BACKGROUND: Antimicrobial resistance (AMR) is a major global public health challenge, particularly in Italy, where surveillance data show high resistance rates for several pathogen-antibiotic combinations. This study aimed to evaluate trends in systemic antibiotic consumption in hospital settings within a Local Health Authority in Emilia-Romagna using PNCAR indicators. MATERIALS AND METHODS: A retrospective analysis of systemic antibiotic consumption (Anatomical Therapeutic Chemical Classification System - ATC, class J01) was conducted at the Piacenza Local Health Authority between 2021 and 2024, using the WHO AWaRe classification. Data were expressed as DDD and DDD per 100 bed-days across seven hospital departments. The European Surveillance of Antimicrobial Consumption (ESAC) indicator for broad-spectrum antibiotics was calculated. An economic analysis of antibiotic expenditure per inpatient day was also performed and compared with regional and national benchmarks. RESULTS: The hospital antibiotic consumption (ATC J01) showed an overall decline, decreasing from 113.3 DDD/100 bed-days in 2022 to 97.5 in 2024. AWaRe analysis revealed a marked reduction in Access antibiotics and a concomitant increase in Watch agents, while Reserve use remained stable. Amoxicillin-clavulanic acid and ceftriaxone were the most frequently prescribed antibiotics. The ESAC indicator remained stable at approximately 54%. CONCLUSIONS: Contextualizing antibiotic consumption data within local epidemiology allows a more accurate interpretation of prescribing patterns and supports the development of tailored stewardship interventions. Integrating local monitoring with national surveillance systems could strengthen the evaluation of PNCAR targets.
Confalonieri et al. (Fri,) studied this question.