{
  "abstract": "Background and Importance Antimicrobial resistance represents a critical public health threat across Europe. The World Health Organization (WHO) developed the AWaRe classification as a stewardship tool, categorising antibiotics into Access, Watch, and Reserve groups to optimise prescribing patterns. Systematic monitoring remains essential to identify prescribing gaps and guide interventions.Aim and Objectives This study aimed to evaluate antibiotic consumption patterns at a public hospital using the AWaRe framework, assess alignment with national benchmarks.Material and Methods A retrospective analysis of systemic antibiotic consumption (ATC J01) throughout 2023 was benchmarked versus the national medicines agency annual report on antibiotic use (2023). Analysis focused on the top 10 systemic antibiotics, classified according to AWaRe groups. Statistical comparisons were performed using t-test or Mann-Whitney test based on data distribution. Results were expressed as percentage deviation from national consumption rates.Results Significant overutilisation of Watch group antibiotics was observed compared to national averages (t(9)=2.32, p=0.045), while Access and Reserve groups showed no overall significant differences, although particularly elevated usage levels emerged for specific Reserve agents. Within the Access group, highest consumption increases versus national data included metronidazole (+415.26%), ampicillin/sulbactam (+367.20%), and amikacin (+177.96%), while lowest consumption was observed for oxacillin (-87.63%), ampicillin (-54.47%), and amoxicillin/clavulanic acid (-53.99%). In the Watch group, vancomycin (+510.44%), meropenem (+459.47%), and teicoplanin (+344.31%) showed highest consumption, whereas azithromycin (-94.04%) and cefixime (-39.64%) showed lowest utilisation. Among Reserve antibiotics, cefiderocol demonstrated the highest deviation (+979.16%), followed by meropenem/vaborbactam (+421.29%) and ceftazidime/avibactam (+356.11%), while ceftaroline (-86.54%), daptomycin (-84.35%), and linezolid (-82.39%) showed lower consumption. Therapeutic category comparison revealed significant differences versus national averages (W=284, p=0.023), with marked increases in carbapenems, other cephalosporins and penems, glycopeptides, and third/fourth-generation cephalosporins.Conclusion and Relevance The findings, indicating excessive reliance on Watch antibiotics and selective, potentially inappropriate use of Reserve agents that deviate from WHO recommendations, will be evaluated by the hospital antimicrobial stewardship committee. These patterns underscore critical prescribing gaps requiring strengthened antimicrobial stewardship programs. Hospital pharmacists play a strategic role in implementing AWaRe-guided protocols, monitoring consumption patterns, and promoting evidence-based prescribing, thereby contributing substantially to antimicrobial resistance containment within European healthcare systems.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "University of Messina Hospital Pharmacy Specialisation, Department of Chemical- Biological- Pharmaceutical and Environmental Sciences., Messina, Italy"
      ],
      "name": "N Cruciata"
    },
    {
      "affiliations": [
        "University of Palermo, Stebicef, Palermo, Italy"
      ],
      "name": "A Alba"
    },
    {
      "affiliations": [
        "University of Palermo, Stebicef, Palermo, Italy"
      ],
      "name": "A Mendola"
    },
    {
      "affiliations": [
        "University of Messina, Department of Chemical- Biological- Pharmaceutical- and Environmental Sciences, Messina, Italy"
      ],
      "name": "G Maggio"
    },
    {
      "affiliations": [
        "Azienda Ospedaliera ‘Ospedali Riuniti Villa Sofia-Cervello’, U.O.C. Farmacia, Palermo, Italy"
      ],
      "name": "D Leonardi"
    },
    {
      "affiliations": [
        "Azienda Ospedaliera ‘Ospedali Riuniti Villa Sofia-Cervello’, U.O.C. Farmacia, Palermo, Italy"
      ],
      "name": "P Polidori"
    }
  ],
  "title": "4CPS-286 World health organisation aware classification for antimicrobial stewardship: a hospital-based consumption analysis and benchmarking versus national data",
  "uid": "4a70f371-4f03-53e2-bc58-b91d01af75ec"
}