Skip to content
2000
image of Optimizing Antibiotic Use and Awareness in Hospitals: Establishing Effective Antimicrobial Stewardship Pathways

Abstract

Intorduction

Antibiotic resistance poses a significant challenge in healthcare, requiring effective management of antibiotic use. This study examines systemic antibiotic consumption at ASST Bergamo Ovest, a northern Italian hospital, from January 2022 to June 2023, with a focus on Healthcare-Associated Infections (HAIs) and prescription appropriateness. This retrospective observational study aims to analyze antibiotic usage trends and to evaluate prescribing practices against national guidelines.

Methods

Data on systemic antibiotic consumption were reviewed, categorized by the AWaRe classification system (Access, Watch, Reserve), and analyzed using the Defined Daily Dose per 100 patient-days metric.

Results

The study observed a 7% overall reduction in antibiotic use, including a 5% decrease in the AWaRe Watch category. Despite this progress, the appropriateness of prescribing remained consistently low. These findings suggest partial alignment with the Italian Plan against Antibiotic Resistance but highlight the need for improvement in prescribing practices.

Discussion

While ASST Bergamo Ovest has reduced antibiotic consumption and the use of higher-risk antibiotics, low prescribing appropriateness underscores the need for enhanced real-time monitoring and more effective stewardship programs.

Conclusion

Targeted interventions are essential to improve prescribing practices, combat multidrug-resistant infections, and meet European antibiotic stewardship standards.

© 2025 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/cds/10.2174/0115748863357518250419160411
2025-05-09
2025-09-16

  • From This Site

    /content/journals/cds/10.2174/0115748863357518250419160411
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. Akram F. Imtiaz M. Haq I. Emergent crisis of antibiotic resistance: A silent pandemic threat to 21st century. Microb. Pathog. 2023 174 105923 10.1016/j.micpath.2022.105923 36526035
    [Google Scholar]
  2. Murray C.J.L. Ikuta K.S. Sharara F. Swetschinski L. Robles Aguilar G. Gray A. Han C. Bisignano C. Rao P. Wool E. Johnson S.C. Browne A.J. Chipeta M.G. Fell F. Hackett S. Haines-Woodhouse G. Kashef Hamadani B.H. Kumaran E.A.P. McManigal B. Achalapong S. Agarwal R. Akech S. Albertson S. Amuasi J. Andrews J. Aravkin A. Ashley E. Babin F-X. Bailey F. Baker S. Basnyat B. Bekker A. Bender R. Berkley J.A. Bethou A. Bielicki J. Boonkasidecha S. Bukosia J. Carvalheiro C. Castañeda-Orjuela C. Chansamouth V. Chaurasia S. Chiurchiù S. Chowdhury F. Clotaire Donatien R. Cook A.J. Cooper B. Cressey T.R. Criollo-Mora E. Cunningham M. Darboe S. Day N.P.J. De Luca M. Dokova K. Dramowski A. Dunachie S.J. Duong Bich T. Eckmanns T. Eibach D. Emami A. Feasey N. Fisher-Pearson N. Forrest K. Garcia C. Garrett D. Gastmeier P. Giref A.Z. Greer R.C. Gupta V. Haller S. Haselbeck A. Hay S.I. Holm M. Hopkins S. Hsia Y. Iregbu K.C. Jacobs J. Jarovsky D. Javanmardi F. Jenney A.W.J. Khorana M. Khusuwan S. Kissoon N. Kobeissi E. Kostyanev T. Krapp F. Krumkamp R. Kumar A. Kyu H.H. Lim C. Lim K. Limmathurotsakul D. Loftus M.J. Lunn M. Ma J. Manoharan A. Marks F. May J. Mayxay M. Mturi N. Munera-Huertas T. Musicha P. Musila L.A. Mussi-Pinhata M.M. Naidu R.N. Nakamura T. Nanavati R. Nangia S. Newton P. Ngoun C. Novotney A. Nwakanma D. Obiero C.W. Ochoa T.J. Olivas-Martinez A. Olliaro P. Ooko E. Ortiz-Brizuela E. Ounchanum P. Pak G.D. Paredes J.L. Peleg A.Y. Perrone C. Phe T. Phommasone K. Plakkal N. Ponce-de-Leon A. Raad M. Ramdin T. Rattanavong S. Riddell A. Roberts T. Robotham J.V. Roca A. Rosenthal V.D. Rudd K.E. Russell N. Sader H.S. Saengchan W. Schnall J. Scott J.A.G. Seekaew S. Sharland M. Shivamallappa M. Sifuentes-Osornio J. Simpson A.J. Steenkeste N. Stewardson A.J. Stoeva T. Tasak N. Thaiprakong A. Thwaites G. Tigoi C. Turner C. Turner P. van Doorn H.R. Velaphi S. Vongpradith A. Vongsouvath M. Vu H. Walsh T. Walson J.L. Waner S. Wangrangsimakul T. Wannapinij P. Wozniak T. Young Sharma T.E.M.W. Yu K.C. Zheng P. Sartorius B. Lopez A.D. Stergachis A. Moore C. Dolecek C. Naghavi M. Global burden of bacterial antimicrobial resistance in 2019: A systematic analysis. Lancet 2022 399 10325 629 655 10.1016/S0140‑6736(21)02724‑0 35065702
    [Google Scholar]
  3. Collignon P. Beggs J.J. Walsh T.R. Gandra S. Laxminarayan R. Anthropological and socioeconomic factors contributing to global antimicrobial resistance: A univariate and multivariable analysis. Lancet Planet. Health 2018 2 9 e398 e405 10.1016/S2542‑5196(18)30186‑4 30177008
    [Google Scholar]
  4. Gugliotta C. Deiana G. Dettori M. Sotgiu G. Azara A. Castiglia P. Prevalence study on health-care associated infections and on the use of antimicrobials carried out with the light protocol of the European Centre for disease prevention and control. Ann. Ig. 2020 32 4 357 367 10.7416/ai.2020.2359 32744294
    [Google Scholar]
  5. Klein E.Y. Van Boeckel T.P. Martinez E.M. Pant S. Gandra S. Levin S.A. Goossens H. Laxminarayan R. Global increase and geographic convergence in antibiotic consumption between 2000 and 2015. Proc. Natl. Acad. Sci. USA 2018 115 15 E3463 E3470 10.1073/pnas.1717295115 29581252
    [Google Scholar]
  6. Olise C. Simon-Oke I. Fomites: Possible vehicle of nosocomial infections. J. Public Health Nutr. 2018 1 1
    [Google Scholar]
  7. Paitan Y. Current trends in antimicrobial resistance of Escherichia coli. Curr. Top. Microbiol. Immunol. 2018 416 181 211 10.1007/82_2018_110 30088148
    [Google Scholar]
  8. Suthar AB Moonan PK Alexander HL Towards national systems for continuous surveillance of antimicrobial resistance: Lessons from tuberculosis. PLoS Med. 2018 15 9 e1002658 10.1371/journal.pmed.1002658
    [Google Scholar]
  9. Versporten A Zarb P Caniaux I Gros M-F Drapier N Miller M Antimicrobial consumption and resistance in adult hospital inpatients in 53 countries: Results of an internet-based global point prevalence survey. Lancet Glob. Health 2018 6 6 e619 e629 10.1016/S2214‑109X(18)30186‑4
    [Google Scholar]
  10. Methodological principles of nationally representative surveys as a platform for global surveillance of antimicrobial resistance in human bloodstream infections. 2023 Available from: https://www.who.int/publications/i/item/9789240067004
  11. Proposals for EU guidelines on the prudent use of anti-microbials in humans. 2017 Available from: https://www.ecdc.europa.eu/sites/default/files/media/en/publications/Publications/EU-guidelines-prudent-use-antimicrobials.pdf
  12. Antibiotic Resistance Threats in the United States 2019 Available from: http://www.cdc.gov/DrugResistance/Biggest-Threats.html
  13. Core Ele-ments of Hospital Antibiotic Stewardship Programs. 2014 Available from: https://www.cdc.gov/antibiotic-use/healthcare/pdfs/core-elements.pdf
  14. Magill S.S. O’Leary E. Janelle S.J. Thompson D.L. Dumyati G. Nadle J. Wilson L.E. Kainer M.A. Lynfield R. Greissman S. Ray S.M. Beldavs Z. Gross C. Bamberg W. Sievers M. Concannon C. Buhr N. Warnke L. Maloney M. Ocampo V. Brooks J. Oyewumi T. Sharmin S. Richards K. Rainbow J. Samper M. Hancock E.B. Leaptrot D. Scalise E. Badrun F. Phelps R. Edwards J.R. Changes in prevalence of health care–Associated infections in U.S. hospitals. N. Engl. J. Med. 2018 379 18 1732 1744 10.1056/NEJMoa1801550 30380384
    [Google Scholar]
  15. Cassini A. Högberg L.D. Plachouras D. Quattrocchi A. Hoxha A. Simonsen G.S. Colomb-Cotinat M. Kretzschmar M.E. Devleesschauwer B. Cecchini M. Ouakrim D.A. Oliveira T.C. Struelens M.J. Suetens C. Monnet D.L. Strauss R. Mertens K. Struyf T. Catry B. Latour K. Ivanov I.N. Dobreva E.G. Tambic Andraševic A. Soprek S. Budimir A. Paphitou N. Žemlicková H. Schytte Olsen S. Wolff Sönksen U. Märtin P. Ivanova M. Lyytikäinen O. Jalava J. Coignard B. Eckmanns T. Abu Sin M. Haller S. Daikos G.L. Gikas A. Tsiodras S. Kontopidou F. Tóth Á. Hajdu Á. Guólaugsson Ó. Kristinsson K.G. Murchan S. Burns K. Pezzotti P. Gagliotti C. Dumpis U. Liuimiene A. Perrin M. Borg M.A. de Greeff S.C. Monen J.C.M. Koek M.B.G. Elstrøm P. Zabicka D. Deptula A. Hryniewicz W. Caniça M. Nogueira P.J. Fernandes P.A. Manageiro V. Popescu G.A. Serban R.I. Schréterová E. Litvová S. Štefkovicová M. Kolman J. Klavs I. Korošec A. Aracil B. Asensio A. Pérez-Vázquez M. Billström H. Larsson S. Reilly J.S. Johnson A. Hopkins S. Attributable deaths and disability-adjusted life-years caused by infections with antibiotic-resistant bacteria in the EU and the European Economic Area in 2015: A population-level modelling analysis. Lancet Infect. Dis. 2019 19 1 56 66 10.1016/S1473‑3099(18)30605‑4 30409683
    [Google Scholar]
  16. Health workers’ education and training on antimicrobial resistance 2019 Available from: https://iris.who.int/bitstream/handle/10665/329380/9789241516358-eng.pdf
  17. Allegranzi B. Bagheri Nejad S. Combescure C. Graafmans W. Attar H. Donaldson L. Burden of endemic health-care-associated infection in developing countries: Systematic review and meta-analysis. Lancet 2011 377 9761 228 241 10.1016/S0140‑6736(10)61458‑4
    [Google Scholar]
  18. Ayobami O. Brinkwirth S. Eckmanns T. Markwart R. Antibiotic resistance in hospital-acquired ESKAPE-E infections in low- and lower-middle-income countries: A systematic review and meta-analysis. Emerg. Microbes Infect. 2022 11 1 443 451 10.1080/22221751.2022.2030196 35034585
    [Google Scholar]
  19. Bhowmik T. Eluru N. A comprehensive county level model to identify factors affecting hospital capacity and predict future hospital demand. Sci. Rep. 2021 11 1 23098 10.1038/s41598‑021‑02376‑y 34845301
    [Google Scholar]
  20. Bjark P.H. Hansen E. Lingaas E. In-hospital deaths attributable to healthcare-associated infections. Tidsskr. Nor. Laegeforen. 2020 140 6 32321217
    [Google Scholar]
  21. Boncea E.E. Expert P. Honeyford K. Kinderlerer A. Mitchell C. Cooke G.S. Mercuri L. Costelloe C.E. Association between intrahospital transfer and hospital-acquired infection in the elderly: A retrospective case–control study in a UK hospital network. BMJ Qual. Saf. 2021 30 6 457 466 10.1136/bmjqs‑2020‑012124 33495288
    [Google Scholar]
  22. Gazzarata R. Monteverde M.E. Ruggiero C. Maggi N. Palmieri D. Parruti G. Giacomini M. Healthcare associated infections: An interoperable infrastructure for multidrug resistant organism surveillance. Int. J. Environ. Res. Public Health 2020 17 2 465 10.3390/ijerph17020465 31936787
    [Google Scholar]
  23. Balasubramanian R. Van Boeckel T.P. Carmeli Y. Cosgrove S. Laxminarayan R. Global incidence in hospital-associated infections resistant to antibiotics: An analysis of point prevalence surveys from 99 countries. PLoS Med. 2023 20 6 e1004178 10.1371/journal.pmed.1004178
    [Google Scholar]
  24. Hazard D. Predicting potential prevention effects on hospital burden of nosocomial infections: A multistate modeling approach Value Health 2021 24 6 830 838 10.1016/j.jval.2021.02.002
    [Google Scholar]
  25. Klevens R.M. Edwards J.R. Richards C.L. Jr Horan T.C. Gaynes R.P. Pollock D.A. Cardo D.M. Estimating health care-associated infections and deaths in U.S. hospitals, 2002. Public Health Rep. 2007 122 2 160 166 10.1177/003335490712200205 17357358
    [Google Scholar]
  26. Manoukian S. Stewart S. Dancer S. Graves N. Mason H. McFarland A. Robertson C. Reilly J. Estimating excess length of stay due to healthcare-associated infections: A systematic review and meta-analysis of statistical methodology. J. Hosp. Infect. 2018 100 2 222 235 10.1016/j.jhin.2018.06.003 29902486
    [Google Scholar]
  27. Raoofi S. Pashazadeh Kan F. Rafiei S. Hosseinipalangi Z. Noorani Mejareh Z. Khani S. Abdollahi B. Seyghalani Talab F. Sanaei M. Zarabi F. Dolati Y. Ahmadi N. Raoofi N. Sarhadi Y. Masoumi M. sadat Hosseini B. Vali N. Gholamali N. Asadi S. Ahmadi S. Ahmadi B. Beiramy Chomalu Z. Asadollahi E. Rajabi M. Gharagozloo D. Nejatifar Z. Soheylirad R. Jalali S. Aghajani F. Navidriahy M. Deylami S. Nasiri M. Zareei M. Golmohammadi Z. Shabani H. Torabi F. Shabaninejad H. Nemati A. Amerzadeh M. Aryankhesal A. Ghashghaee A. Global prevalence of nosocomial infection: A systematic review and meta-analysis. PLoS One 2023 18 1 e0274248 10.1371/journal.pone.0274248 36706112
    [Google Scholar]
  28. Roberts R.R. Costs attributable to healthcare-acquired infection in hospitalized adults and a comparison of economic methods. Med. Care 2010 48 11 1026 1035 10.1097/MLR.0b013e3181ef60a2
    [Google Scholar]
  29. Sax H. Schreiber P.W. Clack L. Ratz D. Saint S. Greene M.T. Kuster S.P. Preventing healthcare-associated infection in Switzerland: Results of a national survey. Infect. Control Hosp. Epidemiol. 2020 41 5 597 600 10.1017/ice.2019.351 32279671
    [Google Scholar]
  30. Stewart S. Robertson C. Pan J. Kennedy S. Haahr L. Manoukian S. Mason H. Kavanagh K. Graves N. Dancer S.J. Cook B. Reilly J. Impact of healthcare-associated infection on length of stay. J. Hosp. Infect. 2021 114 23 31 10.1016/j.jhin.2021.02.026 34301393
    [Google Scholar]
  31. Weiner-Lastinger L.M. Abner S. Edwards J.R. Kallen A.J. Karlsson M. Magill S.S. Pollock D. See I. Soe M.M. Walters M.S. Dudeck M.A. Antimicrobial-resistant pathogens associated with adult healthcare-associated infections: Summary of data reported to the National Healthcare Safety Network, 2015–2017. Infect. Control Hosp. Epidemiol. 2020 41 1 1 18 10.1017/ice.2019.296 31767041
    [Google Scholar]
  32. GLASS method for estimating attributable mortality of antimicrobial resistant bloodstream infections. 2020 Available from: https://www.who.int/ publications/i/item/9789240000650
  33. Prevention of hospital-acquired infections: A practical guide 2002 Available from: https://apps.who.int/iris/handle/10665/67350
  34. AIFA 2023 “.Manuale antibiotici AWaRe”, traduzione de “The WHO AWaRe Antibiotic Book”, OMS 2022 cited 2024 May 10 Available from: 147 otici_AWaRe.pdf
    [Google Scholar]
  35. Canabal R. González-Bello C. Chemical sensors for the early diagnosis of bacterial resistance to β-lactam antibiotics. Bioorg. Chem. 2024 150 107528 10.1016/j.bioorg.2024.107528 38852309
    [Google Scholar]
  36. Eisenreich W. Rudel T. Heesemann J. Goebel W. Link between antibiotic persistence and antibiotic resistance in bacterial pathogens. Front. Cell. Infect. Microbiol. 2022 12 900848 10.3389/fcimb.2022.900848 35928205
    [Google Scholar]
  37. Goossens H. Sprenger M.J.W. Community acquired infections and bacterial resistance. BMJ 1998 317 7159 654 657 10.1136/bmj.317.7159.654 9727998
    [Google Scholar]
  38. Laxminarayan R. Duse A. Wattal C. Zaidi A.K.M. Wertheim H.F.L. Sumpradit N. Vlieghe E. Hara G.L. Gould I.M. Goossens H. Greko C. So A.D. Bigdeli M. Tomson G. Woodhouse W. Ombaka E. Peralta A.Q. Qamar F.N. Mir F. Kariuki S. Bhutta Z.A. Coates A. Bergstrom R. Wright G.D. Brown E.D. Cars O. Antibiotic resistance—The need for global solutions. Lancet Infect. Dis. 2013 13 12 1057 1098 10.1016/S1473‑3099(13)70318‑9 24252483
    [Google Scholar]
  39. Mehrad B. Clark N.M. Zhanel G.G. Lynch J.P. III Antimicrobial resistance in hospital-acquired gram-negative bacterial infections. Chest 2015 147 5 1413 1421 10.1378/chest.14‑2171 25940252
    [Google Scholar]
  40. Pulingam T. Parumasivam T. Gazzali A.M. Sulaiman A.M. Chee J.Y. Lakshmanan M. Chin C.F. Sudesh K. Antimicrobial resistance: Prevalence, economic burden, mechanisms of resistance and strategies to overcome. Eur. J. Pharm. Sci. 2022 170 106103 10.1016/j.ejps.2021.106103 34936936
    [Google Scholar]
  41. Sheikh B.A. Bhat B.A. Mir M.A. Antimicrobial resistance: New insights and therapeutic implications. Appl. Microbiol. Biotechnol. 2022 106 19-20 6427 6440 10.1007/s00253‑022‑12175‑8 36121484
    [Google Scholar]
  42. Singh A. Amod A. Pandey P. Bose P. Pingali M.S. Shivalkar S. Varadwaj P.K. Sahoo A.K. Samanta S.K. Bacterial biofilm infections, their resistance to antibiotics therapy and current treatment strategies. Biomed. Mater. 2022 17 2 022003 10.1088/1748‑605X/ac50f6 35105823
    [Google Scholar]
  43. Šuljagić V. Bajčetić M. Mioljević V. Dragovac G. Mijović B. Janićijević I. Đorđević Z. Krtinić G. Rakić V. Ćirković I. Nikolić V. Marković-Denić L. A nationwide assessment of the burden of healthcare-associated infections and antimicrobial use among surgical patients: Results from Serbian point prevalence survey, 2017. Antimicrob. Resist. Infect. Control 2021 10 1 47 10.1186/s13756‑021‑00889‑9 33676578
    [Google Scholar]
  44. WHO guidelines on hand hygiene in health care: First global patient safety challenge clean care is safer care 2009 Available from: https://www.ncbi.nlm.nih.gov/books/NBK144013/pdf/Bookshelf_NBK144013.pdf
  45. Bertagnolio S. Suthar A.B. Tosas O. Van Weezenbeek K. Antimicrobial resistance: Strengthening surveillance for public health action. PLoS Med. 2023 20 7 e1004265 10.1371/journal.pmed.1004265 37436833
    [Google Scholar]
  46. Bordino V. Vicentini C. D’Ambrosio A. Quattrocolo F. Zotti C.M. Novati R. Sticchi C. Bersani M. Fedeli U. Fabbri L. Brusaferro S. Moro M.L. Ricchizzi E. Poli A. Giovannini G. D’Errico M. Puro V. Parruti G. Ripabelli G. Sarnelli B. Prato R. Pavia M. Agodi A. Mura I. Burden of healthcare-associated infections in Italy: Incidence, attributable mortality and disability-adjusted life years (DALYs) from a nationwide study, 2016. J. Hosp. Infect. 2021 113 164 171 10.1016/j.jhin.2021.04.023 33940090
    [Google Scholar]
  47. Friedrich A.W. Control of hospital acquired infections and antimicrobial resistance in Europe: The way to go. Wien. Med. Wochenschr. 2019 169 S1 Suppl. 1 25 30 10.1007/s10354‑018‑0676‑5 30623278
    [Google Scholar]
  48. Hu Y. Li D. Xu L. Hu Y. Sang Y. Zhang G. Dai H. Epidemiology and outcomes of bloodstream infections in severe burn patients: A six-year retrospective study. Antimicrob. Resist. Infect. Control 2021 10 1 98 10.1186/s13756‑021‑00969‑w 34193300
    [Google Scholar]
  49. Magal P. McCluskey C. Two-group infection age model including an application to nosocomial infection. SIAM J. Appl. Math. 2013 73 2 1058 1095 10.1137/120882056
    [Google Scholar]
  50. Suetens C. Latour K. Kärki T. Ricchizzi E. Kinross P. Moro M.L. Jans B. Hopkins S. Hansen S. Lyytikäinen O. Reilly J. Deptula A. Zingg W. Plachouras D. Monnet D.L. Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: Results from two European point prevalence surveys, 2016 to 2017. Euro Surveill. 2018 23 46 1800516 10.2807/1560‑7917.ES.2018.23.46.1800516 30458912
    [Google Scholar]
  51. Global antimicrobial resistance and use surveillance system (GLASS) report: 2022. 2022 Available from: https://www.who.int/publications/i/item/
  52. Guidance for the surveillance of drug resistance in tuberculosis 2021 Available from: https://www.who.int/publications/i/item/9789240018020
  53. WHO strategic and technical advisory group for antimicrobial resistance (STAG-AMR) 2022 Available from: https://apps.who.int/iris/rest/bitstreams/ 1492083/retrieve
  54. Antimicrobial consumption in the EU/EEA (ESAC-Net) - Annual Epidemiological Report for 2021 2022 Available from: https://www.ecdc.europa.eu/sites/default/files/documents/ESAC-Net_AER_2021_final-rev.pdf
  55. Coenen S. Ferech M. Haaijer-Ruskamp F.M. Butler C.C. Vander Stichele R.H. Verheij T.J.M. Monnet D.L. Little P. Goossens H. European surveillance of antimicrobial consumption (ESAC): Quality indicators for outpatient antibiotic use in Europe. Qual. Saf. Health Care 2007 16 6 440 445 10.1136/qshc.2006.021121 18055888
    [Google Scholar]
  56. National Plan to Control Antibiotic Resistance (PNCAR) 2022-2025 2023 Available from: https://www.salute.gov.it/imgs/C_17_pubblicazioni_3294_allegato.pdf
  57. Kurotschka PK Fulgenzio C Da Cas R Traversa G Ferrante G Massidda O Gágyor I Aschbacher R Moser V Pagani E Spila Alegiani S Massari M Effect of fluoroquinolone use in primary care on the development and gradual decay of escherichia coli resistance to fluoroquinolones: A matched case-control study Antibiotics 2022 11 6 822 10.3390/antibiotics11060822
    [Google Scholar]
  58. Patrick D.M. Chambers C. Purych D. Chong M. George D. Marra F. Value of an aggregate index in describing the impact of trends in antimicrobial resistance for Escherichia coli. Can. J. Infect. Dis. Med. Microbiol. 2015 26 1 33 38 10.1155/2015/274298 25798152
    [Google Scholar]
  59. Carattoli A. Lovari S. Franco A. Extended-spectrum beta-lactamases in Escherichia coli isolated from dogs and cats in Rome, Italy, from 2001 to 2003 Antimicrob. Agents Chemother. 2005 49 2 833 835
    [Google Scholar]
  60. Donati V. Feltrin F. Hendriksen R.S. Extended-Spectrum-Beta-Lactamases, AmpC Beta-Lactamases and plasmid mediated quinolone resistance in Klebsiella spp. from companion animals in Italy. PLOS ONE 2014 9 3 e90564
    [Google Scholar]
  61. Klein E.Y. Tseng K.K. Pant S. Laxminarayan R. Tracking global trends in the effectiveness of antibiotic therapy using the drug resistance index. BMJ Glob. Health 2019 4 2 e001315 10.1136/bmjgh‑2018‑001315 31139449
    [Google Scholar]
  62. Laxminarayan R. Klugman K.P. Communicating trends in resistance using a drug resistance index. BMJ Open 2011 1 2 e000135 10.1136/bmjopen‑2011‑000135 22102636
    [Google Scholar]
  63. Datok DW Ishaleku D Tsaku PA Agya EO Adoga MP Multidrug resistance to commonly prescribed antibiotics in Escherichia coli isolated from barbecued beef (Suya) sold in a Nigerian city. Pan Afr. Med. J. 2021 39 50 10.11604/pamj.2021.39.50.25502
    [Google Scholar]
  64. Dechêne-Tempier M. Jouy E. Bayon-Auboyer M.H. Bougeard S. Chauvin C. Libante V. Payot S. Marois-Créhan C. Antimicrobial resistance profiles of Streptococcus suis isolated from pigs, wild boars, and humans in France between 1994 and 2020. J. Clin. Microbiol. 2023 61 9 e00164-23 10.1128/jcm.00164‑23 37655935
    [Google Scholar]
  65. Jia Y. Chen W. Tang R. Zhang J. Liu X. Dong R. Hu F. Jiang X. Multi-armed antibiotics for Gram-positive bacteria. Cell Host Microbe 2023 31 7 1101 1110.e5 10.1016/j.chom.2023.06.008 37442098
    [Google Scholar]
  66. Ma Z. Liu R. Wang J. Yu T. Zou Y. Chen F. Cui C. Yang H. Xie H. Rapid detection of bacterial resistance to β-Lactam antibiotics with a relay-response chemiluminescence assay. ACS Infect. Dis. 2024 10 6 1970 1979 10.1021/acsinfecdis.3c00682 38819944
    [Google Scholar]
  67. Nasrollahian S. Graham J.P. Halaji M. A review of the mechanisms that confer antibiotic resistance in pathotypes of E. coli. Front. Cell. Infect. Microbiol. 2024 14 1387497 10.3389/fcimb.2024.1387497 38638826
    [Google Scholar]
  68. Nguyen T.P. Vu Thi N.A. Nguyen Diep X.N. Nguyen T.N. Bui L.M. Antimicrobial resistance tendency and collateral sensitivity of Staphylococcus aureus adapted to antibiotics or extracts of medicinal plants grown in Viet Nam. Lett. Appl. Microbiol. 2022 75 3 616 622 10.1111/lam.13697 35285051
    [Google Scholar]
  69. Purba A.K.R. Ascobat P. Muchtar A. Wulandari L. Rosyid A.N. Purwono P.B. van der Werf T.S. Friedrich A.W. Postma M.J. Multidrug-resistant infections among hospitalized adults with community-acquired pneumonia in an Indonesian tertiary referral hospital. Infect. Drug Resist. 2019 12 3663 3675 10.2147/IDR.S217842 31819549
    [Google Scholar]
  70. Qin X. Wang X. Shen Z. The rise of antibiotic resistance in Campylobacter. Curr. Opin. Gastroenterol. 2023 39 1 9 15 10.1097/MOG.0000000000000901 36504031
    [Google Scholar]
  71. Roth N. Käsbohrer A. Mayrhofer S. Zitz U. Hofacre C. Domig K.J. The application of antibiotics in broiler production and the resulting antibiotic resistance in Escherichia coli: A global overview. Poult. Sci. 2019 98 4 1791 1804 10.3382/ps/pey539 30544256
    [Google Scholar]
  72. Hay S.I. Okiro E.A. Gething P.W. Patil A.P. Tatem A.J. Guerra C.A. Snow R.W. Estimating the global clinical burden of Plasmodium falciparum malaria in 2007. PLoS Med. 2010 7 6 e1000290 10.1371/journal.pmed.1000290 20563310
    [Google Scholar]
  73. WHO publishes list of bacteria for which new antibiotics are urgently needed. 2017 Available from: https://www.who.int/news/item/27-02-2017-who-publishes-list-ofbacteria-for-which-new-antibiotics-are-urgently-needed
  74. Thilly N. Pereira O. Schouten J. Hulscher M.E.J.L. Pulcini C. Proxy indicators to estimate appropriateness of antibiotic prescriptions by general practitioners: A proof-of-concept cross-sectional study based on reimbursement data, north-eastern France 2017. Euro Surveill. 2020 25 27 1900468 10.2807/1560‑7917.ES.2020.25.27.1900468 32672150
    [Google Scholar]
  75. National safety and quality health service standards 2017 Available from: https://www.safetyandquality.gov.au/sites/default/files/migrated/National-Safety-and-Quality-Health-Service-Standards-second-edition.pdf
  76. Monitoring and evaluation of the global action plan on antimicrobial resistance: Framework and recommended indicators 2024 Available from: https://iris.who.int/bitstream/handle/10665/325006/9789241515665-eng.pdf?sequence=1&isAllowed=y
  77. Browne A.J. Chipeta M.G. Haines-Woodhouse G. Kumaran E.P.A. Hamadani B.H.K. Zaraa S. Henry N.J. Deshpande A. Reiner R.C. Jr Day N.P.J. Lopez A.D. Dunachie S. Moore C.E. Stergachis A. Hay S.I. Dolecek C. Global antibiotic consumption and usage in humans, 2000–18: A spatial modelling study. Lancet Planet. Health 2021 5 12 e893 e904 10.1016/S2542‑5196(21)00280‑1 34774223
    [Google Scholar]
  78. The use of antibiotic in Italy, national report 2021 2023 Available from: https://www.aifa.gov.it/documents/20142/1804917/Comunicato_AIFA_n.703_EN.pdf
/content/journals/cds/10.2174/0115748863357518250419160411
Loading
Optimizing Antibiotic Use and Awareness in Hospitals: Establishing Effective Antimicrobial Stewardship Pathways
Bentham Science Publishers ; https://doi.org/10.2174/0115748863357518250419160411
/content/journals/cds/10.2174/0115748863357518250419160411
/content/journals/cds/10.2174/0115748863357518250419160411
Loading

Data & Media loading...


  • Article Type:     Research Article
Keywords: antibiotic stewardship ; antimicrobial management ; Antibiotic resistance ; multidrug-resistant infections ; prescribing awareness ; healthcare-associated infections

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test