Issue/Problem: Antimicrobial resistance (AMR) and antibiotic misuse represent a public health emergency worldwide. An high rate of antibiotic prescription in the 14 acute hospitals of the Friuli Venezia Giulia (FVG) Regional Health System (RHS) emerged from ECDC Point Prevalence Survey (PPS) in 2013.
Description of the problem: ECDC PPS showed an overall prevalence of 39% in antibiotic exposure amongst hospitalized patients. The evaluation of the state of the art amongst and within FVG acute hospitals highlighted great variability in the treatment of the most common infectious diseases (ID). Differences in availability of local data on AMR and of internal reference persons for antibiotic management existed.
Results: The regional antimicrobial stewardship (AS) program is structured into the following steps: 1) inclusion of the program as a measurable action in the annual plans of the RHS and regional hospitals since 2014; 2) a regional coordination with experts from each hospital within the patient safety regional committee; 3) identification of one or more professionals expert in antibiotic use within each hospital; 4) adoption of a common set of alert microorganisms at regional level and definition of a regional registry for AMR with periodical reports to clinicians; 5) development of regional guidelines for the most frequent ID (pneumonia and urinary tract infections already available; skin and soft tissue infections currently in progress); 6) availability of all documentation in the RHS website; 7) the periodic monitoring of the rates of antibiotic consumption and the compliance with the regional guidelines.
Lessons: The management of the issue of AMR and antibiotic misuse is a priority for FVG RHS. We adapted the available scientific evidence, mostly referred to single hospitals, to a regional approach. The impact of our AS project is positive in terms of developed processes and available tools. The impact in terms of exposure will be verified in the next months.
