[Management of infections in patients with cancer]. / Infektionsmanagement in der Hämatologie und Onkologie: Verantwortungsvoller Einsatz von Antiinfektiva.

Patients with cancer are at increased risk of infection due to disease-associated or therapy-induced immunosuppression. Taking into account globally increasing antimicrobial resistance rates and negative effects associated with antibiotic treatments, the effective, appropriate and guideline-conform use of anti-infectives must be promoted in this clinical setting. The application of antibacterial prophylaxis should be limited to high-risk patients. Infection diagnostics and therapeutic strategies differ depending on the extent of expected immunosuppression and the patient's individual risk factors.

Antibiotic prescription in primary care from the perspective of family physicians: a qualitative study.

INTRODUCTION: Antibiotic consumption increases worldwide steadily. Turkey is now top on the list of global consumption and became a prototype of excessive use of antibiotics. In the last two decades, family physicians (FPs) have become key figures in the healthcare system. This study aims to understand the reasons for inappropriate antibiotic prescribing and elicit suggestions for improving antibiotic use in primary care from doctors themselves. METHODOLOGY: This is a qualitative semi-structured interview study with research dialogues guided by the Vancouver School of interpretive phenomenology. Fourteen FPs from different parts of Turkey were questioned on inappropriate antibiotic prescriptions and their suggestions for improving antibiotic use. RESULTS: The most important reasons for prescribing antibiotics without acceptable indications were patient expectations, defensive medical decision making, constraints due to workload, and limited access to laboratories. The most remarkable inference was the personal feeling of an insecure job environment of the FPs. The most potent suggestions for improving the quality of antibiotic prescription were public campaigns, improvements in the diagnostic infrastructures of primary care centers, and enhancing the social status of FPs. The FPs expressed strong concerns related to the complaints that patients make to administrative bodies. CONCLUSIONS: Primary care physicians work under immense pressure, stemming mainly from workload, patient expectations, and obstacles related to diagnostic processes. Improving the social status of physicians, increasing public awareness, and the facilitation of diagnostic procedures was the methods suggested for increasing antibiotic prescription accuracy.

[Infectious Diseases - Pioneer of Digital Medicine]. / Infektiologie ­ Pionier der Digitalen Medizin.

Digital Medicine has become an integral part of clinical infectious diseases. For chronic infections such as HIV and Hepatitis C, treatment with software tools for resistance phenotyping has become standard of care. Computer-assisted decision aids as well as electronic health records are currently being implemented on a regional basis in Germany. They assist physicians in avoiding treatment errors and selecting antibiotics rationally.Mobile devices allow documentation of the course of chronic infections and improve communication between patient and physician. This offers new opportunities in areas with underdeveloped health infrastructure. In the future, it will become possible to integrate complex datasets, such as genome and microbiome, into clinical treatment decisions. This would adjust treatment individually based on host immune response, metabolism, and microbiota colonization.