Any treatment with antibiotics can promote the development of resistant pathogenic microorganisms. Therefore, it is important to use antibiotics in a targeted manner to limit over- and underuse. Bloodstream infections including sepsis are a widespread problem in hospitals and represent one of the greatest challenges for diagnostics and therapy.

A Responsible Treatment of Staphylococcal Infections

Use Case HELP © UKJ A. Schroll

The clinical use case HELP is dedicated to a responsible antibiotic therapy for staphylococcal bloodstream infections. Coagulase-negative staphylococci are omnipresent - the bacteria are part of the normal skin flora and colonize mainly the nose. The clinical significance of a positive test for these bacteria is therefore questionable. In 75 percent of the cases, detection in blood culture does not correspond to a bloodstream infection, but rather to  contamination. Nevertheless, antibiotics are often administered. This use of antibiotics, which in most cases is not justified, in turn promotes the development of antibiotic resistance and is associated with an increased risk of drug-related side effects.

In contrast, bloodstream infections caused by the aggressive pathogen Staphylococcus aureus must always be treated with an antibiotic. The infections frequently present complications and have a high mortality rate of up to 25 percent. Several studies have shown that mortality can be reduced by up to 50 percent by following recommendations for therapy and diagnostics.

Zitat Prof. Scherag HELP

The HELP App supports guideline-based antibiotic therapy

The HELP App of the SMITH consortium serves physicians as computer-based decision support for patients with a positive staphylococci blood culture. In accordance with the guidelines, the app provides the treating doctors with information on the next diagnostic and therapeutic steps. In addition to a direct improvement in patient care, it also contributes indirectly to the prevention of antibiotic-related multidrug resistance and to the optimization of inpatient consultation by infectiologists.

The HELP study is being conducted at five German university hospitals in Aachen, Essen, Halle, Jena and Leipzig. The lead partner is the University Hospital Jena. In the first stage of the project, an electronic manual is provided (HELP Manual). It gives information on diagnosis and therapy of bloodstream infections with staphylococci and can be used as an app on stationary and mobile devices. In the second stage, the sustainable development of the HELP app as a medical device in accordance with the European Regulation for Medical Devices will take place.  Within the scope of HELP, the functionality of the data integration centers (DIC) established in SMITH will also be validated.