Antibiotic stewardship (ABS) in intensive care units is confronted with challenges that go beyond a rational assessment of the use of anti-infective substances. Regular analyses of anti-infective prescribing are an essential element of ABS and help to identify areas of ABS activity. Even after 10 years of continuous ABS supervision of an intensive care unit, the need for personnel and time remains high. However, the introduction of an electronically managed patient file makes it significantly easier to prepare and perform ward rounds with focus on ABS. The interdisciplinary discussion at the patient's bedside facilitates the recognition of both intensive care as well as infectious and pharmaceutical aspects of anti-infective therapy evolving in a therapeutic consensus. This requires in-depth clinical experience for all ABS team members. Clinically experienced ward pharmacists can improve communication within the treatment team by being available as an on-site contact person for compatibilities, therapeutic drug monitoring, etc. during a pharmaceutical ward round.