Strategies to enhance rational use of antibiotics in hospital: a guideline by the German Society for Infectious Diseases

• Published in: Infection Vol. 44; no. 3; pp. 395 - 439
• Main Authors: de With, K., Allerberger, F., Amann, S., Apfalter, P., Brodt, H.-R., Eckmanns, T., Fellhauer, M., Geiss, H. K., Janata, O., Krause, R., Lemmen, S., Meyer, E., Mittermayer, H., Porsche, U., Presterl, E., Reuter, S., Sinha, B., Strauß, R., Wechsler-Fördös, A., Wenisch, C., Kern, W. V.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-06-2016; Springer Nature B.V
• Subjects: Anti-Infective Agents - administration & dosage; Anti-Infective Agents - therapeutic use; Antibiotics; Chemotherapy; Communicable Diseases - drug therapy; Drug Resistance; Family Medicine; General Practice; Germany; Guideline; Humans; Inappropriate Prescribing - prevention & control; Infectious Diseases; Internal Medicine; Medicine; Medicine & Public Health; Microbiology; Pharmacy Service, Hospital; Practice Guidelines as Topic; Quality of Health Care; Guideline; ABS; Rational use; Antimicrobial resistance; Antibiotic stewardship; Quality of care
• ISSN: 0300-8126; 1439-0973
• DOI: 10.1007/s15010-016-0885-z

Introduction
In the time of increasing resistance and paucity of new drug development there is a growing need for strategies to enhance rational use of antibiotics in German and Austrian hospitals. An evidence-based guideline on recommendations for implementation of antibiotic stewardship (ABS) programmes was developed by the German Society for Infectious Diseases in association with the following societies, associations and institutions: German Society of Hospital Pharmacists, German Society for Hygiene and Microbiology, Paul Ehrlich Society for Chemotherapy, The Austrian Association of Hospital Pharmacists, Austrian Society for Infectious Diseases and Tropical Medicine, Austrian Society for Antimicrobial Chemotherapy, Robert Koch Institute.
Materials and methods
A structured literature research was performed in the databases EMBASE, BIOSIS, MEDLINE and
The Cochrane Library
from January 2006 to November 2010 with an update to April 2012 (MEDLINE and
The Cochrane Library
). The grading of recommendations in relation to their evidence is according to the AWMF Guidance Manual and Rules for Guideline Development.
Conclusion
The guideline provides the grounds for rational use of antibiotics in hospital to counteract antimicrobial resistance and to improve the quality of care of patients with infections by maximising clinical outcomes while minimising toxicity. Requirements for a successful implementation of ABS programmes as well as core and supplemental ABS strategies are outlined. The German version of the guideline was published by the German Association of the Scientific Medical Societies (AWMF) in December 2013.