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==Therapie==
{| class="wikitable sortable mw-collapsible MsoTableGrid" style="width:488.8pt;" border="1" cellspacing="0" cellpadding="0" width="652"
|+
| style="width:212.4pt;" width="283" valign="top" |'''<span style="font-size:11.0pt;line-height:150%;font-family:&quot;Arial&quot;,sans-serif;
  mso-fareast-language:DE">Herpes simplex Typ 1 und 2</span>'''


<span style="color: black">Primärinfektion</span>
| style="width:276.4pt;" width="369" valign="top" |
*<span style="color: black">Aciclovir 3-4x 400mg oder 5x 200mg 5-7 Tage p.o.</span>
*Valaciclovir 2x 500mg 7-10  Tage p.o.
*Famciclovir 3x 250mg 7-10  Tage p.o.
|- style="height:77.8ptpx;"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: black">Reaktivierung</span>
| style="width:276.4pt;" width="369" valign="top" |
*Aciclovir 2x 800mg oder 3x  400mg oral 5 Tage p.o.
*Aciclovir 3x 800mg 2 Tage p.o.
*Valaciclovir 2x 500mg 3-5  Tage p.o.
*Valaciclovir 1x1g 5 Tage  p.o.
*Famciclovir 2x  125mg 5 Tage
|- style="height:20.8ptpx;"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: black">Schwangere</span>
| style="width:276.4pt;" width="369" valign="top" |
*Aciclovir 3x 400mg 10 Tage p.o.
|- style="height:41.9ptpx;"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: black">Dauertherapie</span>
<span style="color: black">(bis 6 Monate)</span>
| style="width:276.4pt;" width="369" valign="top" |
*Aciclovir 2x 400mg p.o.
*Famciclovir 2x 250mg p.o.
*Valaciclovir 1x 500mg p.o.
|- style="height:166.7ptpx;"
| style="width:212.4pt;" width="283" valign="top" |'''<span style="color: black">Gonorrhoe</span>''' <sup><span style="color: #0070C0">[13</span></sup><ref><span style="font-family:&quot;Arial&quot;,sans-serif;
mso-fareast-font-family:&quot;Times New Roman&quot;;mso-fareast-language:DE">059/004 S2k-Leitlinie: Diagnostik und Therapie der Gonorrhoe, Stand 12/2018</span></ref><sup><span style="color: #0070C0">,14</span></sup><ref>Buder, S.et al., Antimicrobial resistance of Neisseria gonorrhoea in Germany: low levels of cephalosporin resistance, but high azithromycin resistance, BMC Infectious Diseases. 2018 (18); 44.</ref><sup><span style="color: #0070C0">,15</span></sup><ref>Day, M.J., et al., Stably high azithromycin resistance and decreasing ceftriaxon susceptibility in Neisseria gonorrhoeae in 25 European countries, 2016. BMC Infectious Diseases. 2018 (18); 609.</ref><sup><span style="color: #0070C0">]</span></sup>
'''<span style="color: black">(Neisseria  gonorrhoea)</span>'''<sup><span style="color: #0070C0"> </span></sup>
<span style="color: black">Urogenital, Pharynx, Rektum</span>
| style="width:276.4pt;" width="369" valign="top" |<span style="color: black">Empirisch bei nicht  auszuschliessender Begleitinfektion:</span>
*<span style="color: black">Ceftriaxon 1-2g i.v. oder i.m. Tag 1</span>
<span style="color: black">+ Azithromycin 1,5g oral Tag 1</span>
<span style="color: black">ohne  Begleitinfektion:</span>
*<span style="color: black">Ceftriaxon 1-2g i.v. oder i.m. Tag 1</span>
<span style="color: black">Alternativen bei  nachgewiesener Empfindlichkeit:</span>
<span style="mso-list:Ignore">· <span style="font:7.0pt &quot;Times New Roman&quot;">         </span></span>Azithromycin 2g  Tag 1 p.o.
*<span style="color: black">Cefixim 800mg Tag 1 p.o. (nicht bei Pharynx-Befall)</span>
<span style="color: black"><span style="mso-char-type:symbol;mso-symbol-font-family:Symbol">±</span></span><span style="color: black"> Azithromycin 1,5g Tag 1  p.o.</span>
|- style="height:91.1ptpx;"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: #333333">Schwangerschaft</span>
| style="width:276.4pt;" width="369" valign="top" |
*<span style="color: black">Ceftriaxon 1g i.v. oder i.m. Tag 1</span>
<span style="color: black">nur bei  Kontraindikation gegen Ceftriaxon und nachgewiesener Empfindlichkeit:</span>
*Azithromycin 2g Tag 1 p.o.
|- style="height:20.8ptpx;"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: #333333">Kinder</span>
| style="width:276.4pt;" width="369" valign="top" |
*<span style="color: black">Bis 45kg KG Ceftriaxon 20-50mg/kg KG i.v. oder i.m. Tag 1</span>
|- style="height:35.95ptpx;"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: #333333">Disseminierte Gonokokkeninfektion</span>
| style="width:276.4pt;" width="369" valign="top" |
*<span style="color: black">Ceftriaxon 2g alle 24 Stunden 7 Tage i.v. oder i.m. <span style="mso-spacerun:yes">                          </span>+ Azithromycin  1,5g Tag 1 p.o.</span>
|- style="height:134.15ptpx;"
| style="width:212.4pt;" width="283" valign="top" |'''<span style="color: #333333">Chlamydia trachomatis </span>'''<sup><span style="color: #0070C0">[8</span></sup><ref>059/005 S2k-Leitlinie: Infektionen mit Chlamydia trachomatis, Stand 08/2016.</ref><sup><span style="color: #0070C0">]</span></sup>
<span style="color: black">Urogenital,  Pharynx, Rektum</span>
| style="width:276.4pt;" width="369" valign="top" |
*<span style="color: black">Doxycyclin 2x 100mg 7 Tage p.o.</span>
<span style="color: black">Alternativ nach Ausschluss  Serotyp L1-3 bei Proktitis</span><span style="color: black">:</span>
*<span style="color: black">Azithromycin 1,5g Tag 1 p.o.</span>
<span style="color: black">bei synchroner Infektion  mit Gonokokken:</span>
*<span style="color: black">Ceftriaxon 1-2g Tag 1 i.v. oder i.m.</span>
<span style="color: black">+ Azithromycin 1,5g Tag 1 p.o.</span>
|- style="height:77.5ptpx;"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: #333333">Lymphogranuloma venereum (</span><span style="color: black">Serotyp L1-L3)</span>
| style="width:276.4pt;" width="369" valign="top" |
*<span style="color: black">Doxycyclin 2x 100mg 21 Tage p.o.</span>
<span style="color: black">Alternativ:</span>
*Azithromycin 1,5g Tag 1,8,15  p.o.
*Erythromycin 4x 500mg 21  Tage p.o.
|- style="height:64.55ptpx;"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: #333333">Prostatitis</span>
| style="width:276.4pt;" width="369" valign="top" |
*<span style="color: black">Doxycyclin 2x 100mg 7 Tage p.o.</span>
<span style="color: black">Alternativ:</span>
*Levofloxacin 1x 500mg 7 Tage  p.o.
|- style="height:59.55ptpx;"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: #333333">Epididymitis</span>
| style="width:276.4pt;" width="369" valign="top" |
*<span style="color: black">Doxycyclin 2x 100mg 14 Tage p.o.</span>
<span style="color: black">Alternativ:</span>
*Levofloxacin 1x 500mg 7 Tage  p.o.
|- style="height:39.35ptpx;"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: #333333">Konjunktivitis</span>
| style="width:276.4pt;" width="369" valign="top" |
*<span style="color: black">Doxycyclin 2x 100mg 7 Tage p.o.</span>
*<span style="color: black">Azithromycin 1,5g Tag 1 p.o.</span>
|- style="height:81.9ptpx;"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: #333333">Schwangerschaft</span>
| style="width:276.4pt;" width="369" valign="top" |
*<span style="color: black">Azithromycin 1,5g Tag 1 p.o.</span>
*<span style="color: black">Doxycyclin ab 16. SSW ''kontraindiziert''</span>
<span style="color: black">Alternativ:</span>
*Erythromycin 500mg 4x tgl.  oral 7 Tage
|- style="height:41.9ptpx;"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: #333333">Kinder</span>
| style="width:276.4pt;" width="369" valign="top" |<span style="color: black">Kinder <  45kg KG:</span>
*Erythromycin 10mg/kg KG 4x  tgl. 14 Tage p.o.
<span style="color: black">Kinder ab 8  Jahren > 45kg KG:</span>
<span style="color: black">Doxycyclin 200mg Tag 1, 100mg Tag 2-7</span>
|- style="height:125.6ptpx;"
| style="width:212.4pt;" width="283" valign="top" |'''<span style="color: black">Syphilis (Treponema  pallidum)</span>''' <sup><span style="color: #0070C0">[16</span></sup><ref>RKI-Ratgeber Syphilis (2003). Available online at: <nowiki>https://www.rki.de/DE/Content/Infekt/EpidBull/Merkblaetter/Ratgeber_Syphilis.html#doc2382636bodyText8</nowiki></ref><sup><span style="color: #0070C0">]</span></sup>
<span style="color: black">Frühsyphilis  (< 1 Jahr)</span>
| style="width:276.4pt;" width="369" valign="top" |
*Benzathin-Penicillin G 2,4 Mio. IE i.m.
<span style="mso-spacerun:yes">       </span><span style="color: #333333">(jeweils 1,2 Mio. IE glutetal links/rechts)</span>
<span style="color: #333333">bei  Penicillinallergie'':''</span>
*<span style="color: #333333">Ceftriaxon 1x 2g 10 Tage i.v.</span>
*<span style="color: #333333">Doxycyclin 2x 100mg 14 Tage p.o.</span>
*Erythromycin  4x 0,5g 14 Tage p.o.
|- style="height:4.0cmpx;"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: black">Spätsyphilis (> 1 Jahr) o.</span>
<span style="color: black">unbekannter Infektionszeitpunkt</span>
| style="width:276.4pt;" width="369" valign="top" |
*Benzathin-Penicillin G 2,4 Mio. IE <span style="color: black">Tag 1,8,15 </span>i.m.
<span style="color: #333333"><span style="mso-spacerun:yes">       </span>(jeweils 1,2 Mio. IE glutetal links/rechts)</span>
<span style="color: #333333">bei  Penicillinallergie:</span>
*<span style="color: #333333">Ceftriaxon 1x 2g 10-14 Tage i.v.</span>
*<span style="color: #333333">Doxycyclin 2x 100mg 28 Tage p.o.</span>
*<span style="color: #333333">Erythromycin 4x 0,5g/Tag 28 Tage p.o.</span>
|- style="height:4.0cmpx;"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: black">Neurosyphilis</span>
| style="width:276.4pt;" width="369" valign="top" |
*<span style="color: black">Benzylpenicillin G  i.v.</span>
<span style="color: black">(5 Mio  IE 5x tgl. </span><span style="color: black"><span style="mso-char-type:symbol;mso-symbol-font-family:Symbol">³</span></span><span style="color: black"> 14 Tage)</span>
<span style="color: black">(6 Mio  IE 4x tgl. </span><span style="color: black"><span style="mso-char-type:symbol;mso-symbol-font-family:Symbol">³</span></span><span style="color: black"> 14 Tage)</span>
<span style="color: black">(10 Mio IE 3x tgl. </span><span style="color: black"><span style="mso-char-type:symbol;mso-symbol-font-family:Symbol">³</span></span> <span style="color: black">14 Tage)</span>
<span style="color: #333333">bei  Penicillinallergie:</span>
*<span style="color: #333333">Ceftriaxon 2g i.v. 14 Tage i.v.</span>
*<span style="color: #333333">Doxycyclin 2x 200mg 28 Tage p.o.</span>
|- style="height:47.85ptpx;"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: black">Kinder</span>
| style="width:276.4pt;" width="369" valign="top" |
*<span style="color: #333333">Therapie wie bei Erwachsenen</span>
*Dosis: Benzathin-Penicillin G 50.000 IE/kg KG i.m.
*<span style="color: #333333">CAVE: kein Doxycyclin unter 8 Jahren</span>
|- style="mso-yfti-irow:19"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: black">Schwangere</span>
| style="width:276.4pt;" width="369" valign="top" |
*<span style="color: #333333">Therapie wie bei Nicht-Schwangeren</span>
*<span style="color: black">Doxycyclin ab 16. SSW kontraindiziert</span>
|- style="mso-yfti-irow:20"
| style="width:212.4pt;" width="283" valign="top" |'''<span style="color: #333333">Trichomonas vaginalis</span>'''
| style="width:276.4pt;" width="369" valign="top" |
*<span style="color: black">Metronidazol 2x 500mg 7 Tage p.o. <span style="mso-spacerun:yes">                              </span></span>
*<span style="color: black">Metronidazol 2g Tag 1 p.o.</span>
|- style="mso-yfti-irow:21"
| style="width:212.4pt;" width="283" valign="top" |'''<span style="color: black">Mollicutes</span>'''
<span style="color: #333333">Mykoplasma genitalium (Urethritis)</span>
<sup><span style="color: #0070C0">[10</span></sup><ref>Jensen, J.S., et al., European guideline on Mycoplasma genitalium infections. Journal of the European Academy of Dermatology and Venereology. 2016;30: p1650-56.</ref><sup><span style="color: #0070C0">,17</span></sup><ref>Sethi S, Zaman K, Jain N. Mycoplasma genitalium infections: current treatment options and resistance issues. Infect Drug Resist. 2017;10:283-292
<nowiki>https://doi.org/10.2147/IDR.S105469</nowiki></ref><sup><span style="color: #0070C0">]</span></sup>
| style="width:276.4pt;" width="369" valign="top" |
*<span style="color: black">Azithromycin 1g Tag 1, dann 500mg Tag 2-5 p.o.</span>
*<span style="color: black">Azithromycin 1,5-2g Tag 1 p.o. <span style="mso-spacerun:yes">                                               </span>+ Doxycyclin 2x 100mg 7 Tage p.o.</span>
<span style="color: black">bei Azithromycinresistenz:</span>
*Moxifloxacin  400mg 7-10 Tage p.o.
|- style="mso-yfti-irow:22"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: #333333">Mykoplasma hominis</span>
| style="width:276.4pt;" width="369" valign="top" |<span style="color: black">nur bei  Symptomen und ausschließlichem Erregernachweis:</span>
*<span style="color: black">Metronidazol 2x 500mg 7 Tage p.o. <span style="mso-spacerun:yes">                              </span></span>
*<span style="color: black">Metronidazol 2g Tag 1 p.o.</span>
|- style="mso-yfti-irow:23"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: #333333">Ureaplasma urealyticum</span>
| style="width:276.4pt;" width="369" valign="top" |
*<span style="color: black">Doxycyclin 2x100mg 7 Tage p.o.</span>
|- style="mso-yfti-irow:24;mso-yfti-lastrow:yes"
| style="width:212.4pt;" width="283" valign="top" |<span style="color: #333333">Ureaplasma parvum</span>
| style="width:276.4pt;" width="369" valign="top" |
*<span style="color: black">Doxycyclin 200mg Tag 1 p.o.</span>
|}
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Latest revision as of 20:13, 16 June 2021

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