Antibiotic Stewardship – From Bench to Bedside

Abstract

The article explains the practical implementation of Antibiotic Stewardship (ABS) in the clinic. With increasing prevalence of resistant bacteria, the medical profession is challenged to critically question and reduce antibiotic prescriptions. ABS programs are designed to support this. In particular, the involvement of clinic management in the ABS has to improve. There has to be a greater awareness of problems associated with antibiotic use and the data about it must be communicated transparently within the hospital. However, there is also a need for training in the medical profession. The pathophysiological understanding as well as the accurate diagnosis of infectious diseases must be improved. Doctors need courage to forego the use of antibiotics. The consensus within a department and a hospital for withholding antibiotics must be strengthened. However, the awareness of sepsis as an emergency needs to be raised as well, and it is important to focus on hygiene issues and not just on the rapid antibiotic therapy. Microbiological pre-analysis is of crucial importance. In this case, fewer swabs, but more meaningful analytical methods, such as blood cultures or invasive probes, must be attempted. Finally, interactions between clinicians, microbiologists and hospital hygienists are of great importance.