{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:42:01Z","timestamp":1760143321296,"version":"build-2065373602"},"reference-count":39,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T00:00:00Z","timestamp":1706572800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Introduction: The emergence and spread of drug-resistant pathogens due to the improper use of antibiotics have become increasingly apparent in recent years. Objective: This retrospective comparative analysis aimed to assess and compare antibiotic prescription trends in Italy across two different regions based on geographic area and healthcare structure. One region represents a large hospital institution, while the other represents a populous local Italian health agency. The study also examined the impact of documented antibiotic stewardship programs and efforts to promote responsible antibiotic use at all levels, in alignment with international goals. Antibiotic consumption data were collected from the Umberto I Polyclinic Hospital and the ASL Napoli 3 South Local Health Agency. Methods: To compare consumption between regions, a standardized comparison using the Defined Daily Dose (DDD) was employed. The internal management system of each healthcare facility records all prescriptions and drug dispensations, and these data were extrapolated for this retrospective study. Results: A comparative assessment between the first half of 2022 and 2023 (January\u2013June) highlighted a significant increase in beta-lactam antibiotic consumption, showing a twofold rise compared to the previous year\u2019s term. Regarding prescription averages, there was a noticeable increase of +29.00% in hospitalizations and +28.00% in hospital discharges within the ASL Napoli 3 South. Conversely, at Policlinico Umberto I, there was a marginal increase of +1.60% in hospitalizations and a decrease of \u22127.40% in hospital discharges. Conclusions: The study offers valuable insights into expenditure patterns and antibiotic consumption, underscoring the need for enhanced prescribing practices and awareness campaigns to address the issue of antibiotic resistance. The findings stress the importance of implementing international guidelines to combat the growing threat of antibiotic resistance and ensure the effective management of infectious diseases.<\/jats:p>","DOI":"10.3390\/ph17020183","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T11:35:34Z","timestamp":1706614534000},"page":"183","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Comparison and Analysis of Antibiotic Consumption in Two Italian Hospital Settings in Relation to the Fight of Antimicrobial Resistance"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9298-6783","authenticated-orcid":false,"given":"Francesco","family":"Ferrara","sequence":"first","affiliation":[{"name":"Pharmacy Unit, ASL Napoli 3 Sud, 80035 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Pasquinucci","sequence":"additional","affiliation":[{"name":"Pharmacy Unit, ASL Napoli 3 Sud, 80035 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9488-6057","authenticated-orcid":false,"given":"Maurizio","family":"Capuozzo","sequence":"additional","affiliation":[{"name":"Pharmacy Unit, ASL Napoli 3 Sud, 80035 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6158-1045","authenticated-orcid":false,"given":"Giacomo","family":"Polito","sequence":"additional","affiliation":[{"name":"Pharmacy Unit, Pharmacy Department, Policlinico Umberto I, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriele","family":"Bagaglini","sequence":"additional","affiliation":[{"name":"Pharmacy Unit, ASL Latina, 04100 Latina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3931-576X","authenticated-orcid":false,"given":"Marcello","family":"Vaccaro","sequence":"additional","affiliation":[{"name":"Pharmacy Unit, Pharmacy Department, Policlinico Umberto I, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriana","family":"Coluccia","sequence":"additional","affiliation":[{"name":"Pharmacy Unit, Pharmacy Department, Policlinico Umberto I, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Langella","sequence":"additional","affiliation":[{"name":"Italian Society of Hospital Pharmacy (SIFO), SIFO Secretariat of the Lombardy Region, 20159 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ugo","family":"Trama","sequence":"additional","affiliation":[{"name":"Health Protection and Coordination of the Campania Regional Health System, 80143 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Nava","sequence":"additional","affiliation":[{"name":"Pharmacy Unit, ASL Napoli 3 Sud, 80035 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6528-2171","authenticated-orcid":false,"given":"Andrea","family":"Zovi","sequence":"additional","affiliation":[{"name":"Ministry of Health, 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,30]]},"reference":[{"key":"ref_1","unstructured":"European Commission (2023, October 01). Health Emergency Preparedness and Response Authority. Available online: https:\/\/health.ec.europa.eu\/publications\/hera-factsheet-health-union-identifying-top-3-priority-health-threats_it."},{"key":"ref_2","unstructured":"(2023, October 01). European Centre for Disease Prevention and Control, Available online: https:\/\/www.ecdc.europa.eu\/en."},{"key":"ref_3","unstructured":"(2023, October 01). Italian Superior Institute of Health. Available online: https:\/\/www.iss.it\/one-health."},{"key":"ref_4","unstructured":"(2023, October 01). Consiglio Unione Europea Bruxelles 1 Giugno 2023\u2014\u201cRaccomandazione del Consiglio sul Potenziamento Delle Azioni dell\u2019UE per Combattere la Resistenza Antimicrobica con un Approccio \u201cOne Health\u201d\u201d. Available online: https:\/\/health.ec.europa.eu\/antimicrobial-resistance\/eu-action-antimicrobial-resistance_it."},{"key":"ref_5","unstructured":"Italian Ministry of Health (2023, October 01). 2022 \u201cPiano Nazionale di Contrasto all\u2019Antibiotico-Resistenza (PNCAR) 2022\u20132025\u201d, Available online: https:\/\/www.salute.gov.it\/imgs\/C_17_pubblicazioni_3294_allegato.pdf."},{"key":"ref_6","unstructured":"The Medicines Utilisation Monitoring Centre (2023). National Report on Antibiotics Use in Italy."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1093\/jac\/dkn150","article-title":"Antibiotic use in 26 departments of internal medicine in 6 general hospitals in Israel: Variability and contributing factors","volume":"62","author":"Shalit","year":"2008","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1007\/s15010-008-7462-z","article-title":"Quantitative antibiotic use in hospitals: Comparison of measurements, literature review, and recommendations for a standard of reporting","volume":"36","author":"Kuster","year":"2008","journal-title":"Infection"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1086\/589333","article-title":"Differential correlation between rates of antimicrobial drug consumption and prevalence of antimicrobial resistance in a tertiary care hospital in Greece","volume":"29","author":"Iosifidis","year":"2008","journal-title":"Infect. Control Hosp. Epidemiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e2016036","DOI":"10.4084\/mjhid.2016.036","article-title":"Surveillance and Control of Antibiotic Resistance in the Mediterranean Region","volume":"8","author":"Ricciardi","year":"2016","journal-title":"Mediterr. J. Hematol. Infect. Dis."},{"key":"ref_11","first-page":"126","article-title":"Quinolone-induced psychosis: An updated review","volume":"48","year":"2020","journal-title":"Actas Esp. Psiquiatr."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Bell, B.G., Schellevis, F., Stobberingh, E., Goossens, H., and Pringle, M. (2014). A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance. BMC Infect. Dis., 14.","DOI":"10.1186\/1471-2334-14-13"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Tang, K.W.K., Millar, B.C., and Moore, J.E. (2023). Antimicrobial Resistance (AMR). Br. J. Biomed. Sci., 80.","DOI":"10.3389\/bjbs.2023.11387"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1016\/j.ijid.2022.06.013","article-title":"Changes in antibiotic consumption patterns after the implementation of the National Action Plan according to the Access, Watch, Reserve (AWaRe) classification system","volume":"122","author":"Chae","year":"2022","journal-title":"Int. J. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"95","DOI":"10.2174\/2772434417666220720111849","article-title":"Vigilance Needed in Treating Leprosy Patients in Accordance with WHO\u2019s AWaRe","volume":"17","author":"Thangaraju","year":"2022","journal-title":"Recent Adv. Antiinfect. Drug Discov."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"The Lancet Microbe (2023). AMR is more complicated than a lack of drugs. Lancet Microbe, 4, e851.","DOI":"10.1016\/S2666-5247(23)00343-9"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"S565","DOI":"10.1093\/cid\/ciz830","article-title":"Treatment Options for Carbapenem-resistant Gram-negative Bacterial Infections","volume":"69","author":"Doi","year":"2019","journal-title":"Clin. Infect. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/j.pharma.2023.02.003","article-title":"SARS-CoV-2 caused a surge in antibiotic consumption causing a silent pandemic inside the pandemic. A retrospective analysis of Italian data in the first half of 2022","volume":"81","author":"Ferrara","year":"2023","journal-title":"Ann. Pharm. Fr."},{"key":"ref_19","first-page":"277","article-title":"Il contrasto dell\u2019antibiotico-resistenza: Serve una nuova linea di azione [Countering antibiotic resistance: A new course of action is needed]","volume":"114","author":"Ferrara","year":"2023","journal-title":"Recenti Prog. Med."},{"key":"ref_20","first-page":"e41414","article-title":"Antibiotic Consumption in Primary Care in Costa Rica and Italy: A Retrospective Cross-Country Analysis","volume":"15","author":"Zavaleta","year":"2023","journal-title":"Cureus"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.3855\/jidc.17148","article-title":"Antibiotic consumption in hospitals during COVID-19 pandemic: A comparative study","volume":"16","author":"Hussein","year":"2022","journal-title":"J. Infect. Dev. Ctries"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Grau, S., Hern\u00e1ndez, S., Echeverr\u00eda-Esnal, D., Almendral, A., Ferrer, R., Lim\u00f3n, E., Horcajada, J.P., and Catalan Infection Control and Antimicrobial Stewardship Program (VINCat-PROA) (2021). Antimicrobial Consumption among 66 Acute Care Hospitals in Catalonia: Impact of the COVID-19 Pandemic. Antibiotics, 10.","DOI":"10.3390\/antibiotics10080943"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.cmi.2022.12.006","article-title":"Antibiotic resistance associated with the COVID-19 pandemic: A systematic review and meta-analysis","volume":"29","author":"Langford","year":"2023","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1007\/s12012-021-09649-y","article-title":"Scientific Hypothesis for Treatment of COVID-19\u2019s Lung Lesions by Adjusting ACE\/ACE2 Imbalance","volume":"21","author":"Ferrara","year":"2021","journal-title":"Cardiovasc. Toxicol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1016\/j.jiph.2023.02.021","article-title":"A parallel and silent emerging pandemic: Antimicrobial resistance (AMR) amid COVID-19 pandemic","volume":"16","author":"Rehman","year":"2023","journal-title":"J. Infect. Public Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1177\/00185787211069040","article-title":"Could Decreased Reporting of Suspected Adverse Reactions Generate Future Safety Concerns?","volume":"57","author":"Ferrara","year":"2022","journal-title":"Hosp. Pharm."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s12026-021-09244-x","article-title":"A short focus, azithromycin in the treatment of respiratory viral infection COVID-19: Efficacy or inefficacy?","volume":"70","author":"Vitiello","year":"2022","journal-title":"Immunol. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e51034","DOI":"10.15252\/embr.202051034","article-title":"Antibiotic resistance and persistence-Implications for human health and treatment perspectives","volume":"21","author":"Huemer","year":"2020","journal-title":"EMBO Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.biotechadv.2018.11.013","article-title":"Antibiotic resistance in Pseudomonas aeruginosa: Mechanisms and alternative therapeutic strategies","volume":"37","author":"Pang","year":"2019","journal-title":"Biotechnol. Adv."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Eisenreich, W., Rudel, T., Heesemann, J., and Goebel, W. (2022). Link Between Antibiotic Persistence and Antibiotic Resistance in Bacterial Pathogens. Front. Cell. Infect. Microbiol., 12.","DOI":"10.3389\/fcimb.2022.900848"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e026072","DOI":"10.1136\/bmjopen-2018-026072","article-title":"Impact of antimicrobial stewardship managed by clinical pharmacists on antibiotic use and drug resistance in a Chinese hospital, 2010\u20132016: A retrospective observational study","volume":"9","author":"Wang","year":"2019","journal-title":"BMJ Open"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.japh.2021.04.013","article-title":"Antimicrobial stewardship solutions with a smart innovative tool","volume":"61","author":"Shawki","year":"2021","journal-title":"J. Am. Pharm. Assoc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1177\/00185787221074570","article-title":"The Slow Path to Therapeutic Adherence","volume":"57","author":"Ferrara","year":"2022","journal-title":"Hosp. Pharm."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1177\/10600280221082326","article-title":"Ceftaroline: Systematic Review of Clinical Uses and Emerging Drug Resistance","volume":"56","author":"Abate","year":"2022","journal-title":"Ann. Pharmacother."},{"key":"ref_35","first-page":"317","article-title":"Evaluaci\u00f3n del consumo de antimicrobianos mediante DDD\/100 estancias versus DDD\/100 altas en la implantaci\u00f3n de un Programa de Optimizaci\u00f3n del Uso de Antimicrobianos [Measurement of antimicrobial consumption using DDD per 100 bed-days versus DDD per 100 discharges after the implementation of an antimicrobial stewardship program]","volume":"28","author":"Collado","year":"2015","journal-title":"Rev. Esp. Quimioter."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1900022","DOI":"10.2807\/1560-7917.ES.2019.24.34.1900022","article-title":"Antimicrobial use trends, Israel, 2012 to 2017","volume":"24","author":"Dickstein","year":"2019","journal-title":"Eurosurveillance"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10198-023-01640-4","article-title":"Recovery of suspended reimbursements of high-cost drugs subjected to monitoring registries and negotiated agreements (MEAs): A tool for governance and clinical appropriateness in the Italian reality","volume":"25","author":"Capuozzo","year":"2024","journal-title":"Eur. J. Health Econ."},{"key":"ref_38","first-page":"1","article-title":"Atrial fibrillation therapy with new oral anticoagulants: A real-world evidence study","volume":"1","author":"Ferrara","year":"2023","journal-title":"Int. J. Healthc. Manag."},{"key":"ref_39","first-page":"1","article-title":"New drugs for type 2 diabetes mellitus: The challenge of the health care sustainability combined with a better patient care access","volume":"1","author":"Ferrara","year":"2023","journal-title":"Int. J. Healthc. Manag."}],"container-title":["Pharmaceuticals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8247\/17\/2\/183\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:51:54Z","timestamp":1760104314000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8247\/17\/2\/183"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,30]]},"references-count":39,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2]]}},"alternative-id":["ph17020183"],"URL":"https:\/\/doi.org\/10.3390\/ph17020183","relation":{},"ISSN":["1424-8247"],"issn-type":[{"type":"electronic","value":"1424-8247"}],"subject":[],"published":{"date-parts":[[2024,1,30]]}}}