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The Italian Group’s proposals for antimicrobial stewardship to counteract antibiotic resistance

January 21, 2019

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The Italian group for antimicrobial stewardship (Gisa) puts forward some proposals to improve the use of antibiotics, in order to:

  • favor access to those of new formulation
  • decrease inappropriate use
  • reduce the risk of infectious patients in the hospital.

This can happen starting from a greater attention to good welfare practices, from the need to promote vaccinations among adults, those at risk and among hospital operators, from the strengthening of microbiology services and from a strong involvement of hospital pharmacists.

Italian data

Each year there are 450,000 to 700,000 cases of hospital infections. Infections affect from 5% to 8% of hospitalized patients, especially those assisted in intensive care. In 1% of cases these infections are fatal with about 7 thousand deaths per year. The economic impact of the phenomenon can be estimated at around € 1 billion a year, a figure that weighs on the health budget and is therefore subtracted from preventive measures and resources for the correct use of new antibiotics.

Actions needed

Many cases of complications and deaths could be avoided by putting into practice simple rules of hygiene, rapid diagnosis, facilitated and regulated access to new antibiotics (with the fight against the abuse of existing ones) and vaccines.

“Today the new antibiotics are not considered, strictly speaking, innovative drugs, as they represent an evolution of already existing drugs. They therefore do not enjoy routes that favor quick and easy access and do not have the allocation of dedicated resources – says Francesco Menichetti, president of Gisa. – The need to access these new drugs requires a revision of the rules (AIFA, prescription restriction) that does not go towards a senseless liberalization but considers procedures that allow clearly defined areas of potential utility, rapid access by specialists who treat patients with serious infections, for whom such drugs could be a life-saver”.

Support research on new antibiotics

The development of new antibiotics has opened new therapeutic possibilities. The ability of bacteria to develop mechanisms of resistance even against newborn molecules, however, requires a multidisciplinary, multiform and multi-institutional approach.

“For this reason – concludes Menichetti – to effectively combat these species of ‘intelligent microorganisms’ is necessary not only research, but also and above all strategies to control the infections, surveillance, good use of antibiotics in hospitals and local areas, training, education of health workers and citizens also through new means of communication and the involvement of the institutions”.

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