Current Challenges in Antimicrobial Stewardship

A special issue of Antibiotics (ISSN 2079-6382). This special issue belongs to the section "Antibiotics Use and Antimicrobial Stewardship".

Deadline for manuscript submissions: 30 January 2027 | Viewed by 2467

Special Issue Editor


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Guest Editor
Department of Clinical Pharmacy, Sindelfingen-Boeblingen Medical Center, 71065 Sindelfingen, Germany
Interests: antimicrobial stewardship; infectious diseases; microbiome; therapeutic monitoring; neurochemistry; neuropharmacology; neurodegenerative diseases; clinical pharmacy
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Special Issue Information

Dear Colleagues,

It’s not a new information that antibiotics resistance is one of the biggest challenges in treatment of patients suffering from an infectious disease. The problem is not only a matter of quarterly or annual statistics or watching colourful resistance maps, it is more than that and we know that the resistance situation is making patients vulnerable. Several recent publications provide evidence that antimicrobial resistance is leading to a significant burden of patients' situation and even is crucially connected with fatal outcomes.

One known and established strategy is the appropriate management of infectious diseases and among the most important tasks the path towards better antibiotics prescribing quality represents an important approach. Several strategies are dealing with improvement of quality in the clinics and monitoring the state of the process regularly – taken together within the “antimicrobial stewardship” programmatic approaches. These approaches naturally differ between hospitals and outpatient sites and although guidelines are providing useful recommendations, an individual approach perhaps shows a very valuable benefit for the practice.

Against this background, this special issue shall collect such best-practice approaches within antimicrobial stewardship toward a better situation in everyday life. This is a call for submissions: if you have such experience with projects, regardless if the project or idea is simple or complex, we are happy about submission of the report. The one and only required measure is the scientific quality. Additionally, full scientific and even complex study manuscripts are welcome as well. This is valid for every antimicrobial stewardship section.

Thus, invited are papers of any type (case reports, original articles describing the setup of a new local guideline, surveillance data, review articles) with a clear rationale and clear message for the colleagues.

Dr. Andreas A. Von Ameln-Mayerhofer
Guest Editor

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Antibiotics is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

  • antimicrobial stewardship
  • antimicrobial resistance
  • antibiotics prescribing
  • intervention
  • irrational prescriptions
  • surveillance
  • therapeutic monitoring
  • ABS
  • AMS
  • antibiotic stewardship
  • best practice
  • interprofessional
  • rational prescribing
  • DDD/100
  • RDD/100

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Published Papers (2 papers)

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Research

11 pages, 243 KB  
Article
Correlation Between Surgical Ward Stay and High Gentamicin Resistance of Enterococcus faecalis: A Retrospective Study
by Luiza Sannikova, Agnieszka Misiewska-Kaczur, Michał Dyaczyński, Bartosz Socha, Georgii Gogichev and Marcin Basiak
Antibiotics 2026, 15(4), 394; https://doi.org/10.3390/antibiotics15040394 - 13 Apr 2026
Viewed by 426
Abstract
Background: The increasing antimicrobial resistance of Enterococcus faecalis, particularly high-level aminoglycoside resistance, represents a growing challenge in the management of hospital-acquired infections. Surgical wards are considered potential environments for the dissemination of resistant strains due to frequent antibiotic exposure and invasive procedures. [...] Read more.
Background: The increasing antimicrobial resistance of Enterococcus faecalis, particularly high-level aminoglycoside resistance, represents a growing challenge in the management of hospital-acquired infections. Surgical wards are considered potential environments for the dissemination of resistant strains due to frequent antibiotic exposure and invasive procedures. Methods: The aim of this study was to evaluate the association between hospitalization in a general surgery ward and the detection of Enterococcus faecalis isolates with high-level gentamicin resistance (HLGR). A retrospective observational study was conducted using microbiological and clinical data from a single medical center in Poland between 2022 and 2024. Only the first isolate per patient was included in the analysis. HLGR was detected using gentamicin at a screening concentration of 500 µg/mL. Associations between clinical variables and HLGR were assessed using univariate analysis and multivariable logistic regression, including hospitalization in a general surgery ward, age, prior hospitalization, and antibiotic therapy within 90 days. Results: HLGR was identified in a substantial proportion of Enterococcus faecalis isolates. Hospitalization in a general surgery ward was significantly associated with HLGR detection. In multivariable analysis, surgical ward hospitalization remained independently associated with HLGR after adjustment for other variables. Prior antibiotic exposure demonstrated the strongest association with HLGR. Conclusions: Hospitalization in a general surgery ward was associated with an increased likelihood of detecting Enterococcus faecalis isolates with high-level gentamicin resistance. These findings support the importance of antimicrobial stewardship and infection control strategies in surgical settings to limit the spread of resistant enterococcal strains. Full article
(This article belongs to the Special Issue Current Challenges in Antimicrobial Stewardship)
17 pages, 297 KB  
Article
Antimicrobial Stewardship Program Implementation, Perceptions, and Barriers in Zambia: A Cross-Sectional Study Among Healthcare Professionals
by Steward Mudenda, Joseph Yamweka Chizimu, Victor Daka, Jimmy Hangoma, Kelvin Mwangilwa, Priscilla Gardner, Chikwanda Chileshe, Taona Sinyawa, Zoran Muhimba, Charles Chileshe, Sandra Diana Mwadetsa, Shikanga O-Tipo, Duncan Chanda, Maisa Kasanga, Geoffrey Mainda, Webrod Mufwambi, Samson Mukale, Andrew Bambala, Fusya Goma, Aubrey Chichonyi Kalungia, Yasuhiko Suzuki, Brian Godman, John Bwalya Muma and Roma Chilengiadd Show full author list remove Hide full author list
Antibiotics 2025, 14(11), 1094; https://doi.org/10.3390/antibiotics14111094 - 1 Nov 2025
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Abstract
Background/Objectives: Antimicrobial stewardship programs (ASPs) play a vital role in combating antimicrobial resistance (AMR). However, their implementation in Zambia remains variable despite some notable progress. This study assessed healthcare professionals’ awareness of the Multisectoral National Action Plan (NAP) on AMR, alongside their [...] Read more.
Background/Objectives: Antimicrobial stewardship programs (ASPs) play a vital role in combating antimicrobial resistance (AMR). However, their implementation in Zambia remains variable despite some notable progress. This study assessed healthcare professionals’ awareness of the Multisectoral National Action Plan (NAP) on AMR, alongside their perceptions, barriers, and implementation practices related to ASPs. Methods: A cross-sectional survey conducted between August and December 2024 included 364 healthcare professionals (HCPs) in 58 randomly selected public healthcare facilities in Zambia. Data were analysed using IBM SPSS 25.0. Results: Findings revealed that while 75.3% of respondents were aware of the Zambian NAP on AMS, only 68.1% of the respondents reported that their hospitals had established AMS committees. Conversely only 41.2% of the respondents stated that their hospitals possessed hospital-specific treatment guidelines. Encouragingly, 97.5% believed ASPs could enhance clinical outcomes and reduce AMR. Key barriers included limited funding (75.9%), inadequate IT infrastructure (64.1%), limited access to essential data (64%), and healthcare workforce shortages (53.8%). Conclusions: Whilst HCPs in Zambia demonstrated high awareness of the NAP and supported ASP implementation, systemic challenges hindered their consistent execution across health facilities. Gaps in treatment guideline development, AMR data usage, and the integration of antimicrobial susceptibility recording systems into clinical activities must be addressed to strengthen ASP efforts nationwide. Full article
(This article belongs to the Special Issue Current Challenges in Antimicrobial Stewardship)
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