Established by University Hospital Vienna, the Antibiotic Stewardship Programme is designed to achieve continuous quality improvements in the prescription of anti-infectives in terms of the choice of active agent, dosage, administration and the duration of treatment. In turn, this is aimed at ensuring the provision of rational anti-infective-based treatments and reversing the increasing incidence of drug-resistant pathogens.
Antibiotics revolutionised the world of medicine and significantly improved survival rates among patients. However, there is a growing risk that indiscriminate or improper use of antibiotics will cause the drugs to lose their efficacy, especially in the treatment of multiresistant Gram-negative pathogens.
As it is part of the evolution of bacteria, development of resistance is unavoidable. However, it can be delayed through the more selective use of antibiotics. This means that the responsible use of antibiotics is essential.
The objective of the ASP is to establish both structural and individual anti-infective treatment, in accordance with the National Action Plan on Antimicrobial Resistance (NAP-AMR) and the S3 guidelines on strategies to ensure rational application of antibiotics at the hospital. The NAP-AMR addresses the formation of ASP teams to analyse local usage and resistance data, and implement corresponding recommendations and algorithms in clinical practice. The S3 guidelines relate to specific, individual decisions taken at the patient’s bedside: how can we conserve (broad-spectrum) antibiotics without endangering patients?
The ASP members form a multidisciplinary team that pursues a shared goal: promoting the optimum use of antibiotics at the hospital.
Rules of procedure:
ASP spokesman
Univ.-Prof. Dr. Heinz Burgmann
Department of Medicine I, Division of Infectious Diseases and Tropical Medicine
E-mail: heinz.burgmann@meduniwien.ac.at
ASP steering committee
Mag.a Martina Anditsch
University Hospital Vienna Pharmacy
E-mail: post_akh_apo@akhwien.at
Univ.-Prof.in Dr.in Elisabeth Presterl, MBA
Department of Hospital Epidemiology and Infection Control
E-mail: elisabeth.presterl@meduniwien.ac.at
Ao. Univ.-Prof.in Dr.in Birgit Willinger
Department of Laboratory Medicine, Division of Clinical Microbiology
E-mail: birgit.willinger@meduniwien.ac.at
Univ.-Prof. Dr. Heinz Burgmann
Department of Medicine I, Division of Infectious Diseases and Tropical Medicine
E-mail: heinz.burgmann@meduniwien.ac.at
Division of Infectious Diseases and Tropical Medicine – ASP officer
Assoc.-Prof. PD Dr. Heimo Lagler, MPH (head of divisional managers)
E-mail: heimo.lagler@meduniwien.ac.at
PD Dr. Matthias Vossen, PhD
E-mail: matthias.vossen@meduniwien.ac.at
PD Dr. Ludwig Traby, PhD
E-mail: ludwig.traby@meduniwien.ac.at
Numerous studies have confirmed that the financial aspects of treatment with anti-infectives are compatible with optimum clinical outcomes. In other words, adopting certain financially advantageous treatment strategies is not detrimental for patients.
Selecting the right antibiotic – especially in the initial treatment phase – has an important part to play. Inadequate therapies are associated with increased mortality, longer hospital stays and, as a consequence, unnecessarily high costs (see Kalkulierte parenterale Initialtherapie bakterieller Erkrankungen bei Erwachsenen [Calculated Initial Parenteral Treatment of Bacterial Infections in Adults]; German only).
The local situation as regards drug resistance must be considered, as (multi)resistant germs are not only harmful to patients, but also cause significant financial losses.
Prompt initiation of sequential treatment can also help to avoid unnecessary costs. Apart from the potential for direct savings by choosing drugs that are administered orally – which as a rule are cheaper – this often results in shorter inpatient hospital stays, which reduces the use of human resources and disposables (infusion sets, etc.) and avoids additional costs.
De-escalating initial treatment, taking drug administration costs into account (preparation and application) and therapeutic drug monitoring for antibiotics that are less commonly used in treatments can also make a meaningful contribution to enhancing the clinical-financial balance.
This means that considering pharmacoeconomic aspects does indeed play a part in optimising treatments – as a consequence, it also represents an important contribution by the Antibiotic Stewardship team.
The current treatment guidelines on the strategy to ensure rational use of antibiotics at University Hospital Vienna are available here (German only):
Professional collection of samples is essential for ensuring efficient microbiological diagnostics.
Click on the link below for detailed information on the correct pre-analytical procedures for microbiological samples:
As the foundation for empirical antimicrobial therapies, data on local drug resistance are hugely important for the Antibiotic Stewardship Programme (ASP).
Links to the latest drug resistance data can be found below:
“Surveillance of antibiotic consumption is an important quantitative parameter for determining the form and scope of antibiotic use. It indirectly reflects the prescription patterns of clinical physicians and allows changes in use to be identified at an early stage. It is also an indispensable instrument for the medium- and long-term assessment of the effectiveness of ABS interventions.” (S3 Guidelines on strategies to ensure rational application of antibiotics in hospitals)