Background/Objectives: Antimicrobial stewardship programs (ASPs) optimize antimicrobial use, improving outcomes and reducing resistance. This study assessed the impact of a ward-specific ASP. Methods: A pre/post quasi-experimental study was conducted in an internal medicine ward at a tertiary hospital in Padua, Italy. During the intervention year (September 2023–August 2024), a multidisciplinary team (infectious disease consultants, pharmacists, microbiologists, nurses, and hygienists) held bi-weekly ward-based audits, reviewing antimicrobial prescriptions and performing bedside assessments. Therapy adjustments followed guidelines and local epidemiology. Educational sessions and infection prevention and control (IPC) protocols were also reinforced. Outcomes were compared to the previous year, considering patient characteristics. The primary outcome was antimicrobial consumption (DDD/100 patient days, DDD/100PD); secondary outcomes included cost savings, length of stay (LOS), and mortality. Results: Fifty audits assessed 1074 patients and 1401 antimicrobial treatments. Patient characteristics were similar. Antibiotic suspension or de-escalation occurred in 37.9% and 22% of patients, respectively. AWARE ACCESS class use increased (+17.5%), while carbapenem (−54.4%) and fluoroquinolone (−42.0%) use significantly declined (p < 0.05). IPC and microbiological culture guidance were provided in 12.1% of cases. Antimicrobial consumption dropped from 107.7 to 84.4 DDD/100PD (p < 0.05). No significant changes in LOS or mortality were observed. Antimicrobial costs fell by 48.8% (with EUR 57,100 saved). Conclusions: ASP reduced antimicrobial consumption, improved prescription quality, and cut costs without compromising patient outcomes. Multidisciplinary collaboration, audits, and education proved essential. Future studies should assess long-term resistance trends and integrate rapid diagnostics for enhanced stewardship.

Dermatitis herpetiformis (DH) shares a pathophysiological basis with celiac disease (CD), but its epidemiology remains poorly defined. This systematic review and meta‐analysis estimated the prevalence of DH among CD patients. Following the PRISMA 2020 guidelines, PubMed, Embase, Web of Science, and Scopus were searched. Observational studies with extractable DH data in CD patients were pooled using a random‐effects model, with subgroup and meta‐regression analyses. The risk of bias was assessed using the JBI Checklist. Of 7271 records, 24 studies published between 1996 and 2023, comprising 73,905 patients with celiac disease and 2203 DH cases (crude prevalence: 3.0%), met the inclusion criteria. Pooled DH prevalence in CD was 6.8% (95% CI: 5.0–9.3). When restricting the analysis to nonselected populations, the pooled prevalence was 6.7% (95% CI: 4.7–9.6). Prevalence was lower in pediatric CD (2.6%, 1.4–4.5) than in adults (8.6%, 5.8–12.6). Gender‐specific prevalence, based on 5 of the 24 studies and not directly comparable with the overall estimate, was 12.9% (7.0–22.7) in males and 9.6% (3.7–22.9) in females. Sensitivity analyses yielded comparable estimates across all models (range: 6%–9%), indicating that the results were consistent across different methodological assumptions and not driven by specific study characteristics. Given the very high heterogeneity (I ² = 98.9%), the pooled estimate should be interpreted as an average across diverse settings rather than a single generalizable figure. These findings emphasize the need for standardized diagnostic approaches and more consistent reporting in clinical settings. Trial Registration: PROSPERO (CRD42023444060)

Background: The relationship between diet and body composition in people with HIV (PWH) is still not well defined. Therefore, our primary objective was to assess the association between Mediterranean diet (MD) adherence and body composition measured by whole-body dual-energy X-ray absorptiometry (DXA). Secondly, we aimed to assess differences between people living in the north (Padua, Veneto Region, Italy) vs. those living in the south of Italy (Catanzaro, Calabria Region, Italy) and with respect to ethnicity. Methods: In this cross-sectional study, adults with HIV with a confirmed virological suppression were enrolled at two Italian HIV clinics. MD adherence was assessed using the validated MedDiet Score, with high adherence being defined as a score ≥ 25. All participants underwent whole-body DXA. Anthropometric and DXA-derived measures were compared between people with high vs. low adherence to MD, and multivariable linear regression adjusted for age, sex, and CD4⁺ count at nadir was performed. Results: Among 130 participants (81.5% male; median age 57 years), 105 (80.8%) showed high MD adherence. High adherence to MD was more common among participants from Southern Italy than among those from Northern Italy and was associated with Caucasian ethnicity, higher education, higher CD4⁺ count and CD4/CD8 ratio, and a lower prevalence of obesity and neurological disorders. DXA analyses showed lower total and trunk fat mass and higher lumbar spine bone mineral density in highly adherent individuals. After adjustment, high MD adherence remained independently associated with lower BMI (β −5.3, 95% CI −7.3 to −3.4; p < 0.001). Conclusions: In ageing PWH, high MD adherence was associated with a more favourable clinical profile and healthier body composition, particularly lower central adiposity and BMI. Prospective and interventional studies are needed to clarify the role of this type of diet in PWH.

Background: Education is a cornerstone of antimicrobial stewardship, yet evidence on its impact across the entire hospital workforce remains limited. This study aimed to assess knowledge, attitudes, and practices regarding antibiotic use and AMR among workers employed at an Italian tertiary-care hospital, and to explore the association between questionnaire performance and participation in antibiotic-related training activities. Methods: A repeated cross-sectional survey was conducted in 2024 and 2025 at a large Italian tertiary-care hospital (Padua, Northern Italy). A structured questionnaire adapted from an ECDC-validated instrument was distributed through the institutional email system to all hospital employees, including healthcare professionals and non-healthcare workers. The questionnaire investigated demographic and professional characteristics, participation in antibiotic-related training activities, and knowledge, attitudes and practices regarding antibiotic use and AMR. Questionnaire performance was assessed using both a binary scoring system and a partial credit scoring system. Multivariable linear regression analysis was performed to identify independent predictors of performance. Results: A total of 3193 participants completed the survey (1928 and 1265 in 2024 and in 2025, respectively). The mean (SD) total score was 5.75 ± 2.25 out of 15 points, with the lowest performance observed in the practice domain. No significant differences were found between the two survey years (2024 and 2025). Participants who attended antibiotic-related training performed significantly better than untrained participants (6.23 vs. 5.01; p < 0.001), with prior training emerging as the strongest independent predictor of questionnaire performance (β = 4.8; p < 0.001). Younger age was associated with better performance, while longer seniority (>30 years) was associated with lower scores. Among healthcare professionals, modestly higher scores were observed in 2025 compared with 2024, particularly in the practice domain. Conclusions: Persistent opportunities for improvement remain in AMR-related knowledge, attitudes and particularly practices across the hospital workforce. Participation in antibiotic-related training activities was associated with improved questionnaire performance, supporting the role of structured and continuous educational interventions within hospital AMS programs. Repeated institutional educational initiatives may contribute to strengthening stewardship-related awareness and practices over time.

National and international frameworks provide strategic direction for antimicrobial stewardship (AMS), while their translation into operational practice remains inconsistent. Building on ARCO Step I findings, this study aimed to establish an interregional, multidisciplinary consensus on sustainable AMS implementation strategies across hospital and community settings in Northeastern Italy. A modified Delphi methodology engaged 33 interdisciplinary professionals from Northeastern Italy. Eighteen operational statements across three domains (Governance, Hospital AMS, Community AMS) underwent two quantitative scoring rounds (relevance and feasibility; 1–10 scale) separated by a structured in-person workshop with thematic round-table discussions. Consensus threshold was defined as median score ≥ 8.0; high-priority statements required combined score ≥ 8.5. All 18 statements achieved consensus for relevance, whereas 12 statements achieved consensus for feasibility. Post-discussion median scores feasibility showed a numerically larger increase for feasibility (Δ +0.78) compared to relevance (Δ +0.44), indicating that structured deliberation reduced perceived implementation barriers. Furthermore, 14 statements were classified as high-priority. Qualitative analysis identified key enablers (CEO performance mandates, multidisciplinary teams, standardized indicators) and barriers (digital infrastructure gaps, resource constraints). The participatory approach helped translate strategic policy into a set of practice-oriented recommendations, offering a potentially transferable model for regional health authorities implementing AMR action plans, pending evaluation of actual implementation.