Antimicrobial Stewardship and Infection Prevention and Control in the Veneto Region, Northeastern Italy: Governance Models, Resources, and Key Challenges Across Hospital and Community Settings-Findings from the ARCO Project.

Antimicrobial resistance represents a global health challenge, with Italy among the most affected countries in Europe. In response, the Veneto Region developed governance models to enhance antimicrobial stewardship (AMS) and infection prevention in both hospital and community settings. This study assessed the implementation of these models and explored strategies for improvement. A survey targeting hospital medical and district health management, hospital pharmacies, and primary care pharmaceutical departments was conducted to evaluate governance adherence, resource allocation, training, and reporting practices. Findings were analyzed by a focus group comprising regional experts, infectious disease specialists, microbiologists, and policymakers, which identified critical gaps and proposed actionable recommendations. Results revealed disparities in AMS implementation between hospital and community care, with key challenges including limited multidisciplinary collaboration, inconsistent resource distribution, and gaps in training. The focus group emphasized the need for stronger governance, standardized protocols, and improved communication to address these shortcomings. This study underscores significant gaps and opportunities within the Veneto Region's healthcare system and provides a framework for enhancing AMS and infection prevention strategies, bridging the divide between hospital and community care to combat antimicrobial resistance effectively.