Antibiotic Stewardship (ABS) im Krankenhaus: ein Update

Dieser Beitrag basiert auf einer früheren Übersicht zu ABS [1]. Er lehnt sich zunächst eng an die Gliederung der aktuellen deutschen S3-Leitlinie „Strategien zur Sicherung rationaler Antibiotika-Anwendung im Krankenhaus“ von 2019 an. Vor allem im klinischen Bereich zu Diagnostik und Therapie gibt er jedoch auch konkrete Empfehlungen – im Sinne „alter Wahrheiten und Tugenden“, aber auch auf Basis neuerer (überwiegend randomisierter) Studien.

Kernaussagen

• Antibiotic Stewardship (ABS) fördert den rationalen Einsatz von Antibiotika.

• ABS-Teams sind interdisziplinär aus den Bereichen klinische Infektiologie, Mikrobiologie, Krankenhaushygiene und Apotheke zusammengestellt. Sie brauchen ein Mandat und Deputat seitens der Klinikleitung.

• Die Messung des Antibiotikaverbrauchs sowie die Erstellung der Resistenzstatistik sind Kernaufgaben des ABS-Teams und gesetzlich gefordert.

• ABS-Interventionen sind: hausinterne Leitlinienerstellung, Schulungen, Restriktion von Reserveantibiotika und die regelmäßige Durchführung von ABS-Visiten.

• Auf einer ABS-Visite werden die Indikation, die Substanz(en) und die Therapiedauer besprochen. ABS ist kein Ersatz für klinische Infektiologie.

Publication History

Article published online:
22 February 2022

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