Deutsche medizinische Wochenschrift
-
Antibiotic stewardship (ABS) denotes structured and continuous measures to improve the quality of prescribing anti-infectives. The aim is to achieve optimal treatment results and to minimize undesirable effects, especially the emergence of antibiotic resistance. This review summarizes the most important ABS principles based on recently published studies with implications for the management of community-acquired pneumonia. ⋯ However, the implementation of ABS programs requires trained personnel and may be impeded by limited structural and time resources. Hence, electronic health records and computer-based interventions are useful support for ABS programs and offer potential to facilitate ABS in inpatient and outpatient care. PCR-based rapid diagnostic tests, PCT-guided algorithms and penicillin allergy testing are suitable procedures to supplement ABS programs.
-
Dtsch. Med. Wochenschr. · Mar 2020
Review[Diagnostics and Treatment of indeterminate Biliary Stenoses].
Biliary stenoses represent a differential diagnostic challenge. Diagnostic methods to clarify the underlying dignity are often invasive, and provide high specificity beside insufficient sensitivity. In many cases, an accurate diagnosis is only possible over time, and therefore limits curative treatment options. This article provides an overview of the diagnostic challenges and treatment options for unclear biliary stenosis.
-
Community-acquired pneumonia (CAP) is one of the most common infectious diseases worldwide. To reduce the high morbidity and mortality of CAP, appropriate diagnosis, risk stratification and therapy are necessary. This review summarizes the current recommendations for the management of CAP in Germany. ⋯ A reevaluation in the first 48-72 hours is mandatory. A therapy duration of 5-7 days is usually sufficient. Preventive influenza and pneumococcal vaccination and nicotine withdrawal are important.