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„Antibiotic Stewardship“

Maßnahmen zur Optimierung der Verordnung von Antiinfektiva

Antibiotic stewardship

Measures for optimizing prescription of anti-infective agents

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Zusammenfassung

Antibiotic Stewardship (ABS) umfasst ein Bündel unterschiedlicher Maßnahmen, die eine Verbesserung des Antiinfektivaeinsatzes verfolgen. Kernstrategie von ABS ist eine interdisziplinäre Visite zum Infektionsmanagement auf der Station, bei der die behandelnden ÄrztInnen vom ABS-Team beraten werden. Häufige Ansatzpunkte zur Optimierung sind Substanzauswahl, Applikationsweg, Dosierung der Medikamente und die Therapiedauer. Neben der unmittelbar patientenbezogenen Tätigkeit kümmern sich ABS-Teams um eine infrastrukturelle Verbesserung des Infektionsmanagements. Hierunter fallen die Erstellung und die Interpretation von Resistenzstatistiken, die Surveillance von nosokomialen Infektionen und die Erstellung lokaler Therapieleitlinien. Antibiotic stewardship führt typischerweise zu einer Reduktion des Antibiotikaverbrauchs, was günstige Effekte auf die Resistenzinduktion hat. Das Outcome der Patienten ist hierdurch nicht nachteilig beeinflusst. Die Strategien von ABS können ohne Bedenken auch bei kritisch kranken Patienten auf der Intensivstation angewandt werden.

Abstract

Antibiotic stewardship (ABS) comprises a bundle of different interventions to improve anti-infective treatment in a hospital setting. An important component of ABS interventions is the interdisciplinary approach to infection management. Besides improving infrastructural aspects on a hospital level, including surveillance of the use of anti-infective agents and nosocomial infections, collation and interpretation of statistics on resistance and formulation of local treatment guidelines, ABS teams go to the wards and advise treating physicians on antibiotic therapy. Frequent approaches for optimization are selection of substances, administration route, dosing of medication and duration of treatment. An important overall objective of ABS is the reduction of resistance induction in order to preserve the therapeutic efficiency of antibiotics. A number of studies have shown that this goal can be achieved in different clinical settings without negatively affecting patient outcome. The strategies of ABS can also be applied with no problems to critically ill patients on the intensive care unit.

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Authors and Affiliations

  1. Antibiotic Stewardship (ABS)-Team, Institut für Hygiene, Universitätsklinikum Münster, Robert-Koch-Str. 41, 48149, Münster, Deutschland

    C. Lanckohr EDIC, ABS-Experte (DGI)

  2. Klinik für Anästhesiologie, operative Intensivmedizin und Schmerztherapie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Geb. A1, 48149, Münster, Deutschland

    C. Lanckohr EDIC, ABS-Experte (DGI)

  3. Klinik für Anästhesiologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland

    H. Bracht ABS-Experte (DGKH)

Authors
  1. C. Lanckohr EDIC, ABS-Experte (DGI)
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  2. H. Bracht ABS-Experte (DGKH)
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Correspondence to C. Lanckohr EDIC, ABS-Experte (DGI).

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Interessenkonflikt

C. Lanckohr und H. Bracht geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Lanckohr, C., Bracht, H. „Antibiotic Stewardship“. Anaesthesist 67, 3–8 (2018). https://doi.org/10.1007/s00101-017-0398-x

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