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S2k-Leitlinie der PEG zur kalkulierten parenteralen Initialtherapie bakterieller Erkrankungen bei Erwachsenen

Fokussierte Zusammenfassung und ergänzende Informationen zur Antibiotikatherapie kritisch kranker Patienten

S2k guidelines of the PEG on calculated parenteral initial treatment of bacterial diseases in adults

Focussed summary and supplementary information on antibiotic treatment of critically ill patients

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Zusammenfassung

Im Januar dieses Jahres wurde das Update 2018 der S2k-Leitlinie (LL) „Kalkulierte parenterale Initialtherapie bakterieller Erkrankungen bei Erwachsenen – Update 2018“ (Herausgeber: Paul-Ehrlich-Gesellschaft für Chemotherapie e. V., PEG) publiziert. Diese aktuelle Überarbeitung ist ein hilfreiches Tool für die tägliche Arbeit auf einer Intensivstation, die bezüglich des Infektionsmanagements immer komplexer wird. Die vorliegende fokussierte Zusammenfassung des Update 2018 für den Bereich der Intensivmedizin berücksichtigt neben Antibiotikaklassifikationen und neuen Substanzen zahlreiche aktuelle Aspekte der Pharmakokinetik und Pharmakodynamik, der Mikrobiologie und der Resistenzvermeidung und -entwicklung sowie Empfehlungen für die kalkulierte Behandlung der Sepsis. Wie bei früheren Überarbeitungen werden hierbei die aktuelle Resistenzsituation der Erreger und die Ergebnisse neuer klinischer Studien berücksichtigt und die Substanzen in tabellarischer Form zusammengefasst.

Abstract

In January 2018 the recent revision of the S2k guidelines on calculated parenteral initial treatment of bacterial diseases in adults—update 2018 (Editor: Paul Ehrlich Society for Chemotherapy, PEG) was realized. It is a helpful tool for the complex infectious disease setting in an intensive care unit. The present summary of the guidelines focuses on the topics of anti-infective agents, including new substances, pharmacokinetics and pharmacodynamics as well as on microbiology, resistance development and recommendations for calculated drug therapy in septic patients. As in past revisions the recent resistance situation and results of new clinical studies are considered and anti-infective agents are summarized in a table.

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Authors and Affiliations

  1. Klinik für Anästhesie, operative Intensivmedizin und spezielle Schmerztherapie, Klinikum Heidenheim, Schlosshaustraße 100, 89522, Heidenheim, Deutschland

    A. Brinkmann MBA

  2. Apotheke, Klinikum Heidenheim, Heidenheim, Deutschland

    A. C. Röhr & O. R. Frey

  3. Klinik für Anästhesiologie und Operative Intensivmedizin, Klinikum Konstanz, Konstanz, Deutschland

    W. A. Krüger

  4. Klinik für Anästhesiologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland

    T. Brenner & D. C. Richter

  5. Klinik für Internistische Intensiv- und Notfallmedizin und Klinische Infektiologie, Klinikum Barnim GmbH, Werner Forßmann Krankenhaus, Eberswalde, Deutschland

    K.‑F. Bodmann

  6. Antiinfectives Intelligence GmbH, Campus Rheinbach, Hochschule Bonn-Rhein-Sieg, Rheinbach, Deutschland

    M. Kresken

  7. Rheinische Fachhochschule Köln gGmbH, Köln, Deutschland

    M. Kresken

  8. Stabsstelle Klinische Mikrobiologie und Krankenhaushygiene, Klinikum der Universität München, Campus Großhadern, München, Deutschland

    B. Grabein

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Correspondence to A. Brinkmann MBA.

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Interessenkonflikt

A. Brinkmann, W.A. Krüger, K.‑F. Bodmann, M. Kresken, D.C. Richter und B. Grabein sind ordentliche Mitglieder der Paul-Ehrlich-Gesellschaft für Chemotherapie e. V. A. Brinkmann erhielt: Forschungsförderung von FreseniusMedical Care (FMC), Reisekostenerstattung und Honorare für Vorträge von Grünenthal GmbH, Pfizer Pharma GmbH, FMC, Niedersächsisches Landesgesundheitsamt, LADR-Labor Bremen, Laborbetriebsgesellschaft Dr. Dirkes-Kersting mbH (Gelsenkirchen), Labor Volkmann (Karlsruhe). W.A. Krüger erhielt: Reisekostenerstattung und Honorare für Vorträge von MSD Sharp & Dohme GmbH, Pfizer Pharma GmbH, Astellas Pharma GmbH. T. Brenner erhielt: Reisekostenerstattung und Honorare für Vorträge von Baxter Deutschland GmbH, Schöchl medical education GmbH, Boehringer Ingelheim Pharma GmbH, CSL Behring GmbH, Astellas Pharma GmbH, B. Braun Melsungen AG, MSD Sharp & Dohme GmbH. D.C. Richter erhielt: Reisekostenerstattung und Honorare für Vorträge von Gilead Science Inc., Astellas Pharma GmbH. K.‑F. Bodmann erhielt: Reisekostenerstattung und Honorare für Vorträge von Abbott Medical GmbH, Astellas Pharma GmbH, Basilea Pharmaceutica, Bayer AG, InfectoPharm, MSD Sharp & Dohme GmbH, Novartis, Pfizer Pharma GmbH, Thermo-Fisher Scientific. M. Kresken erhielt: Forschungsförderung von AstraZeneca Deutschland, BAH Bundesverband der Arzneimittel-Hersteller e. V., Basilea Pharmaceutica, Eumedica Pharmaceuticals AG, Cubist Pharmaceuticals, LeoPharma GmbH, MSD Sharp & Dohme GmbH, PEG, Rosen Pharma und Reisekostenerstattung und Honorare für Vorträge von Basilea Pharmaceutica, Eumedica Pharmaceuticals AG, InfectoPharm, Leo Pharma GmbH, MSD Sharp & Dohme GmbH, Pfizer Pharma GmbH, Rosen Pharma. B. Grabein erhielt: Reisekostenerstattung und Honorare für Vorträge von Astellas Pharma GmbH, Basilea Pharmaceutica, Correvio GmbH, InfectoPharm, MSD Sharp & Dohme GmbH, Pfizer Pharma GmbH. A.C. Röhr und O.R. Frey geben an, dass kein Interessenkonflikt besteht.

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Brinkmann, A., Röhr, A.C., Frey, O.R. et al. S2k-Leitlinie der PEG zur kalkulierten parenteralen Initialtherapie bakterieller Erkrankungen bei Erwachsenen. Anaesthesist 67, 936–949 (2018). https://doi.org/10.1007/s00101-018-0512-8

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