Antibiotico resistenza ed appropriato uso dell’antibioticoterapia in Regione Puglia: dall’alleanza terapeutica ai bisogni non soddisfatti – 2021

Introduction. Antibiotic resistance is closely linked to the excessive and inappropriate use of antibiotics. The aim of the project is to support professionals in a targeted, ethical and conscious therapeutic choice. Methods. A scientific panel, met twice in 2021, analysed the current national and regional framework concerning appropriateness of antibiotic prescription. That allows to identify a homogeneous, ethical and sustainable approach in the antibiotic therapy management, diagnostic approach and prevention and control of antibiotic resistance. Results. An algorithm for antibiotic therapy management decision making which provides two distinct paths for the patient, based on the level of risk defined through the prognostic stratification and the evaluation of risk of MDR pathogens. Discussion. The proposed algorithm allows to guide operators in making decisions on the antibiotic therapy, through: a) Prognostic stratification: definition of the severity of the patient’s clinical condition through objective criteria; b) MDR pathogen risk stratification: definition of the risk of therapeutic failure through multi-antibiotic resistant pathogens (MDR) risk factors. Depending on the site of infection and the place of acquisition of the infection itself, the proposed algorithm will have to be diversified on the basis of the necessary microbiological investigations and the most appropriate antibiotic molecules, in accordance with the approved indications and the most recent scientific findings. Conclusions. The project allowed to develop a tool that can help operators to formulate a targeted therapeutic strategy, as a guide for the rationalization of antibiotic prescription, especially in a hospital setting.