Antibiotic-resistant bacteria circulate in hospitals, in long-term care facilities, and in the community, making the management of urinary, respiratory, abdominal, or bloodstream infections more complex. Faster diagnoses, prescription appropriateness, targeted therapies, and collaboration among specialists, primary care physicians, pharmacists, and local health services are among the messages of the HTIDE Conference, scheduled to take place in Genoa on October 14–15, 2026.
Antibiotic Resistance in Italy: AR-ISS 2024 Data
According to the latest AR-ISS surveillance data coordinated by the Italian National Institute of Health (ISS), in 2024 resistance to third-generation cephalosporins in Escherichia coli rose to 27.7%, up from 26.7% in 2023. For carbapenem-resistant Klebsiella pneumoniae, there is a decline, but the rate remains at 24.0%. Monitoring has been extended to urine cultures, underscoring the significance of resistant urinary infections even outside hospital settings.
Antibiotic Therapies: A Call for a Paradigm Shift
«Italy remains among the European countries most exposed to antimicrobial resistance – notes Matteo Bassetti, President of SITA and Chairman of the HTIDE Conference – Antibiotics that for years were the reference drugs, such as carbapenems, are increasingly less effective against a range of resistant microorganisms. A recent analysis conducted in our country showed that almost 60% of antibiotic therapies used in critically ill patients with carbapenem-resistant infections are inappropriate. This means that we often start too late, start poorly, or use drugs, dosages, timing, and administration routes that are not appropriate. A paradigm shift is needed».
The three priorities that SITA believes require action are:
- rapid diagnosis,
- the correct duration of therapies,
- the appropriateness of the chosen antibiotic.
Community Diagnostics and Collaboration Between Doctors and Pharmacists
«The first lever is diagnostics – continues Bassetti – We must reduce reliance on empiric therapy when it is not needed and shorten the time to identify the pathogen. This applies both in hospital and in the community. The Gemmato Decree and the evolution of the pharmacy of services are moving in an important direction: bringing the patient closer to diagnosis within regulated pathways and in coordination with doctors and specialists, fostering better antibiotic use and reducing unnecessary treatments. Doctors and pharmacists can become allies in the fight against antimicrobial resistance. Regarding the appropriate duration of therapies, continues Bassetti, the problem is that in Italy we often treat for too long, risking side effects, increasing selective pressure on bacteria, and giving rise to new resistances. The overall appropriateness of therapy, finally, concerns the choice of drug, dosage, dosing interval, and route of administration».
Urinary Tract Infections: Resistance and Community Management
Urinary tract infections are very common, especially among women, and can become problematic when recurrent or driven by resistant bacteria. According to AR-ISS, in 2024 15.8% of E. coli isolates from urine cultures were resistant to third-generation cephalosporins, while 10.6% of Klebsiella pneumoniae isolates from urine cultures were resistant to carbapenems.
«Urinary infections are probably the clearest example of how antimicrobial resistance has moved beyond the hospital – notes Bassetti – A complicated cystitis acquired at home can become difficult to treat because oral antibiotics no longer work. In hospitals and long-term care facilities, where we care for fragile, catheterized patients often exposed to multiple therapies, the problem reaches even more worrying levels. This is why diagnosis, prevention, and appropriateness are essential».
HTIDE Conference and the National SITA Congress
The seventh edition of the HTIDE Conference, chaired by Matteo Bassetti, will be held at the Starhotels President in Genoa. Topics include vaccine prevention in vulnerable patients, vaccine hesitancy, monoclonal antibodies in the prevention of respiratory infections, emerging fungal infections, management of immunocompromised patients, and new global viral threats. Vaccines represent a tool to reduce antibiotic resistance by preventing infections.
The topics will be carried forward at the 16th National SITA Congress, planned for November 5–6 in Turin, with a national focus on antimicrobial resistance, stewardship, MDR infections, hospital-community collaboration, new therapies, and the role of the infectious disease specialist in the Italian National Health Service pathways.
Subscribe to Karla Miller
