Rising significance of antibiotic stewardship in urology and urinary tract infections - a rapid review.

To give an overview of the significance as well as recent developments in antibiotic stewardship (ABS) in urology and for the treatment of urinary tract infections (UTI). This rapid review is focused on recent publications during the past 18 months.

Despite the evidence to support the use of ABS interventions in the treatment of UTIs, there remains considerable inappropriate use of antibiotics, up to 68%, especially concerning the treatment of asymptomatic bacteriuria and the overuse of fluoroquinolones. Emerging evidence indicate that ABS programs can improve patient outcome and reduce multidrug-resistant pathogens.Interestingly, in this past 18 months new targets for ABS have been developed, e.g. involvement of a pharmacist, strict adherence to guidelines, improvement of the guidelines itself and understanding the prescription process in the emergency room as well as the analysis of own surveillance data.

ABS programs in urology are essential and their significance has become more apparent than ever before. New targets for ABS interventions should be evaluated in prospective controlled clinical trials of their effectiveness to reduce further inappropriate antibiotic use without hindering the treatment of UTIs.

Current opinion in urology. 2021 May 18 [Epub ahead of print]

Laila Schneidewind, Jennifer Kranz, Zafer Tandogdu

University Medical Center Rostock, Department of Urology, Rostock St. Antonius Hospital Eschweiler, Department of Urology, Eschweiler Martin-Luther-University, Department of Urology and Kidney Transplantation, Halle (Saale), Germany University College London Hospitals, Department of Urology, London University College London, Division of Surgery and Interventional Science, London, UK.