Antibiotic stewardship: ripartiamo dalla pratica clinica

Area of Science:

• Urology
• Infectious Diseases
• Clinical Practice

Background:

• Increasing global prevalence of multi-resistant pathogens presents significant clinical challenges, particularly in urological settings.
• Limited development of new antibiotics exacerbates the threat of antimicrobial resistance.
• Alarming antibiotic resistance rates in Italy for common pathogens like Escherichia coli and Klebsiella pneumoniae underscore the urgency.

Purpose of the Study:

• To highlight the critical need for antibiotic stewardship in everyday clinical practice.
• To advocate for a revision of current approaches to urinary tract infections in light of antimicrobial resistance.
• To emphasize the importance of guideline-conform antibiotic use.

Main Methods:

• Review of current data on antibiotic resistance patterns.
• Analysis of the impact of uncritical antibiotic use on pathogen selection.
• Discussion of antibiotic stewardship principles in the context of clinical practice.

Main Results:

• High resistance rates of Escherichia coli and Klebsiella pneumoniae to fluoroquinolones and sulfamethoxazole-trimethoprim were reported.
• Low resistance rates (<5%) against fosfomycin indicate its potential utility.
• Overuse of antibiotics contributes to the selection of multidrug-resistant pathogens.

Conclusions:

• A paradigm shift towards antibiotic stewardship is urgently required in urological clinical practice.
• Adherence to guidelines and judicious antibiotic use are paramount to combatting antimicrobial resistance.
• Revising current treatment strategies for urinary tract infections is essential to preserve antibiotic effectiveness.