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Submitted: 07 Apr 2025
Revision: 28 Aug 2025
Accepted: 25 Sep 2025
ePublished: 11 Oct 2025
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Adv Pharm Bull. 2025;15(4): 871-882.
doi: 10.34172/apb.025.45467
PMID: 41835046
PMCID: PMC12980278
  Abstract View: 811
  PDF Download: 301

Original Article

The Phenomenon of Antimicrobial Resistance in Southern Italy: An Overview of the Current Situation

Stefano Ruga 1 ORCID logo, Raffaele Petti 2, Mara Masullo 2, Fabio Castagna 1, Roberto Bava 1, Michelangelo Armenise 2, Elisabetta Labbate 3, Carmen Lombardi 4, Antonio Giordano 5, Massimiliano Quintiliani 6, Luigi Alfano 7, Emilia Langella 8* ORCID logo, Giovanna Liguori 2 ORCID logo, Renato Lombardi 9 ORCID logo

1 Department of Health Sciences, University of Catanzaro Magna Græcia, 88100 Catanzaro, Italy
2 Local Health Authority, ASL, 71121 Foggia, Italy
3 University of Bari Aldo Moro, 70100, Bari, Italy
4 University Cattolica of Rome, 00168, Roma, Italy
5 Sbarro Institute for Cancer Research and Molecular Medicine, Center for Biotechnology, Department of Biology, College of Science and Technology, Temple University, Philadelphia, U.S.A.
6 Sbarro Health Research Organization ETS, 10060, Candiolo (TO), Italy
7 Department of Breast and Thoracic Oncology, Istituto Nazionale Tumori, IRCSS-G Pascale, 80131, Napoli, Italy
8 Department of Agricultural, Forestry, Food and Environmental Sciences, Università degli Studi della Basilicata Campus di Macchia Romana Via dell’Ateneo Lucano, 10 - 85100 Potenza, Italy
9 Local Health Authority of Foggia, Via Monte Grappa 25, 71121, Foggia, Italy
*Corresponding Author: Emilia Langella, Email: emilia.langella@unibas.it

Abstract

Purpose: Antimicrobial resistance (AMR) is an escalating global health challenge with region-specific implications. This study investigated AMR prevalence in Southern Italy, with particular attention to demographic variables such as gender and age.

Methods: A retrospective analysis of antibiograms from 146 patients (68 males and 78 females, aged 36–101 years) collected between 2022 and 2023 was conducted. Given the retrospective design and reliance on routinely collected clinical data from a local hospital microbiology laboratory, molecular analyses were not feasible, as isolates were processed solely for diagnostic purposes and not preserved.

Results: The most frequently isolated pathogens were Escherichia coli (52.3%), Klebsiella pneumoniae (14.9%), Enterococcus faecalis (6.9%), Proteus mirabilis (6.3%), Staphylococcus aureus (4.6%), and Pseudomonas aeruginosa (4.3%). In males, the highest resistance rates were recorded for ciprofloxacin (47.9%), levofloxacin (47.2%), and trimethoprim/sulfamethoxazole (40.5%). Female patients showed greater resistance to amoxicillin/clavulanate, levofloxacin, and trimethoprim/sulfamethoxazole, with women≥70 years displaying particularly elevated resistance compared with age-matched men and younger females.

Conclusion: Despite the absence of molecular data, phenotypic surveillance through antibiograms remains a critical tool for monitoring AMR trends in underrepresented regions. Incorporating gender-specific differences into clinical practice may improve therapeutic efficacy and stewardship strategies. These findings provide a foundation for future molecular and epidemiological investigations.


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