Background and Objective: To evaluate non-adherence to guideline on rational antibioticotherapy, proportions of hospital infections and empirical treatments in antibioticotherapy, and the need for making intervention to non-rational antibiotics prescriptions. Design: Observational study of non-adherence to guidelines on rational antibioticotherapy. Analysis of antibiotics prescriptions in tertiary hospital settings. Setting: 34 wards in tertiary hospital - University hospital at Kaunas University of Medicine. Main Outcome Measures: Proportions of non-rational treatment. Results: 331 (29,82%) patient of 1110, received antibiotics prescription. 166 (50.15%) rescriptions for treatment and 165 (49.75 %) for prophylaxis. Empiric treatment 279 (84.29%) cases, 52 (15.71%) treatment cases based on bacteriological analysis. Community infections 111 (67.27%) cases. 206 (62,24%) prescriptions were non-adherent to guidelines rational antibioticotherapy. Correlation of non-adherence with rational antibioticotherapy for hospital and community infections was found as r = 0.43 (P < 0.05) and 0.64 (P < 0.01), correspondingly; and for empiric treatment and treatment based on bacteriological analysis as r=0.8 (P < 0.01) and 0.06 (P > 0.05), correspondingly. Conclusions: Empirical treatments in hospital settings comprise high (84%) proportion of cases of antibioticotherapy. Hospital infections comprise high (33%) proportion of infections in hospital settings. Prescription analysis has shown... [to full text]