title: [Antibiotic stewardship (ABS). Definition, contents, necessity and practice on examples of current clinical-urological controversies].
abstract: BACKGROUND
  Infectious diseases caused by multi-resistant pathogens are increasing worldwide and are posing a challenge to German urology as well. Furthermore, there is a limited perspective of new antibiotic developments. One way out of this dilemma is a differentiated handling and use of antibiotics (antibiotic stewardship, ABS).
  
  
  OBJECTIVE
  The aim of this review is to identify key issues in modern urological antibiotic therapy, which can be considered as exemplary for the whole topic of ABS. This includes a review of the current data of the individual topics, including thought-provoking impulse for future clinical application and research.
  
  
  METHODS
  The research group "infectious diseases" of GeSRU Academics identified the following central topics: excessive use of fluoroquinolones, diagnosis and treatment of urethritis and perioperative antibiotic prophylaxis. Subsequently, we performed a literature research in MEDLINE to uncover controversies and open questions of the individual topics within the meaning of ABS.
  
  
  RESULTS
  The analysis of modern antibiotic therapy in urology shows numerous open questions in all quality dimensions of ABS: structural quality (e.g. through improved training of medical staff in the differentiated use of antibiotics), process quality (e.g. by improved adherence to existing infectiological guidelines, here in particular the perioperative prophylaxis and therapy of urethritis) and outcome (e.g. by detection of resistance rates and infection rates).
  
  
  CONCLUSIONS
  The overarching and common goal is to avoid a post-antibiotic era. ABS programmes and a 10-point plan of the federal government are considered positive political developments in this area but do not release the individual urologist from a personal responsibility as part of his daily routine. A critical analysis of the topic "antibiotic treatment" is essential.
authors.affiliation: Klinik für Urologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland. laila.schneidewind@uni-greifswald.de.
authors.forename: L
authors.initials: L
authors.lastname: Schneidewind
authors.affiliation: St.-Antonius Hospital, Klinik für Urologie und Kinderurologie, Akademisches Lehrkrankenhaus der RWTH Aachen, Dechant-Deckers-Straße 8, 52249, Eschweiler, Deutschland. jennifer.kranz@sah-eschweiler.de.
authors.forename: J
authors.initials: J
authors.lastname: Kranz
authors.affiliation: Martini-Klinik, Prostatakrebszentrum, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
authors.forename: K
authors.initials: K
authors.lastname: Boehm
authors.affiliation: Klinik für Urologie, Universität Regensburg, Caritas Krankenhaus St. Josef, Regensburg, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Spachmann
authors.affiliation: Klinik für Urologie, Universitätsmedizin Mannheim, Mannheim, Deutschland.
authors.forename: F
authors.initials: F
authors.lastname: Siegel
authors.affiliation: Klinik für Urologie, Universitätsmedizin Mannheim, Mannheim, Deutschland.
authors.forename: N
authors.initials: N
authors.lastname: Huck
authors.affiliation: Klinik für Urologie, Universität Regensburg, Caritas Krankenhaus St. Josef, Regensburg, Deutschland.
authors.forename: H M
authors.initials: HM
authors.lastname: Fritsche
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001424:Bacterial Infections / Q000188:drug therapy* / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005858:Germany; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000592:standards*; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic Stewardship ABS; Antibiotic resistance; Multi-resistant pathogens; Urethritis; Urinary tract infection