Diagnostic stewardship: zin of onzin?!

The right test at the right time for the right patient to answer the right questions and to start the right treatment - many important decisions have to be made involving multiple medical specialists. The importance of appropriate and timely diagnostics to guide this process (stewardship) are obvious but are often neglected in classic stewardship concepts of infection management.
We describe the approach of a multidisciplinary, intertwined stewardship concept with a focus on diagnostics, where medical specialists in general and medical microbiologists in particular closely interact for optimal quality of care and patient safety in successful infection management. Diagnostics in medical microbiology laboratories are advancing fast with regards to new technologies and improved workflows. Yet, diagnostics in infection management is broader than this and cover many clinical areas where communication and interaction are the key to make the best use of knowledge and expertise that all specialisms can contribute to patient care. These aspects are demonstrated in two cases of patients with prosthetic joint infections with two very different outcomes.