Background and Importance Resistant bacteria and multidrug-resistant bacteria (MDRO) represent a problem for public health, both for the epidemiological impact and clinical manifestations and for the associated economic consequences.

Aim and Objectives Antimicrobial stewardship includes the use of the AwaRe classification which divides antibiotics into Access, Watch and Reserve categories. An analysis of the DDD (defined daily dose) consumption of antibiotics distributed by the Hospital Pharmacy to the departments between 2018 and 2021 was conducted in order to implement the use of antibiotic drugs as suggested by the World Health Organization Healthcare (WHO).

Material and Methods In order to monitor the use of drugs, the hospital pharmacy extracted the consumption into dosage units using the SAP software and then converting them into DDD. To compare the consumption data with the literature reports, it was necessary to relate the DDDs to the days of hospitalisation. Finally, the drugs were divided into AwaRe categories and the trend in consumption of each molecule in the period considered was calculated.

Results The analysis revealed that the most used category is Watch, whose consumption decreased in 2019 compared to the previous year by -6.31%, and then increased in 2020 by +21.49%. Watch consumption in 2021 is comparable to that of 2019. Access consumption underwent a slight increase in 2019 compared to 2018 of +24.77%, while it decreased in the following two years (-21.19% in 2021 vs 2019). The Reserves showed a growth trend between 2018 and 2020 (+83.90%). Compared to 2020, in 2021 the data relating to the use of these antibiotics decreased slightly (-24.36%). Finally, the Access to Watch indicator was calculated to evaluate the appropriateness of antibiotic consumption. The results emerging from this report does not match to the ideal value recommended by the WHO.¹

Conclusion and relevance The consumption of antibiotics in the Watch and Reserve categories should decrease in favour of those belonging to the Access category. The use of latest generation antibiotics belonging to the Reserve category should be limited to cases in which antibiotics from other classes are inappropriate.

References and/or Acknowledgements 1. WHO Regional Office for Europe, «Antimicrobial Medicines Consumption (AMC) Network. AMC data 2019» WHO.Regional Office for Europe, Copenhagen, 2022.

Conflict of Interest No conflict of interest.