Title: pREVention and management tools for rEducing antibiotic Resistance in high prevalence SEttings.

Design: Prospective multi-centre, cluster-randomised, stepped-wedge trial in 24 hospitals of four European countries (Greece, Italy, Romania, Spain) to evaluate the effectiveness of diagnostic stewardship, infection prevention and control, and antibiotic stewardship programmes on antimicrobial resistance in acute care.

Registration Number: n.a.

Primary Objective:

• To develop and implement cost-effective strategies and tools for the prevention and clinical management of healthcare-associated infections (HAIs) due to multidrug-resistant pathogens, and to reduce the burden of antimicrobial resistance (AMR) in high prevalence care settings.

Three complementary intervention programmes, for the prevention and management of infections due to AMR pathogens, will be developed. They will run in 6 hospitals and four Member States: Microbiology and Diagnostic Stewardship (MDS) Programme; Infection Prevention and Control (IPC) Programme, and Antibiotic Stewardship (ABS) Programme.

The University of Verona will be responsible for managing the clinical studies in the selected sites in Italy and will be in charge of the ABS programme for the overall project.

Secondary Objective:

To develop knowledge that can be of use for other countries around the globe, including low and middle income countries, benefitting their local population and diminishing the global spread of resistant bacteria.

Publications: n.a.

Interested in a collaboration? Maela Tebon (maela.tebon@univr.it), Ruth Davis (ruthjoanna.davis@univr.it).