Antimicrobial stewardship – a critical pillar in the fight against antimicrobial resistance in Romanian hospitals

Mihaela Cristina Negulescu ^{1, 2 *,} Adrian Marinescu ^{1, 3}

¹ Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
² Fundeni Clinical Institute, Bucharest, Romania
³ Prof. Dr. Matei Bals National Institute of Infectious Diseases, Bucharest, Romania
* Correspondence to: Mihaela Cristina Negulescu, Fundeni Clinical Institute, 258 Fundeni Ave., 022328, Bucharest, Romania. E-mail: mihaela-cristina.bondoc@drd.umfcd.ro

Abstract

Antimicrobial resistance (AMR) directly threatens patient safety and treatment efficacy. Romania continues to rank among European Union (EU) countries with a high prevalence of carbapenem-resistant Klebsiella pneumoniae and Acinetobacter baumannii, while broad-spectrum antibiotic consumption remains high. Consistent implementation of antimicrobial stewardship (AMS) programmes is essential to reduce the selection pressure for resistant strains and improve patient outcomes. This article presents recent epidemiological data from ECDC reports for 2023, describes the main pillars of AMS, and proposes a “10-step AMS bundle” for intensive care units, based on ESCMID and IDSA guidelines.