At a time when a single virus like SARS-CoV-2 is drawing everyone's attention, other viruses and bacteria, fungi and parasites have a much harder time getting into the spotlight.

The World Health Organization (WHO) is still trying to focus on them and, above all, on how to combat them, as it does every year at the end of November with the “Antimicrobial Awareness Week”.

It is intended to raise awareness that we are gradually giving up our sharpest weapons against dangerous microbes.

Monika Ganster

Editor in the Rhein-Main-Zeitung.

  • Follow I follow

The growing insensitivity of bacteria to antibiotics, especially because far too much of them are used worldwide, is a daily challenge at the Institute for Medical Microbiology and Hospital Hygiene at the Frankfurt University Clinic.

This is where “Antibiotic Stewardship” (ABS) is anchored, a team that is committed to the targeted and responsible use of antibiotics.

The funds should be used as narrowly as possible and as little as necessary in order to avoid resistance.

Consequences of resistance can be fatal

Bacteria have already armed themselves against numerous antibiotics and no longer or significantly less reacted to them, explains Thomas Wichelhaus, deputy director of the institute.

He and his committee draft the guidelines for the ABS, while Johanna Kessel and her team monitor the practical implementation.

The consequences of resistance can be fatal for patients because infections can then no longer be controlled.

Studies predict up to 10 million deaths for the year 2050, Wichelhaus describes the situation.

"Neonatology, organ transplantation, prosthesis surgery, stem cell transplantation are only possible if you have mastered the complications of the infection," adds Kessel.

That's why the armory is protected at the university clinic in order to stay in the picture.

Antibiotics, which are also effective against multi-resistant germs, the reserve anti-infectives, may only be used there after consultation with the ABS, explains Kessel.

The infectiologist and her team advise colleagues who are looking for advice on the treatment of patients.

In July, the first “Frankfurt Infection Primer” was published, a small-print reference work for doctors who can find the antibiotics recommended for treatment as well as information on their handling and dosage for many clinical pictures.

50 percent of antibiotics are used inappropriately

At the university clinic, the specialists have also contributed their knowledge to an online training series that will enable a kind of “antibiotics driver's license” from January onwards.

This type of training is unique in Germany, emphasizes Wichelhaus.

It is important for the team to pass on their knowledge: in consultations for doctors from other clinics who do not have any microbiology or infectious diseases departments themselves, but also for resident colleagues.

50 percent of the antibiotics that are prescribed on a daily basis are used inappropriately, Kessel estimates.

Not half of all prescriptions are ineffective, but the remedies are given for too long, in an unsuitable dose or an incorrect substance that is unsuitable for this type of infection.

The consequences must not only be borne by the patient, but also by those around him through collateral damage if antibiotics get into the environment.

While clinical use is only a fraction of what is used in abundance in animal husbandry or agriculture, or prescribed to patients by general practitioners, the need is most urgent in the hospital.

At university hospitals, up to 60 percent of patients are prescribed antibiotics, says Kessel.