The Antibiotic Stewardship Program was set up by Vienna General Hospital with the aim of continuously improving the quality of anti-infective prescriptions in terms of drug selection, dosage, administration and treatment duration, thus ensuring rational anti-infective therapy and counteracting the increasing incidence of resistant pathogens.
Antibiotics have revolutionized medicine and greatly improved the survival of patients. However, there is an increasing risk that the uncritical or improper use of antibiotics will result in the drugs losing their effectiveness due to the development of resistance, especially in the case of multi-resistant gram-negative pathogens.
The development of resistance is bacterial evolution and is therefore unavoidable, but it can be delayed through the restrictive use of antibiotics. Responsible use of antibiotics is therefore essential.
In accordance with the National Action Plan on Antibiotic Resistance (NAP-AMR) and the S3 guideline "Strategies for ensuring rational antibiotic use in hospitals", the aim of ASP is structural and individual anti-infective therapy. The former involves the establishment of ASP teams, the analysis of local consumption and resistance data and the implementation of corresponding recommendations and algorithms in the hospital. The latter involves concrete, individual decisions at the patient's bedside: how can (broad-spectrum) antibiotics be saved without putting patients at risk?
Together, the members of the ASP form a multidisciplinary TEAM that pursues a common goal: The promotion of optimal antibiotic use within the hospital.
Rules of procedure:
ASP spokesperson
Prof. Dr. Heinz Burgmann
Department of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine
E-mail: heinz.burgmann@meduniwien.ac.at
ASP Steering Committee
Martina Anditsch
Hospital Pharmacy of the Vienna General Hospital
E-mail: post_akh_apo@akhwien.at
Prof. Dr. Elisabeth Presterl, MBA
University Clinic for Hospital Hygiene and Infection Control
E-mail: elisabeth.presterl@meduniwien.ac.at
Associate Professor Dr. Birgit Willinger
Clinical Institute for Laboratory Medicine, Department of Clinical Microbiology
E-mail: birgit.willinger@meduniwien.ac.at
Prof. Dr. Heinz Burgmann
Department of Internal Medicine I, Division of Infectious Diseases and Tropical Medicine
E-mail: heinz.burgmann@meduniwien.ac.at
ASP responsible for the Division of Infectious Diseases and Tropical Medicine
Assoc.-Prof. Priv.-Doz. Dr. MPH Heimo Lagler (Head of the Department)
E-mail: heimo.lagler@meduniwien.ac.at
Priv.-Doz. Dr. Matthias Vossen, PhD
E-mail: matthias.vossen@meduniwien.ac.at
Priv.-Doz. Dr. Ludwig Traby, PhD
E-Mail: ludwig.traby@meduniwien.ac.at
Numerous studies have demonstrated the compatibility of economic aspects of anti-infective therapy with optimal clinical outcome. Adherence to certain economically favorable treatment strategies therefore does not lead to any disadvantages for the patient.
The selection of the "right" antibiotic plays an important role here - especially in the initial therapy. Inadequate therapy is associated with increased mortality, longer hospital stays and thus unnecessarily high costs (see calculated parenteral initial therapy of bacterial diseases in adults).
The local resistance situation must be taken into account when selecting a therapy, as (multi-)resistant germs not only cause harm to the patient, but also considerable financial damage.
Unnecessary costs can also be avoided by initiating sequential therapy in good time. Apart from the direct savings potential due to the generally cheaper oral dosage forms, personnel resources, disposable items (infusion set, etc.) and additional costs can be saved due to the often shorter inpatient stay of patients.
Other useful contributions to the clinical-economic balance include the de-escalation of initial therapy, the consideration of "administration costs" (preparation and application) or therapeutic drug monitoring for antibiotics with a narrow therapeutic range.
The consideration of pharmacoeconomic aspects therefore definitely contributes to therapy optimization and thus represents an important contribution of the Antibiotic Stewardship Team.
Proper sample collection is crucial for efficient microbiological diagnostics.
Detailed information on the correct pre-analysis of microbiological samples can be found under the following link:
"Surveillance of antibiotic consumption is an important quantitative measure for determining the type and extent of antibiotic use. It indirectly reflects the prescribing behavior of clinicians and allows changes in consumption to be identified at an early stage. It is also an indispensable tool for assessing the effectiveness of ABS interventions in the medium and long term." (S3 guideline Strategies for ensuring rational antibiotic use in hospitals)