Rational prescription of antibiotics in human medicine

Rational prescription of antibiotics has become a priority in undergraduate and continued professional medical education and in quality management systems. Areas for optimization have been identified, above all, in critically establishing the indication for therapy, in increasing targeted therapy, and shortening treatment duration, and affect both outpatient and inpatient settings. They are partly related to deficiencies in clinical research, but aberrations in the development of the postgraduate training system, in the infrastructure, and in the reimbursement system of the various healthcare sectors in Germany contribute to problems in these areas. "Antibiotic stewardship" (ABS) programmes at different levels are capable of efficiently combining interventions to improve the quality of prescription. Progress has been made and experience gained in the professional training of physicians and pharmacists in antibiotic prescribing and with the hospital-wide establishment of ABS teams and specialist infectious disease consultation services. Close interaction and collaboration with diagnostic microbiology services are important and greatly enhance the impact of ABS programmes on the quality of prescription. Political support and investment are required for this new infrastructures to be sustainable and to further develop it for the cross-section between inpatients and outpatients, and for the outpatient setting.