Wendt S, Ranft D, de With K, Kern W V, Salzberger B, Lübbert C
Bereich Infektions- und Tropenmedizin, Klinik und Poliklinik für Gastroenterologie, Hepatologie, Infektiologie, Pneumologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig, AöR, Liebigstr. 20, 04103, Leipzig, Deutschland.
Interdisziplinäres Zentrum für Infektionsmedizin (ZINF), Universitätsklinikum Leipzig, Leipzig, Deutschland.
Internist (Berl). 2020 May;61(5):475-486. doi: 10.1007/s00108-020-00763-7.
Antibiotic stewardship (ABS) is an important measure to counteract the spread of resistant pathogens and multidrug resistance. The most important ABS tools include the implementation of local guidelines, the development of a house-related list of anti-infective agents, regular ABS visits and practice-oriented internal training events. Effective strategies for therapy optimization include indication testing and therapy evaluation, dose optimization as well as determining an appropriate duration of therapy. Oralization of anti-infectives (sequence therapy) should be supported by consistent clinical criteria in in-house guidelines. The incidence of Clostridioides difficile infections (CDI) can be more than halved by restricting the so-called "4C antibiotics". Point-of-care tests help to minimize the use of antibiotics in the outpatient setting. Vaccination reduces the need for antibiotic therapy.
抗生素管理（ABS）是应对耐药病原体传播和多重耐药的一项重要措施。最重要的抗生素管理工具包括实施当地指南、制定医院相关抗感染药物清单、定期进行抗生素管理查房以及开展以实践为导向的内部培训活动。优化治疗的有效策略包括适应症检测与治疗评估、剂量优化以及确定合适的治疗疗程。医院内部指南中的一致临床标准应支持抗感染药物的口服化（序贯治疗）。通过限制使用所谓的“4C抗生素”，艰难梭菌感染（CDI）的发生率可降低一半以上。即时检测有助于减少门诊环境中抗生素的使用。接种疫苗可减少对抗生素治疗的需求。
