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Antiinfektive Therapie

Therapiestrategien bei Sepsis und septischem Schock

Anti-infective treatment

Treatment strategies for sepsis and septic shock

  • Schwerpunkt: Sepsis
  • Published:
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Zusammenfassung

Sepsis und septischer Schock sind weiter mit einer hohen Mortalität und Morbidität verbunden. Ein entscheidender Faktor für die Verbesserung des Outcomes ist die schnelle Einleitung einer wirksamen Antibiotikatherapie. Das frühe Erkennen einer Sepsis innerhalb der ersten Stunde stellt dabei eine der größten Herausforderungen dar. Zu einer wirksamen empirischen Therapie gehören gezielt ausgewählte Breitspektrumantibiotika, in speziellen Situationen auch Kombinationstherapien bzw. Antimykotika. Deeskalationsstrategien zur Verschmälerung bzw. Verkürzung der Therapie sind sicher und können Nebenwirkungen begrenzen.

Abstract

Sepsis and septic shock are still associated with a high mortality and morbidity. A decisive factor for improvement of the outcome is the prompt initiation of an effective antibiotic treatment. The early recognition of sepsis within the first hour is here one of the biggest challenges. Effective empirical treatment comprises purposefully selected broad-spectrum antibiotics and also combination treatment or antimycotics in special situations. De-escalation strategies to narrow down or shorten the treatment are safe and can limit the side effects.

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  1. Interdisziplinäre Notaufnahme und Abteilung für Krankenhaushygiene und Infektiologie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland

    Frank Hanses

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Correspondence to Frank Hanses.

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F. Hanses gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden vom Autor keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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B. Salzberger, Regensburg

T. Welte, Hannover

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Hanses, F. Antiinfektive Therapie. Internist 61, 1002–1009 (2020). https://doi.org/10.1007/s00108-020-00855-4

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