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New S3 guideline for the targeted use of reserve antibiotics in multidrug-resistant pathogens

by | Mar 3, 2026 | Health, Research

In view of increasing antibiotic resistance worldwide, a new S3 guideline for the treatment of severe infections with multidrug-resistant bacteria has been published in Germany. The document, entitled “Antibiotic Therapy of Severe Infections with Multidrug-Resistant Bacteria” (MRETher, AWMF registry number 067-011), is intended to help intensive care physicians and clinicians to use reserve antibiotics precisely and responsibly in critically ill patients.

The guideline aims to ensure optimal chances of recovery for those affected and at the same time to ensure the economical use of these last treatment options. It is primarily aimed at specialists in intensive care units who treat patients with life-threatening infections caused by multidrug-resistant gram-negative and other pathogens.

The work was coordinated by Prof. Dr. Sören Gatermann (Ruhr University Bochum, Department of Medical Microbiology) and Prof. Dr. Matthias Pletz (Jena University Hospital, Institute for Infection Medicine and Hospital Hygiene). A total of 14 professional societies and a patient organization from Germany and Austria were involved, including the German Society for Hygiene and Microbiology (DGHM) as the lead society. The preparation took place over more than two years and was funded by the Innovation Committee at the Federal Joint Committee, among others.

Credits: AWMF
Credits: AWMF

The guideline provides concrete recommendations for microbiological diagnostics, the determination of resistance mechanisms and the targeted use of newer or combined active ingredients with often narrow spectrum. Especially in the case of multi-resistant gram-negative bacteria – with around 100 pathogen species and around 10,000 resistance mechanisms – highly specific use is essential to avoid further resistance developments.

The authors emphasize the social character of antibiotics: Unlike many other drugs, their use influences not only the individual patient but the entire population through selection pressure. Every mission must therefore be carried out particularly responsibly.

Original Paper:

AWMF Guideline Register


Editor: X-Press Journalistenbüro GbR

Gender Notice. The personal designations used in this text always refer equally to female, male and diverse persons. Double/triple naming and gendered designations are used for better readability. ected.

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