Reach a reliable diagnosis sooner
We bring clinicians and microbiologists together so that rapid, precise diagnostics can guide treatment.
An initiative of the Croatian Society for Infectious Diseases
Keeping
antibiotics
effective.
AMS Akademija is Croatia’s national education platform for the responsible use of antimicrobials. We bring together modern diagnostics, infection treatment and multidisciplinary care.
01About the Academy
A new generation of education in antimicrobial therapy.
NextGen AMS Akademija supports ongoing learning and professional exchange. We bring together infectious diseases specialists, clinical microbiologists, internists, intensivists, pharmacists, nurses and others involved in infection care.
Our goals
Make better treatment decisions
We tackle questions about drug choice, dose and duration and discuss new medicines and treatment options.
Put knowledge into practice
We train the next generation of professionals and help teams make responsible antimicrobial use part of everyday care.
In development · mentorship programme
NextGen
AMS Fellows
A structured programme for infectious diseases specialists, microbiologists, clinical pharmacologists, pharmacists and other professionals involved in antimicrobial treatment.
Register your interestOnline workshops and clinical cases
The interactive “Smart use of antibiotics” series explores decisions we make every day.
In-person workshops and site visits
Learn from clinical cases with stewardship teams at referral centres.
Guides and practical tools
Four steps for reviewing treatment, with selected resources for further learning.
International collaboration
Share experience and develop joint projects with experts and centres of excellence.
01
Five modules
Teaching, discussion, practical work and site visits. The first module, “Fundamentals of antimicrobial therapy”, is planned as a two-day workshop.
02
Mentorship and a project
With planned mentoring and scholarships, fellows will develop their own project, such as an audit, local protocol or stewardship campaign.
03
Competency certificate
Fellows are expected to complete a project and a final exam to receive a certificate of competency for working in a stewardship team.
02Antimicrobial resistance
When treatment options
start running out.
In Croatia, resistance limits treatment options for common as well as severe infections. Explore how the share of resistant isolates and the incidence of selected bloodstream infections have changed.
Antimicrobial resistance
3.7×
Carbapenem-resistant Klebsiella pneumoniae
The estimated incidence of carbapenem-resistant K. pneumoniae bloodstream infections in Croatia in 2024 compared with 2019. Incidence was about seven times higher than in Slovenia in 2024.
ECDC · EARS-Net, Table 7Croatia and the EU, 2019–2024
Bloodstream infections per 100,000 inhabitantsSelect a year to see exact values.
Antimicrobial resistance
29%
ESBL-positive E. coli
The share of invasive E. coli isolates that were ESBL-positive rose from 17% in 2019 to 29% in 2024. ESBLs are enzymes that can break down many penicillins and cephalosporins.
Croatian report · invasive isolates, Table 2National surveillance, 2019–2024
ESBL-positive invasive isolates (%)Select a year to see exact values.
Antimicrobial resistance
93%
Carbapenem-resistant Acinetobacter baumannii
In Croatia, 93% of invasive isolates of this bacterium were resistant to carbapenems in 2024. The proportion ranged from 93% to 99% between 2019 and 2024.
Croatian report · invasive isolates, Table 2National surveillance, 2019–2024
Carbapenem-resistant invasive isolates (%)Select a year to see exact values.
Antimicrobial resistance
24 → 54%
Glycopeptide resistance
The share of invasive E. faecium isolates that were resistant more than doubled between 2023 and 2024. Vancomycin is a glycopeptide.
Croatian report · invasive isolates, Table 2National surveillance, 2019–2024
Resistant invasive isolates (%)Select a year to see exact values.
Antimicrobial resistance
+84%
MRSA bloodstream infections
Estimated incidence in Croatia rose from 2.73 to 5.03 per 100,000 inhabitants between 2019 and 2024. Incidence fell by 20% in the EU over the same period.
ECDC · EARS-Net, Table 6Croatia and the EU, 2019–2024
Bloodstream infections per 100,000 inhabitantsSelect a year to see exact values.
The charts show different measures. The proportion of resistant isolates depends on testing and reporting. Bloodstream infection incidence refers to the whole population.
02.1Burden of disease
How many lives do resistant infections claim?
Drug-resistant infections already claim tens of thousands of lives each year in the EU and EEA.
EU and EEA · 2020 estimate
35,000+estimated deaths in 2020 due to infections caused by antibiotic-resistant bacteria.
ECDC · mortality estimateEurope · 2050 scenario
≈ 390,000deaths per year due to antimicrobial resistance in a scenario without effective action.
O’Neill · 2014 modelThe 2020 estimate and the 2050 scenario cover different geographical areas and use different models.
What does the OECD model show for the EU and EEA?
The OECD estimates an average of about 22,000 deaths per year up to 2050, compared with a scenario without resistant infections. Compared with infections caused by susceptible bacteria, it estimates about 6,000 additional deaths per year. OECD · 2023 model
02.2Antibiotic consumption
Antibiotic use is rising in Croatia.
Use has increased in both community and hospital settings. The gap with the European average was wider in hospitals in 2024.
Total consumption
Defined daily doses (DDD) per 1,000 inhabitants per daySelect a year to see exact values.
Community consumption
Defined daily doses (DDD) per 1,000 inhabitants per daySelect a year to see exact values.
Hospital consumption
Defined daily doses (DDD) per 1,000 inhabitants per daySelect a year to see exact values.
02.3From numbers to clinical decisions
Which antibiotics are we using?
HOSPITAL CONSUMPTION · J01DH
+75%
0.08 → 0.14 DDD per 1,000 inhabitants per day
Hospital use rose between 2019 and 2024. In national surveillance, 31% of invasive K. pneumoniae isolates were carbapenem-resistant in 2024.
National report · Table 2 and invasive isolatesDefined daily doses (DDD) per 1,000 inhabitants per daySelect a year to see exact values.
EU ranking · 20242nd of 26
ECDCOnly Greece had higher per-capita hospital carbapenem use than Croatia.
COMMUNITY AND HOSPITAL CONSUMPTION · J01MA
1.45 / 0.25
community / hospital in 2024, in DDD per 1,000 inhabitants per day
Community use fell from 1.51 in 2023 to 1.45 in 2024, while hospital use stayed at 0.25. In 2024, 28% of invasive E. coli isolates were resistant to fluoroquinolones.
National report · Tables 1 and 2 and invasive isolatesDefined daily doses (DDD) per 1,000 inhabitants per daySelect a year to see exact values.
EU ranking · 20242nd in hospitals · 8th in the community
ECDCFluoroquinolone consumption among 26 EU Member States with data.
HOSPITAL GLYCOPEPTIDE CONSUMPTION · J01XA
0.05 → 0.07
DDD per 1,000 inhabitants per day, 2019–2024
These figures cover the whole glycopeptide class, which includes vancomycin. The share of vancomycin-resistant E. faecium isolates rose from 40% in 2023 to 54% in 2024.
National report · Table 2 and enterococciDefined daily doses (DDD) per 1,000 inhabitants per daySelect a year to see exact values.
EU ranking · 20245th of 26
ECDCHospital consumption of the whole glycopeptide class. The ECDC public dashboard does not break out vancomycin.
How should I read the data?
DDD (defined daily dose) is a standardised measure of consumption. Population rates do not measure the proportion of patients treated or the appropriateness of individual prescriptions. Total consumption is compared with the EU average, while sector comparisons use the population-weighted average of the EU/EEA countries covered by the ECDC report. Resistance proportions refer to tested isolates, while bloodstream infection incidence measures infections in the population. Figures for 2020 and 2021 also reflect pandemic-related changes in consumption.
Class rankings use unrounded values from the ECDC dashboard, ordered from highest to lowest consumption per inhabitant among 26 EU Member States with data. ECDC’s public dashboard presents ATC groups up to level four. The glycopeptide ranking therefore cannot be assigned to vancomycin alone (J01XA01).
03Using antimicrobials wisely
Antimicrobial
stewardship.
AMS is a coordinated way to deliver effective treatment promptly and avoid unnecessary antibiotic use. It combines decisions at the bedside with monitoring antibiotic use and giving feedback to prescribers.
Questions from clinical practice
Are we choosing the right antibiotic dose?
When can an antibiotic harm a patient?
Five decisions about treatment
01 / 05
Does the patient need an antibiotic?
Assess the likelihood of bacterial infection and severity of illness. Prompt treatment matters in serious infections.
02 / 05
Which antibiotic is appropriate?
Choose a spectrum that matches the infection site, likely pathogen, local resistance patterns and microbiology results.
03 / 05
How can we achieve an effective dose?
Tailor it to the drug, infection site, kidney function and other patient characteristics.
04 / 05
Can the antibiotic be given orally?
Match the route to the severity of illness and properties of the drug. Plan a switch to oral therapy when appropriate.
05 / 05
When should treatment end?
Set the duration according to the diagnosis, guidelines, source control and response to treatment.
Revisit each decision when new results come in or the patient’s condition changes.
Four decisions during an antibiotic course
Establish a working diagnosis.
Assess infection severity and resistance risk. Obtain appropriate samples when feasible without delaying urgent treatment.
A QUESTION FOR THE TEAM
What infection are we treating, and why is an antibiotic needed?
Revisit the initial decision.
Review the diagnosis, microbiology results and clinical course. Decide whether to continue, narrow, change or stop treatment.
A QUESTION FOR THE TEAM
What do we know now that we did not know at the start?
Tailor treatment to the patient.
Check the dose, renal function and site of infection. Assess whether a switch to oral treatment is appropriate.
A QUESTION FOR THE TEAM
Can a simpler regimen achieve the same goal?
Agree on a stop date.
Set duration according to the diagnosis, guidelines, source control and clinical response. Document the plan clearly.
A QUESTION FOR THE TEAM
When will treatment end, and who will review the plan?
What do hospital stewardship programmes achieve?
Systematic reviews of hospital interventions assessed treatment duration, mortality, and the frequency of resistant infections and colonisation.
shorter antibiotic courses
A Cochrane review of hospital interventions. Mortality was similar in randomised trials, at 11% in both groups.
Davey et al. · Cochrane, 2017infections and colonisation with MDR Gram-negative bacteria
Estimated relative reduction in incidence in a meta-analysis of hospital stewardship programmes.
Baur et al. · Lancet Infect Dis, 2017C. difficile infections
Estimated relative reduction in incidence in the same meta-analysis.
Baur et al. · Lancet Infect Dis, 2017↘From the stewardship team to the bedside
Microbiologists help interpret results, pharmacists help optimise antibiotic use, and infectious diseases specialists connect this information with the patient’s clinical picture and treatment plan.
04The role of infectious diseases specialists
Why involve an infectious diseases specialist as well?
A consultation can change the whole management plan, from finding the source to selecting an antibiotic. It is particularly valuable when the pathogen is hard to treat, the source is unclear or the patient is failing to improve.
Confirm the diagnosis
Interpret microbiology in the context of the patient and distinguish infection from colonisation or contamination.
Find and control the source
Guide evaluation for endocarditis, deep infection or an infected device, and coordinate source control.
Plan treatment and follow-up
Select an effective drug, optimise the dose and duration, and agree on follow-up with the treating team.
S. aureus bloodstream infection
30-day mortality in a meta-analysis of 18 studies (5,337 patients)
Bars show unadjusted mortality from observational studies. Consultation was associated with lower mortality (RR 0.53, 95% CI 0.43–0.65).
Vogel et al. · J Infect, 2016Candida bloodstream infection
90-day mortality in a cohort of 1,691 patients
Bars show unadjusted mortality. In the weighted analysis, consultation was associated with lower mortality (HR 0.81, 95% CI 0.73–0.91).
Mejía-Chew et al. · Lancet Infect Dis, 2019≤ 2 daysfrom admission to consultation
Earlier consultation, shorter stays and lower treatment costs
Consultation within two days of admission was associated with shorter hospital stays and lower treatment costs compared with later consultation.
The US observational study assessed costs using hospital billing and Medicare claims data. In the overall comparison of patients with and without consultation, the cost difference was not statistically significant.
Schmitt et al. · Clin Infect Dis, 201405Education and events
Smart use of antibiotics.
Clinical cases, audience decisions and expert discussion. Register for the final online workshop and explore topics from the 2026 series.
FINAL ONLINE WORKSHOP · 18:00 CET
The patient with infection in the emergency department – 10 decisions in 60 minutes
Vladimir Krajinović · Marija Kusulja · Lorna Stemberger Marić
Workshops from the 2026 series
Common errors in antimicrobial treatment
Iva Butić · Neven Papić
Antibiotics and resistance – what the microbiologist says and what we hear
Arjana Tambić Andrašević · Branimir Gjurašin
Multidrug-resistant infections – treatment strategies in practice
Marija Santini · Nataša Andrijašević
Optimising treatment – de-escalation, PK/PD, allergies and duration
Tomislava Skuhala · Viktor Kotarski · Irina Pristaš
2026 speakers
Iva Butić
Neven Papić
Arjana Tambić Andrašević
Branimir Gjurašin
Marija Santini
Nataša Andrijašević
Tomislava Skuhala
Viktor Kotarski- Irina Pristaš
Vladimir Krajinović- Marija Kusulja
Lorna Stemberger Marić
06The people behind the Academy
Academy leadership.
AMS Akademija is a project of the Croatian Society for Infectious Diseases, part of the Croatian Medical Association.
Neven Papić
MD, PhD · Infectious diseases specialist
Short biography+
Neven Papić
MD, PhD · Infectious diseases specialist
Short biographyHe founded AMS Akademija. He is Head of Clinic at the University Hospital for Infectious Diseases “Dr. Fran Mihaljević” in Zagreb and Assistant Professor and Deputy Head of the Department of Infectious Diseases at the University of Zagreb School of Medicine. He leads hospital antibiotic policy and chairs the hospital medicines committee. He led SepsisFAT and leads SteatoCAP, which studies how metabolic health relates to pneumonia outcomes.
Iva Butić
MD, PhD · Clinical microbiologist
Short biography+
Iva Butić
MD, PhD · Clinical microbiologist
Short biographyShe is a clinical microbiology specialist and heads the Department of Bacteriology at the University Hospital for Infectious Diseases “Dr. Fran Mihaljević” in Zagreb. Her teaching and consultation work connect laboratory diagnostics with clinical decisions. Her research focuses on antimicrobial resistance, invasive bacterial infections and pneumococcal disease. She is a full member of the Croatian Academy of Medical Sciences.
07Programme preview
AMS Akademija 2027
Online workshops
Seven AMS Academy sessions, from everyday decisions about antibiotics to infection prevention and teamwork.
All sessions start at 18:00 Zagreb time
-
Online workshop
Antibiotics: myths and facts
Adverse effects, interactions and consequences we often underestimate.
-
Online workshop
Urinary tract infections in practice
From asymptomatic bacteriuria to urosepsis.
-
Mini-symposium
Is our food full of antibiotics?
From farm to home. How does antimicrobial resistance spread between animals and people?
-
Online workshop
Are care homes safe in the era of multidrug-resistant bacteria?
From colonisation to infection. When to treat, how to manage fever and how to prevent transmission.
-
Symposium · World Sepsis Day
Sepsis in practice
Which decisions cannot wait?
-
Online workshop
Vaccination as part of stewardship
Prevention that reduces the need for antibiotics.
-
Mini-symposium for nurses and pharmacists
An antibiotic has been prescribed. What happens next?
What can nurses and pharmacists change as part of the care team?