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Antibiotics
Special Issues
Antibiotic Stewardship Implementation Strategies
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Antibiotic Stewardship Implementation Strategies

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

Deadline for manuscript submissions: 31 August 2025 | Viewed by 441

Special Issue Editor

Dr. Massimo Sartelli

E-Mail Website
Guest Editor
Department of General and Emergency Surgery, Macerata Hospital, 62100 Macerata, Italy
Interests: surgical infections; intra-abdominal infections; healthcare-associated infections; sepsis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Since the discovery of penicillin in the late 1920s, antibiotics have saved the lives of millions of people. The capacity of healthcare systems to ensure patient safety is strictly based on access to effective antibiotics, both for preventing and treating infections. However, despite their essential benefits, antibiotics are often used inappropriately, posing a potential challenge in hospital settings.

Antibiotic stewardship can optimize antibiotic treatment and reduce adverse events associated with antibiotics. Evidence has demonstrated that antimicrobial stewardship can significantly reduce infections and colonization with multidrug-resistant bacteria and Clostridioides difficile in hospital settings. Therefore, hospitals worldwide should utilize the existing resources to organize an effective interdisciplinary team.

Antimicrobial stewardship programs (ASPs) have emerged as a key initiative aimed at optimizing antibiotic usage, improving patient outcomes, and mitigating the emergence of antimicrobial resistance. Fifteen years after the joint guidelines for developing institutional ASPs were devised, best practices are still poorly defined and can vary based on local practice patterns and the available resources.

This Special Issue aims to evaluate how these programs can be implemented in hospital settings.

Dr. Massimo Sartelli
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • antibiotic stewardship
  • implementation
  • hospital settings

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

8 pages, 206 KiB  
Article
The Cost-Effectiveness of Beta-Lactam Desensitization in the Management of Penicillin-Allergic Patients
by Alicia Rodríguez-Alarcón, Santiago Grau, Silvia Gómez-Zorrilla and Carlos Rubio-Terrés
Antibiotics 2025, 14(7), 646; https://doi.org/10.3390/antibiotics14070646 - 25 Jun 2025
Viewed by 74
Abstract
Background/Objectives: Antibiotic management of hospitalized penicillin-allergic patients (PAPs) is associated with prolonged hospital stays, adverse reactions and treatment failure, resulting in increased healthcare costs. This study aimed to estimate the cost-effectiveness of beta-lactam desensitization (DES) in the management of PAPs. Methods: A [...] Read more.
Background/Objectives: Antibiotic management of hospitalized penicillin-allergic patients (PAPs) is associated with prolonged hospital stays, adverse reactions and treatment failure, resulting in increased healthcare costs. This study aimed to estimate the cost-effectiveness of beta-lactam desensitization (DES) in the management of PAPs. Methods: A cost-effectiveness analysis was performed using a probabilistic model with 1000 s-order Monte Carlo simulations. Hospital costs (in 2025 Euros) and effectiveness outcomes (cure and survival rates) were derived from a Spanish retrospective case–control study conducted between 2015 and 2022, which included 56 PAPs (14 in the desensitization group [DES] and 42 in the control group without DES [NDES]; ratio 1:3), and collected healthcare costs per patient. Results: The incremental cost of the DES group was EUR 37,805 (95% CI: EUR 2023–EUR 126,785), with a 100% probability of incurring additional costs compared to the NDES group. The cure rate was 16.5% higher in the DES group (95% CI: 13.3–20.0%), and the estimated gain in life-years per patient (LYG) was 1.42 (95% CI: 1.15–1.73) versus NDES. The cost per life-year gained (LYG) with DES versus NDES was EUR 24,618 ± EUR 19,535 (95% CI: EUR 1755–EUR 73,488). The probability that DES would be cost-effective (cost per LYG < EUR 25,000 and <EUR 30,000) was 61.1% and 100%, respectively. Conclusions: According to this analysis, DES appears to be a cost-effective option for managing PAPs. These findings should be confirmed in clinical studies with larger sample sizes. Full article
(This article belongs to the Special Issue Antibiotic Stewardship Implementation Strategies)
12 pages, 243 KiB  
Article
Adherence to Staphylococcus aureus Bacteremia Management Recommendations Before, During, and After the COVID-19 Pandemic: Prognostic Implications
by Elizabeth Lorenzo-Hernández, Francisco Rivas-Ruiz, Jorge Fernández-Casañas, Vanesa Puerto-Romero, Maria Dolores Martín-Escalante and Alfonso Del Arco-Jiménez
Antibiotics 2025, 14(6), 615; https://doi.org/10.3390/antibiotics14060615 - 18 Jun 2025
Viewed by 194
Abstract
Background/Objectives: This work aims to assess the evolution in the management of Staphylococcus aureus bacteremia (SAB) and the impact of the COVID-19 pandemic on it. SAB is associated with high morbidity and mortality, requiring structured management strategies. The COVID-19 pandemic led to major [...] Read more.
Background/Objectives: This work aims to assess the evolution in the management of Staphylococcus aureus bacteremia (SAB) and the impact of the COVID-19 pandemic on it. SAB is associated with high morbidity and mortality, requiring structured management strategies. The COVID-19 pandemic led to major changes in hospital workflows, potentially affecting the quality of SAB care. Methods: We conducted a retrospective per-protocol analysis of SAB episodes at Costa del Sol University Hospital (Marbella, Spain) across three periods: pre-pandemic, pandemic, and post-pandemic. Patients with early mortality or early transfer were excluded. Clinical variables, adherence to recommended management bundles, and outcomes were compared. Demographic characteristics were similar across the analyzed periods. Results: The incidence of SAB increased over time, with a notable rise post-pandemic. Key management indicators such as the identification of infection source and appropriate antibiotic therapy showed adherence rates of above 90%, while echocardiography exhibited an adherence rate of above 75% throughout the study. Adherence to the full management bundle was suboptimal, with no significant differences between periods. However, an appropriate treatment duration significantly improved in the post-pandemic group (p = 0.038). Mortality at 14 and 30 days was highest during the pandemic period (10.3% and 17.6%, respectively), although differences were not statistically significant. Complications and mortality were more frequent in patients with complete adherence to the bundle (p = 0.031). Conclusions: Despite stable or improved adherence to certain SAB management measures during the pandemic, mortality and complication rates did not significantly decrease, likely reflecting increased patient severity or healthcare system overload. These findings highlight the need for sustained, multidisciplinary, bedside-based approaches to SAB care, even during public health emergencies. Further research is needed to explore modifiable factors and enhance adherence to evidence-based recommendations. Full article
(This article belongs to the Special Issue Antibiotic Stewardship Implementation Strategies)
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