Topics of great relevance about hospital and community infectious diseases will be considered at the fourth AMIT Congress. AMIT wants to share international scientific experiences in order to increase and update medical knowledge. As in the other editions, we have decided to discuss the epidemiology of multi-resistant organisms in European and Italian healthcare facilities and to evaluate the impact of new EUCAST breakpoints in clinical practice.
The global epidemiological situation, which in some cases is dramatic because of a large spread of bacterial strains with little or no sensitivity to the different classes of antibiotics, requires a strict infection control strategy. However resources are often limited. So we need rational and effective control models especially in some situations such as the continuity of care in the elderly, a striking problem during this century . The different strategies adopted for the infection management and treatment should be related to the antibiotic stewardship based on the local epidemiology and the international guidelines. In any case, an appropriate antibiotic therapy must assure a high quality of care and has to be submitted to regular reviews and monitoring.
At present, few new molecules are currently available for the clinician and equally they will not be available in the pipeline for some time. We must therefore review the standard antibiotic regimens increasing dosages and verifying them by current pharmacokinetics and pharmacodynamics therapeutic drug monitoring methods. The case of high resistance microorganisms in critically ill patients is typical. For this reason, clinicians must take care not only of the management of infections but also of the specific characteristics of the diseases (e.g vascular prostheses and osteoarticular, lung, Clostridium difficile and MRSA infections). An update of new HAART options, the HIV/HCV co-infections and new antiviral drugs in viral hepatitis are of great importance for the clinician.
An important topic is the impact and influence of international clinical trials on current practice. An assessment of their benefits and a review of the literature by meta analysis methods are very useful tools for clinical decisions. We believe that translational researches, considered as synergistic beween basic and clinical research, can both improve patientsí care quality and reduce the costs. It is the modern cornerstone of the medical profession.