[Antimicrobial Stewardship in Daily Life - "Ask Your Doctor and Your Pharmacist"]. / Antibiotic Stewardship im Alltag ­ "Fragen Sie Ihren Arzt und Apotheker!".

ABSTRACT

Antimicrobial Stewardship (AMS) cannot be practised as a one-man show. A well-established AMS-team with formal authority and dedicated time given by the hospital management can manage its tasks also in exceptional situations as for example an outbreak due to a multi-drug-resistant pathogen. Know-how of clinical infectious diseases is mandatory for all members of the AMS-team. The AMS-team plays various roles in an outbreak situation with the rational use of last-resort antibiotics and optimization of the dosage by therapeutic drug monitoring being most important. Restrictive usage of antibiotics can decrease the antibiotic selection pressure and counteract with the development of new bacterial resistances. Usage of last-resort antibiotics in an outbreak situation leads to an exceptional increase of therapeutic costs with fewer patients at the same time. Interdisciplinary work of infection control, the AMS-team, the different clinical departments and the hospital management are important for the prevention and the management of outbreak situations due to multi-drug-resistant pathogens.