course of the study.•Carbapenem treatment durations no longer than three days in 41% of cases, and no longer than seven days in 71% of cases. To assess the level and factors of compliance of carbapenem prescriptions with guidelines and to determine the impact of an antibiotic stewardship team in a university hospital. Five-month prospective study in the intensive care, surgery, and medicine units to measure the compliance of carbapenem prescriptions with guidelines from French scientific societies; compliance was assessed by an infectious disease specialist warned by the pharmacy, and the prescribers’ compliance with the infectious disease specialist's advice was then assessed. One hundred and four treatment initiations for 94 patients were included. Prescriptions were mostly empirical (64%), for pulmonary (35%), urinary tract (23%), and intra-abdominal (17%) infections. Prescriptions were mostly made in an intensive care unit (50%), by a junior physician (66%), with the use of imipenem (74%), and were followed by an objective reassessment (80%). Compliance with guidelines (82%) was significantly higher for empirical than documented prescriptions (91% vs 65%, P