Zusammenfassung
Antibiotic Stewardship (ABS) hat den rationalen Einsatz von Antibiotika in allen Bereichen der Humanmedizin zum Ziel. Zunehmend geht es jedoch nicht nur um Antibiotika, sondern um Antiinfektiva allgemein. Hauptgrund für die Implementierung von ABS ist die besorgniserregende, bakterielle Resistenzentwicklung weltweit, die auf einen steigenden Einsatz von Antibiotika zurückzuführen ist, mit einer Zunahme des globalen Antibiotikaverbrauchs um 65 % vom Jahr 2000 bis zum Jahr 2015. In Deutschland hinkt die ABS-Bewegung zwar grundsätzlich anderen Ländern hinterher, hat jedoch in den letzten Jahren große Fortschritte gemacht. Allen voran werden interdisziplinäre ABS-Teams in Krankenhäusern eingerichtet. Jedoch werden zunehmend auch ABS-Projekte auf der Ebene einer Stadt oder einer Region etabliert, die v. a. auch niedergelassene Ärzte einschließen, und nationale Bemühungen wie die Klug entscheiden-Empfehlungen der Deutschen Gesellschaft für Innere Medizin (DGIM) stellen Ergänzungen dar. All diese Anstrengungen lohnen sich, wie viele Publikationen zeigen, dass nämlich der Antibiotikaverbrauch durch ABS-Maßnahmen deutlich gesenkt werden kann. Aufwendige, über viele Jahre durchgeführte Auswertungen können auch zeigen, dass durch ABS-Interventionen tatsächlich die bakterielle Resistenzrate gesenkt wird. Dies trifft auf Deutschland ebenfalls zu. Eine Analyse, die 2020 publiziert wurde, zeigt, dass der Antibiotikaverbrauch in Deutschland langsam gesenkt wird, insbesondere in der Kinder- und Jugendmedizin. Substanzen wie Cephalosporine und Fluorchinolone werden weniger eingesetzt, wohingegen Aminopenicilline häufiger verwendet werden – ganz im Sinne von ABS.
Abstract
The goal of antibiotic stewardship (ABS) is a rational administration of antibiotics in all areas of human medicine; however, the idea increasingly applies not only to antibiotics but to anti-infective agents in general. The main reason for the implementation of ABS is the alarming global development of bacterial resistance, which can be attributed to the increasing use of antibiotics globally with a 65% rise in antibiotic consumption from 2000 to 2015. For some time Germany dragged behind many other countries in terms of ABS; however, within the past few years substantial progress has been made. Specifically, interdisciplinary ABS teams are being established in German hospitals; however, ABS projects at the level of a town or a geographic region are also being established, which particularly include general practitioners, and national efforts, such as the choosing wisely recommendations of the German Society of Internal Medicine (DGIM), supplement these efforts. All these efforts are worthwhile as many publications show. By implementing ABS measures the use of antibiotics can be clearly reduced. Very elaborate evaluations conducted over many years were also able to show that the bacterial resistance rate is actually reduced by ABS interventions. This holds true for Germany as well. An analysis that was published in 2020 showed that the antibiotic consumption is decreasing slowly in Germany, especially in the pediatric and adolescent medicine sector. Substances, such as cephalosporins and fluoroquinolones are used in decreasing amounts, whereas aminopenicillins are applied more often, in line with ABS.
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T. Welte, Hannover
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Draenert, R. Antibiotic Stewardship – eine Einführung. Z Pneumologie 19, 335–342 (2022). https://doi.org/10.1007/s10405-022-00472-y
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DOI: https://doi.org/10.1007/s10405-022-00472-y
Schlüsselwörter
- Bakterielle Resistenzen
- Antibiotikaverbrauch
- Klug entscheiden-Empfehlungen
- Aminopenicilline
- Antiinfektiva