[Antibiotic stewardship in urology : Time to rethink?]

Urological infections are among the most frequent bacterial diseases and result in a correspondingly high consumption of antibiotics with the associated known increased risk for the development of multidrug-resistant pathogens. For this reason, the measures summarized under the term antibiotic stewardship (ABS) are becoming increasingly more important for a rational use of antibiotics, which are explicitly underlined in the current European and German guidelines on urological infections. Despite these clear guideline recommendations the use of antibiotics in the urological practice is often suboptimal, especially in the treatment of asymptomatic bacteriuria and the excessive use of fluoroquinolones. In this article the principles of ABS are illustrated based on the current guidelines, frequent false applications are described and practical recommendations are given for urologists when dealing with antibiotics in cases of urinary tract infections and urological interventions.