ANTIMICROBIAL RESISTANCE IN ITALY: A SYSTEMATIC AND POLICY ORIENTED ANALYSIS
DOI:
https://doi.org/10.55197/qjmhs.v5i2.215Keywords:
antimicrobial resistance, antibiotic policy, health governance, Italy, public healthAbstract
Antimicrobial resistance (AMR) is increasingly recognized as one of the most pressing challenges facing modern healthcare systems. Italy provides a particularly interesting case within Europe, as it continues to experience relatively high levels of antibiotic consumption alongside significant rates of resistance. This paper explores the issue from a broader perspective, moving beyond clinical explanations to consider the role of healthcare organization, policy frameworks, and social behavior. The study is based on a qualitative review of scientific literature, institutional reports, and publicly available data. The findings suggest that AMR in Italy is closely linked to structural factors, including regional disparities in healthcare performance, differences in prescribing practices, and uneven implementation of national policies. While recent initiatives, such as national action plans and stewardship programs, have improved awareness and monitoring, their impact has not been uniform across the country. Overall, the Italian case highlights the need for coordinated strategies that combine regulation, education, and institutional support. Addressing AMR effectively requires not only better clinical practices, but also stronger alignment between national policies and local realities.
References
[1] Agenzia Italiana del Farmaco (AIFA) (2022): National report on medicines use in Italy. – AIFA, Rome 127p.
[2] Berendonk, T., Manaia, C., Merlin, C., Fatta‑Kassinos, D., Cytryn, E., Walsh, F., Bürgmann, H., Sørum, H., Norström, M., Pons, M., Kreuzinger, N., Huovinen, P., Stefani, S., Schwartz, T., Kisand, V., Baquero, F., Martinez, J. (2015): Tackling antibiotic resistance: The environmental framework. – Nature Reviews Microbiology 13(5): 310-317.
[3] Bianco, A., Licata, F., Zucco, R., Papadopoli, R., Pavia, M. (2020): Knowledge and practices regarding antibiotics use: Findings from a cross‑sectional survey among Italian adults. – Evolution, Medicine, and Public Health 9p.
[4] Cangini, A., Fortinguerra, F., Di Filippo, A., Pierantozzi, A., Da Cas, R., Villa, F., Trotta, F., Moro, M.L., Gagliotti, C. (2021): Monitoring the community use of antibiotics in Italy within the National Action Plan on antimicrobial resistance. – British Journal of Clinical Pharmacology 87(3): 1033-1042.
[5] Davies, J., Davies, D. (2010): Origins and evolution of antibiotic resistance. – Microbiology and Molecular Biology Reviews 74(3): 417-433.
[6] European Centre for Disease Prevention and Control (ECDC) (2022): Antimicrobial resistance surveillance in Europe 2022. – Stockholm: ECDC 132p.
[7] Ferrara, F., Pasquinucci, R., Capuozzo, M., Polito, G., Bagaglini, G., Vaccaro, M., Coluccia, A., Langella, R., Trama, U., Nava, E., Zovi, A. (2024): Comparison and analysis of antibiotic consumption in two Italian hospital settings in relation to the fight of antimicrobial resistance. – Pharmaceuticals 17(2): 183‑199.
[8] Hernando‑Amado, S., Coque, T., Baquero, F., Martínez, J. (2019): Defining and combating antibiotic resistance from One Health and global health perspectives. – Nature Microbiology 4(9): 1432-1442.
[9] Istituto Superiore di Sanità (ISS) (2022): AR‑ISS: Sorveglianza nazionale dell’Antibiotico‑Resistenza. – Rome: ISS 56p.
[10] Laxminarayan, R., Duse, A., Wattal, C., Zaidi, A., Wertheim, H., Sumpradit, N., Vlieghe, E., Hara, G., Gould, I., Goossens, H., Cars, O. (2013): Antibiotic resistance-the need for global solutions. – The Lancet Infectious Diseases 13(12): 1057-1098.
[11] Marston, H., Dixon, D., Knisely, J., Palmore, T., Fauci, A. (2016): Antimicrobial resistance. – Journal of the American Medical Association 316(11): 1193-1204.
[12] Ministero Della Salute (MDS) (2022): Piano Nazionale di Contrasto all’Antibiotico‑Resistenza (PNCAR) 2022-2025. – Rome: Ministry of Health 92p.
[13] Ministero Della Salute (MDS) (2017): Piano Nazionale di Contrasto dell’Antimicrobico‑Resistenza (PNCAR) 2017-2020. – Rome: Ministry of Health 84p.
[14] O’Neill, J. (2016): Tackling drug‑resistant infections globally: Final report and recommendations. – Review on Antimicrobial Resistance, London 76p.
[15] Prestinaci, F., Pezzotti, P., Pantosti, A. (2015): Antimicrobial resistance: A global multifaceted phenomenon. – Pathogens and Global Health 109(7): 309-318.
[16] Sanchez, G., Fleming‑Dutra, K., Roberts, R., Hicks, L. (2016): Core elements of outpatient antibiotic stewardship. – MMWR Recommendations and Reports 65(6): 1-12.
[17] Snyder, H. (2019): Literature review as a research methodology: An overview and guidelines. – Journal of Business Research 104: 333-339.
[18] Ventola, C. (2015): The antibiotic resistance crisis: Causes and threats. – Pharmacy and Therapeutics 40(4): 277-283.
[19] World Bank (2017): Drug‑resistant infections: A threat to our economic future. – Washington, DC: World Bank 78p.
[20] World Health Organization (WHO) (2021): Global antimicrobial resistance surveillance system (GLASS) report. – Geneva: WHO 176p.
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