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01.10.2015 | Übersichten

Leberfunktionsstörungen in der Intensivmedizin

Konsequenzen für die Therapie invasiver Candidainfektionen

verfasst von: Ali E. Canbay, Dr. Andreas Glöckner

Erschienen in: Wiener klinisches Magazin | Ausgabe 5/2015

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Zusammenfassung

Viele Intensivpatienten weisen Leberfunktionsstörungen auf, die durch intensivmedizinische Maßnahmen, Sepsis, chronische Lebererkrankungen, ischämische Hepatitis oder Medikamententoxizität verursacht sind. Bei invasiven Pilzinfektionen auf der Intensivstation (IST) ist es daher vorteilhaft, Medikamente einzusetzen, die nicht über die Leber verstoffwechselt werden. Dadurch können Komplikationen durch Wirkstoffkumulation, inadäquate Dosierung oder Interaktionen vermieden werden.
In der Therapie invasiver Candidainfektionen sind Echinocandinantimykotika als Substanzklasse der Wahl etabliert. Anidulafungin wird leberunabhängig abgebaut und kann bei schwerer Leberinsuffizienz ohne Dosisanpassung eingesetzt werden. Relevante Arzneimittelinteraktionen sind nicht bekannt. Im primären Endpunkt der Zulassungsstudie bei Candidämie/invasiver Candidiasis wurde die Überlegenheit gegenüber Fluconazol bei insgesamt sehr guter Verträglichkeit gezeigt. Studien speziell bei Intensivpatienten und Patienten mit Leberdysfunktion bestätigen die Effektivität von Anidulafungin für diese Gruppen. Insgesamt ist Anidulafungin eine wichtige antimykotische Therapieoption bei Patienten mit Leberfunktionsstörungen.
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Metadaten
Titel
Leberfunktionsstörungen in der Intensivmedizin
Konsequenzen für die Therapie invasiver Candidainfektionen
verfasst von
Ali E. Canbay
Dr. Andreas Glöckner
Publikationsdatum
01.10.2015
Verlag
Springer Vienna
Erschienen in
Wiener klinisches Magazin / Ausgabe 5/2015
Print ISSN: 1869-1757
Elektronische ISSN: 1613-7817
DOI
https://doi.org/10.1007/s00740-015-0060-7

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