[Requirements for the rational use of antibiotics based on antibiotic stewardship]

Given the inadequate and excessive use of antibiotics and the critical development of resistance, the rational prescription of antibiotics has become a key priority in human medicine. A broad range of initiatives to optimize antibiotic use has already been implemented in Germany. These include comprehensive antibiotic stewardship (ABS) training leading to the certification of ABS specialists; the development of a guideline for ABS programs in hospitals; the establishment of regional ABS networks integrating expertise from clinical practice, pharmacy, and microbiology; and the execution of funded interventional studies within the outpatient sector. There is significant potential for improvement in the establishment and financing of ABS teams, infectious disease consultation services, and infection boards in hospitals as well as in the promotion of innovative microbiological diagnostics and the development of sustainable concepts for outpatient care. The systematic integration of microbiological and pharmaceutical expertise into ABS programs is essential, as is the ongoing implementation and further development of modern electronic prescription systems. All these measures substantially improve prescription quality and support key strategies for targeted therapy and shorter treatment durations. To ensure the long-term establishment of these new structures and their further development at intersectoral interfaces, political support and substantial investment are indispensable.