Infektiologie – ein Schwerpunkt der Inneren Medizin

Abstract

Infectious diseases have recently gained wide public interest. Emerging infections and rising rates of antibiotic resistance are determining this trend. Both challenges will need to be addressed in international and local collaborations between different specialties in medicine and basic science. Infectious diseases as a clinical specialty in this scenario is directly responsible for the care of patients with infectious diseases. Its involvement in the care of patients with complicated infections has proved to be highly effective. Antibiotic stewardship programmes are effective measures in slowing the development of antibiotic resistance and have been widely implemented. But antibiotic stewardship specialists should not be confused with or taken as an alternative to infectious disease experts. Infectious diseases requires appropriate and specific training. It mainly uses the instrumentarium of internal medicine. With the current challenges in modern medicine, infectious diseases in Germany should thus be upgraded from a subspecialty to a clinical specialty, ideally within Internal Medicine.

Complexity of patients with or without infectious disease consultation in tertiary-care hospitals in Germany

“…After all, our results strengthen the risen claim that physicians treating these complex patients need to have an in-depth training in infectious diseases as well as internal medicine, as many of these patients have a high number of secondary diagnoses needing to be taken into consideration when recommending treatment regimens and diagnostics [ 16 , 21 ]. In addition, even though not always visible in clinical practice, one can assume that the ID consultations service is called especially to the critical and complex patients, suggesting a working selection mechanism in the participating study hospitals.…”

Ist die Fachrichtung assoziiert mit der Selbstsicherheit im Umgang mit rationaler Antibiotikaverordnung?

“…Von infektiologischer Seite wird auch das Fehlen eines designierten Facharzttitels für Infektiologie und der daraus resultierende Mangel an ausreichender konsiliarischer Beratung derklinischenFachabteilungenals weitere Ursache für problematische Antibiotikaverwendung genannt, denn gerade im Kontext von Infektionen mit multiresistenten Erregern können innovative Therapieansätze von entsprechend qualifiziertem Personal zur Steigerung der Therapieeffizienz führen [11]. Eine Infektionsbehandlung ausschließlich durch designierte internistische Infektiologen, wie sie von den entsprechenden Fachgesellschaften diskutiert wird, sollte jedoch kritisch betrachtet werden [12,13].…”