title: Strategies to enhance rational use of antibiotics in hospital: a guideline by the German Society for Infectious Diseases.
abstract: BACKGROUND
  In the time of increasing resistance and paucity of new drug development there is a growing need for strategies to enhance rational use of antibiotics in German and Austrian hospitals. An evidence-based guideline on recommendations for implementation of antibiotic stewardship (ABS) programmes was developed by the German Society for Infectious Diseases in association with the following societies, associations and institutions: German Society of Hospital Pharmacists, German Society for Hygiene and Microbiology, Paul Ehrlich Society for Chemotherapy, The Austrian Association of Hospital Pharmacists, Austrian Society for Infectious Diseases and Tropical Medicine, Austrian Society for Antimicrobial Chemotherapy, Robert Koch Institute.
  
  
  METHODS
  A structured literature research was performed in the databases EMBASE, BIOSIS, MEDLINE and The Cochrane Library from January 2006 to November 2010 with an update to April 2012 (MEDLINE and The Cochrane Library). The grading of recommendations in relation to their evidence is according to the AWMF Guidance Manual and Rules for Guideline Development.
  
  
  CONCLUSIONS
  The guideline provides the grounds for rational use of antibiotics in hospital to counteract antimicrobial resistance and to improve the quality of care of patients with infections by maximising clinical outcomes while minimising toxicity. Requirements for a successful implementation of ABS programmes as well as core and supplemental ABS strategies are outlined. The German version of the guideline was published by the German Association of the Scientific Medical Societies (AWMF) in December 2013.
authors.affiliation: Division of Infectious Diseases, University Hospital Carl Gustav Carus at the TU Dresden, Fetscherstr. 74, 01307, Dresden, Germany. Katja.deWith@uniklinikum-dresden.de.
authors.forename: K
authors.initials: K
authors.lastname: de With
authors.affiliation: Division Public Health, Austrian Agency for Health and Food Safety (AGES), Vienna, Austria.
authors.forename: F
authors.initials: F
authors.lastname: Allerberger
authors.affiliation: Hospital Pharmacy, Munich Municipal Hospital, Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Amann
authors.affiliation: Institute for Hygiene, Microbiology and Tropical Medicine (IHMT), National Reference Centre for Nosocomial Infections and Antimicrobial Resistance, Elisabethinen Hospital Linz, Linz, Austria.
authors.forename: P
authors.initials: P
authors.lastname: Apfalter
authors.affiliation: Department of Infectious Disease Medical Clinic II, Goethe-University Frankfurt, Frankfurt, Germany.
authors.forename: H-R
authors.initials: HR
authors.lastname: Brodt
authors.affiliation: Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Eckmanns
authors.affiliation: Hospital Pharmacy, Schwarzwald-Baar Hospital, Villingen-Schwenningen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Fellhauer
authors.affiliation: Department of Hospital Epidemiology and Infectiology, Sana Kliniken AG, Ismaning, Germany.
authors.forename: H K
authors.initials: HK
authors.lastname: Geiss
authors.affiliation: Department for Hygiene and Infection Control, Danube Hospital, Vienna, Austria.
authors.forename: O
authors.initials: O
authors.lastname: Janata
authors.affiliation: Section of Infectious Diseases and Tropical Medicine, Medical University of Graz, Graz, Austria.
authors.forename: R
authors.initials: R
authors.lastname: Krause
authors.affiliation: Division of Infection Control and Infectious Diseases, University Hospital RWTH Aachen, Aachen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Lemmen
authors.affiliation: Institute of Hygiene and Environmental Medicine, Charité, University Medicine Berlin, Berlin, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Meyer
authors.affiliation: Institute for Hygiene, Microbiology and Tropical Medicine (IHMT), National Reference Centre for Nosocomial Infections and Antimicrobial Resistance, Elisabethinen Hospital Linz, Linz, Austria.
authors.forename: H
authors.initials: H
authors.lastname: Mittermayer
authors.affiliation: Department for Clinical Pharmacy and Drug Information, Landesapotheke, Landeskliniken Salzburg (SALK), Salzburg, Austria.
authors.forename: U
authors.initials: U
authors.lastname: Porsche
authors.affiliation: Department of Infection Control and Hospital Epidemiology, Medical University of Vienna, Vienna, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Presterl
authors.affiliation: Clinic for General Internal Medicine, Infectious Diseases, Pneumology and Osteology, Klinikum Leverkusen, Leverkusen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Reuter
authors.affiliation: Department of Medical Microbiology and Infection Prevention, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: B
authors.initials: B
authors.lastname: Sinha
authors.affiliation: Department of Medicine 1, Gastroenterology, Pneumology and Endocrinology, University Hospital Erlangen, Erlangen, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Strauß
authors.affiliation: Department of Antibiotics and Infection Control, Krankenanstalt Rudolfstiftung, Vienna, Austria.
authors.forename: A
authors.initials: A
authors.lastname: Wechsler-Fördös
authors.affiliation: Medical Department of Infection and Tropical Medicine, Kaiser Franz Josef Hospital, Vienna, Austria.
authors.forename: C
authors.initials: C
authors.lastname: Wenisch
authors.affiliation: Division of Infectious Diseases, Department of Medicine, Freiburg University Medical Center, Freiburg, Germany.
authors.forename: W V
authors.initials: WV
authors.lastname: Kern
mesh_terms: D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003141:Communicable Diseases / Q000188:drug therapy*; D004351:Drug Resistance; D005858:Germany; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control; D010607:Pharmacy Service, Hospital; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care
chemical_list: D000890:Anti-Infective Agents
keywords: ABS; Antibiotic stewardship; Antimicrobial resistance; Guideline; Quality of care; Rational use