Optimizing Antibiotic Use: Addressing Resistance Through Effective Strategies and Health Policies

Background: Antimicrobial resistance (AMR) has emerged as a significant challenge to public health, posing a considerable threat to effective disease management on a global scale. The increasing incidence of infections caused by resistant bacteria has led to heightened morbidity and mortality rates, particularly among vulnerable populations. Main text: This review analyzes current strategies and health policies adopted in the European Union (EU) and Italy to manage AMR, presenting an in-depth examination of approaches for containment and mitigation. Factors such as excessive prescriptions, self-medication, and the misuse of antibiotics in livestock contribute to the selection and spread of resistant strains. Furthermore, this review provides a detailed overview of resistance mechanisms, including enzymatic inactivation, reduced permeability, efflux pump activity, and target site protection, with specific examples provided. The review underscores the urgent need to develop new antibiotics and implement diagnostic testing to ensure targeted prescriptions and effectively combat resistant infections. Current estimates indicate that AMR-related infections cause over 60,000 deaths annually in Europe and the United States, with projections suggesting a potential rise to 10 million deaths per year by 2050 if current trends are not reversed. The review also examines existing public health policies in Europe and Italy, focusing on national and regional strategies to combat AMR. These include promoting responsible antibiotic use, improving surveillance systems, and encouraging research and development of new therapeutic options. Conclusions: Finally, the review presents short- and long-term perspectives from the authors, suggesting actionable steps for policymakers and healthcare providers. Ultimately, a coordinated and multidisciplinary approach involving healthcare professionals, policymakers, and the public is essential to mitigate the impact of AMR and ensure the effectiveness of antibiotics for future generations.