Impact of italian anti-AMR national plan on antibiotic consumption: interrupted time series analysis

Abstract Antimicrobial resistance (AMR) is a global concern, representing a rising threat for public health, with a huge health and economic burden worldwide. In Italy AMR is responsible of about 10,000 deaths every year, equal to about one third of the total deaths in Europe, representing an urgent public health issue. To contrast AMR, in 2017 the Ministry of Health approved the National Action Plan (NAP) to contrast AMR, aligning with Global and Eropean Action Plan on AMR. The aim of this study is to analyse the impact of the Italian NAP on antibiotic trends consumption in primary care. The ECDC data set was employed as data source. Specifically, we collected data about the antibiotic consumption, expressed as Defined Daly Doses - DDD/1,000 inhabitants per day from 1999 to 2023. We conducted an Interrupted Time Series Analysis to analyse the impact of the first Italian NAP approved in 2017 on antibiotic trends consumption in primary care. We found a significant upward trajectory in antibiotic use in the absence of any policy intervention, with a positive coefficient for the time variable (0.099, p = 0.002, 95% CI 0.036-0.163). Upon NAP implementation, the negative coefficient (-4.761, p < 0.001, 95% CI -6.250 to -3.273) for the intervention indicates a significant reduction in consumption levels. Our findings show the upward trend in antibiotic use before the implementation of NAP. A consistent decrease on antibiotic usage in the short-term was observed after the implementation of the plan. In conclusion, the study highlights the pivotal role of policy intervention in countering urgent public health problem, such as AMR. Key messages • The study evaluates the impact of italian AMR national action plan on antibiotic consumption in primary care from 1999 to 2023: an interrupted time series analysis shows the policy relevant role. • The study highlights the pivotal role of policy intervention in countering urgent public health problem, such as AMR.