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Background and Importance Antimicrobial stewardship programmes (ASP) have gained increasing relevance in recent years, particularly in critically ill patients admitted to intensive care units (ICU). These patients often receive multiple antibiotics due to their clinical complexity, which makes stewardship interventions essential for improving treatment adequacy and reducing unnecessary exposure.Aim and Objectives To evaluate the acceptance rate of antibiotic stewardship interventions in critically ill patients.Material and Methods A retrospective, observational, single-centre study was conducted over six months (January–June 2024). All ASP interventions regarding antimicrobial therapy in ICU patients were included. Interventions were classified as antibiotic discontinuation, de-escalation, pharmacokinetic/pharmacodynamic (pK/pD) optimisation, escalation, and requests for additional diagnostic tests such as blood cultures.Results A total of 197 recommendations were issued, of which 84.7% (n=167) were accepted by treating physicians.The most frequent intervention was antibiotic discontinuation (n=111), accepted in 82.9% (n=92) of cases. Agents most frequently discontinued were J01XX group antibiotics (linezolid, tedizolid, daptomycin) (n=46), with an acceptance rate of 82.6% (n=38).De-escalation accounted for 19.8% (n=39) of interventions, with 82.1% acceptance (n=32). The most frequent targets were ceftolozane/tazobactam, ceftazidime/avibactam, and ceftaroline (n=18), accepted in 66.7% (n=12), followed by carbapenems (n=10), accepted in 90% (n=9). pK/pD optimisation (n=14) achieved the highest acceptance rate among major interventions (85.7%, n=12). Escalation was proposed in 12 cases, accepted in 91.7% (n=11). Additional diagnostic tests were recommended in 13 cases, with full acceptance (100%).Conclusion and Relevance Antibiotic discontinuation was the most frequent ASP intervention, whereas de-escalation and pK/pD optimisation achieved the highest acceptance rates. Overall, the high acceptance rate (84.7%) highlights the value of multidisciplinary stewardship teams in optimising antimicrobial therapy and ensuring adequate treatment of critically ill patients. The hospital pharmacist plays a key role in this team due to their knowledge of these medications.Conflict of Interest No conflict of interest