ArticlePloS one2022
SPiNCAR: A systematic model to evaluate and guide actions for tackling AMR.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Antimicrobial Resistance in Six Priority Bacteria in Italy: Trends and Regional Variation, 2015-2024.Antibiotics (Basel, Switzerland) · 2026Article
- Bridging the Gap Between Strategy and Implementation in Antimicrobial Stewardship: Insights from the ARCO Step II Interregional Delphi Consensus in Northeastern Italy.Microorganisms · 2026Article
- Mind the governance gap: a one health scoping review of national AMR performance indicators.npj antimicrobials and resistance · 2026Article
- Italy's progress towards the objectives of the national action plan to combat antimicrobial resistance.PloS one · 2026Article
- Assessment of the implementation of the Italian National action plan to combact antimicrobial resistance (PNCAR) 2017-2021 through SPiNCAR-1: results for the Piedmont Region, 2022.Antimicrobial resistance and infection control · 2025Article
- Article
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Authors and funding
23 authors.
Funding
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Abstract
backgroundItaly records very alarming levels antimicrobial resistance (AMR), so a National Action Plan on Antimicrobial resistance (PNCAR) was developed, adopting the AMR European Union's recommendations based on the results of the ECDC site visit of January 2017. For achieving PNCAR objectives, it is necessary to support and harmonize the implementation of recommendations in all the different healthcare levels (regional authorities and local trusts), so the SPiNCAR project was launched to create a tool for reaching this goal.
methodsWe developed a framework based on a scientific literature and national and international guidelines. Firstly, we identified the major intervention areas for tackling AMR, then, for each area, we built a set of standards, both for regional authorities than for local trusts. Every standard is composed by a set of essential and additional criteria, which refer to a minimum or supplemental performance level respectively. The contents were firstly discussed by the project's team during face-to-face kick-off meetings, then confirmed with Delphi methodology and finally validated through a pilot study.
resultsThe final framework consists of seven different areas that reflect the PNCAR structure: Governance, Surveillance and Monitoring, Appropriate Use of antimicrobials, Healthcare-associated Infections (HAIs) control and prevention, Education and Training, Alliance among Stakeholders, Implementation. The total number of standards for the regional framework was 34 with 264 criteria and for the local version 36 criteria with 279 standards.
conclusionThe ongoing use of this tool, developed on international evidences and recommendations that were tailored on the Italian specific context, allows monitoring the improvement achieved over time and plan the next steps.
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