Objective To explore the assessment modes of outpatient and emergency antimicrobial prescriptions, and provide reference for the use and management of antimicrobial agents. Methods Outpatient and emergency antimicrobial prescriptions in a hospital from February 2015 to August 2019 were randomly selected by prescription assessment software. The irrational prescriptions of antimicrobial agents and involved problems were initially assessed by dispensing pharmacists and clinical pharmacists and then re-assessed by experts, the irrational prescriptions of antimicrobial agents in different years and inconsistent assessment between clinical pharmacists and experts were compared. Results The inappropriate prescription rate of outpatient antimicrobial agents decreased from 1.05% (372/35 446) in 2015 to 0.18% (73/39 719) in 2019, and that in emergency department decreased from 0.43% (75/17 432) in 2015 to 0.13% (24/18 657) in 2019, presenting a downward trend year by year. The main inappropriate prescription of antimicrobial agents was inappropriate usage and dosage (1 209/1 468, 82.36%). From 2015 to 2019, the inconsistency rates of initial assessment of clinical pharmacists and the re-assessment of experts were 10.29%-12.46%. Conclusion Management of antimicrobial agents is quite effective, and assessment process and method of prescription should be improved in the future.