Capuozzo Maurizio, Zovi Andrea, Langella Roberto, Ottaiano Alessandro, Cascella Marco, Scognamiglio Manlio, Ferrara Francesco
Pharmaceutical Department, Asl Napoli 3 Sud, Marittima Street 3, 80056 Ercolano, Italy.
Ministry of Health, Viale Giorgio Ribotta 5, 00144 Rome, Italy.
Antibiotics (Basel). 2024 Nov 21;13(12):1112. doi: 10.3390/antibiotics13121112.
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. 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. 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.
抗菌药物耐药性(AMR)已成为公共卫生领域的一项重大挑战,在全球范围内对有效的疾病管理构成了相当大的威胁。耐药细菌引起的感染发病率不断上升,导致发病率和死亡率升高,特别是在弱势群体中。本综述分析了欧盟(EU)和意大利为管理抗菌药物耐药性而采取的当前战略和卫生政策,深入研究了遏制和缓解的方法。过度处方、自我用药以及家畜中抗生素的滥用等因素导致了耐药菌株的选择和传播。此外,本综述详细概述了耐药机制,包括酶失活、通透性降低、外排泵活性和靶点保护,并提供了具体实例。该综述强调迫切需要开发新的抗生素并实施诊断检测,以确保有针对性的处方并有效对抗耐药感染。目前的估计表明,欧洲和美国每年有超过6万例与抗菌药物耐药性相关的感染导致死亡,如果当前趋势不扭转,预计到2050年每年可能增至1000万例死亡。该综述还研究了欧洲和意大利现有的公共卫生政策,重点关注国家和地区对抗菌药物耐药性的战略。这些措施包括促进抗生素的合理使用、改善监测系统以及鼓励新治疗选择的研发。最后,该综述呈现了作者的短期和长期观点,为政策制定者和医疗服务提供者提出了可采取的行动步骤。最终,医疗专业人员、政策制定者和公众共同参与的协调多学科方法对于减轻抗菌药物耐药性的影响并确保抗生素对后代的有效性至关重要。