Resistant pathogens: Prevention in hospitals and when manufacturing antibiotics
Antibiotics play a key role in modern medicine. They treat bacterial infections and prevent them from spreading. In certain cases, however, their reliability can no longer be relied upon. That’s because antimicrobial resistance (AMR) – the incidence of resistant pathogens – is spreading worldwide.
Such bacteria are mainly transmitted from person to person, often in hospitals. If they enter the environment via wastewater, however, they can also spread in this way. As a result, infections that were once easily treatable can now be life-threatening. The main cause of this development is the incorrect and excessive use of antibiotics in humans, animals, and plants.
As a healthcare company, Fresenius wants to play its part in containing the spread of resistant pathogens. To this end, the Group is taking various measures – both in the manufacture of antibiotics and in everyday clinical practice.
The responsible manufacture of antibiotics
Fresenius Kabi makes intravenous antibiotics. Careful monitoring of waste and wastewater is essential to prevent antibiotic residues from entering natural ecosystems in an uncontrolled manner. In 2025, Fresenius Kabi received BSI Kitemark™ certification for Minimized Risk of Antimicrobial Resistance for four antibiotics manufactured across three sites in Austria, Poland, and Portugal. This certification confirms compliance with the AMR Industry Alliance’s Antibiotic Manufacturing Standard and that antibiotic residues in waste and wastewater are appropriately controlled and that companies therefore promote responsible antibiotic manufacturing.
What is the AMR Industry Alliance?
In 2022, the AMR Industry Alliance published the Antibiotic Manufacturing Standard, which Fresenius Kabi as a member helped to develop. This standard is designed to give manufacturers guidance on how to manufacture antibiotics responsibly. Since 2023, manufacturers have been able to have their compliance with the standard externally certified by the BSI Group in the form of the BSI Kitemark™ for Minimized Risk of Antimicrobial Resistance.
Antibiotic management in hospitals
There is also a focus on ensuring that a consistent approach is taken to antibiotic management in our hospitals. Helios and Quirónsalud use antibiotics to treat bacterial infections in their hospitals. Effective hygiene measures are an important way of preventing AMR and ultimately nosocomial infections, which are infections that can be acquired during a hospital stay. In addition, all Helios hospitals introduced antibiotic reporting back in 2012 to monitor how often and to what extent antibiotics are used. This was followed in 2019 by an antibiotic stewardship (ABS) program, which includes training for medical staff, joint therapy guidelines, digitally managed prescriptions, and a central infection monitoring system.
“The problem of antimicrobial resistance is still a relatively minor one in Germany compared to other countries, but it is expected to increase – which means that fewer antibiotics could be effective here in the future. Only targeted antibiotic management can prevent or at least curb that.”
A similar program was launched in 2020 at the Quirónsalud Hospital in Barcelona, promoting the targeted and responsible use of antibiotics – on the basis of standardized guidelines, interdisciplinary teams, and the continuous review of prescriptions. Quirónsalud has also developed an AI-supported infection control and prevention system.