DGI:Gynäkologische Infektionen/Erreger: Difference between revisions

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=Erreger=
 
Generell ist zu sagen, dass es sich bei gynäkologischen Infektionen meist um eine Mischinfektion handelt. Häufig spielen Bakterien der Darm- und Hautflora eine wichtige Rolle. Es kommen allerdings auch häufig Viren, Pilze und Protozoen vor.
Generell ist zu sagen, dass es sich bei gynäkologischen Infektionen meist um eine Mischinfektion handelt. Häufig spielen Bakterien der Darm- und Hautflora eine wichtige Rolle. Es kommen allerdings auch häufig Viren, Pilze und Protozoen vor.


mso-yfti-tbllook:1184;mso-padding-alt:0cm 5.4pt 0cm 5.4pt"
<br />
{| class="MsoTableGrid" border="1" cellspacing="0" cellpadding="0" style="border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;" data-ve-attributes="{&quot;style&quot;:&quot;border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;&quot;}"
{| class="wikitable sortable bs-exportable MsoTableGrid" style="border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;" data-ve-attributes="{&quot;style&quot;:&quot;border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;&quot;}" cellspacing="0" cellpadding="0" border="1"
| style="width:205.3pt;" width="274" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:205.3pt;&quot;}" |Erkrankung/Infektion
|+
| style="width:261.95pt;" width="349" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:261.95pt;&quot;}" |Erreger
! style="width:205.3pt;" class="col-grey-light-bg" data-ve-attributes="{&quot;style&quot;:&quot;width:205.3pt;&quot;}" width="274" valign="top" |'''Erkrankung/Infektion'''
! style="width:261.95pt;" class="col-grey-light-bg" data-ve-attributes="{&quot;style&quot;:&quot;width:261.95pt;&quot;}" width="349" valign="top" |'''Erreger'''
|- style="mso-yfti-irow:1" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}"
|- style="mso-yfti-irow:1" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}"
| style="width:205.3pt;" width="274" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:205.3pt;&quot;}" |Vulvitis pustulosa/Furunkel/Karbunkel
| style="width:205.3pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:205.3pt;&quot;}" width="274" valign="top" |Vulvitis pustulosa / Furunkel / Karbunkel
| style="width:261.95pt;" width="349" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:261.95pt;&quot;}" |meist Staph. aureus
| style="width:261.95pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:261.95pt;&quot;}" width="349" valign="top" |Meist Staph. aureus
|- style="mso-yfti-irow:2" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2&quot;}"
|- style="mso-yfti-irow:2" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2&quot;}"
| style="width:205.3pt;" width="274" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:205.3pt;&quot;}" |Bakterielle Vaginose
| style="width:205.3pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:205.3pt;&quot;}" width="274" valign="top" |Bakterielle Vaginose
| style="width:261.95pt;" width="349" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:261.95pt;&quot;}" |Dysbiose zu Ungunsten H2O2 bildender  Laktobazillen zu Gunsten von
| style="width:261.95pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:261.95pt;&quot;}" width="349" valign="top" |Dysbiose zu Ungunsten H2O2 bildender  Laktobazillen zu Gunsten von
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Gardnerella vaginalis
 
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Anaerobier


<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Mykoplasmen
*Gardnerella vaginalis
*Anaerobier
*Mykoplasmen


ß-hämolysierende Streptokokken der Gruppe A
ß-hämolysierende Streptokokken der Gruppe A


<span class="ve-pasteProtect" style="mso-list:
*Streptococcus pyogenes
  Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:\n  Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Streptococcus pyogenes
|- style="mso-yfti-irow:3" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:3&quot;}"
|- style="mso-yfti-irow:3" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:3&quot;}"
| style="width:205.3pt;" width="274" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:205.3pt;&quot;}" |Bartholinitis
| style="width:205.3pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:205.3pt;&quot;}" width="274" valign="top" |Bartholinitis
| style="width:261.95pt;" width="349" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:261.95pt;&quot;}" |Darmbakterien
| style="width:261.95pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:261.95pt;&quot;}" width="349" valign="top" |Darmbakterien
|- style="mso-yfti-irow:4" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:4&quot;}"
|- style="mso-yfti-irow:4" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:4&quot;}"
| style="width:205.3pt;" width="274" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:205.3pt;&quot;}" |Erythrasma
| style="width:205.3pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:205.3pt;&quot;}" width="274" valign="top" |Erythrasma
| style="width:261.95pt;" width="349" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:261.95pt;&quot;}" |Corynebacterium minutissimum
| style="width:261.95pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:261.95pt;&quot;}" width="349" valign="top" |Corynebacterium minutissimum
|- style="mso-yfti-irow:5;mso-yfti-lastrow:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:5;mso-yfti-lastrow:yes&quot;}"
|- style="mso-yfti-irow:5;mso-yfti-lastrow:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:5;mso-yfti-lastrow:yes&quot;}"
| style="width:205.3pt;" width="274" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:205.3pt;&quot;}" |Kolpitis
| style="width:205.3pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:205.3pt;&quot;}" width="274" valign="top" |Kolpitis
| style="width:261.95pt;" width="349" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:261.95pt;&quot;}" |Mögliche Erreger:
| style="width:261.95pt;" data-ve-attributes="{&quot;style&quot;:&quot;width:261.95pt;&quot;}" width="349" valign="top" |Mögliche Erreger:
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Papilloma-Viren
 
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Herpes-Viren
 
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Candida albicans
 
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Trichomonas vaginalis
 
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>A-Streptokokken
 
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Staph. aureus
 
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Ohne Keimnachweis
|}<span class="berschrift1Zchn ve-pasteProtect"><span class="ve-pasteProtect" style="font-size:20.0pt;line-height:115%" data-ve-attributes="{&quot;style&quot;:&quot;font-size:20.0pt;line-height:115%&quot;}">Therapie</span></span>
 
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">a) <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">  </span></span>Bakterielle Vaginose
 
Da es sich bei der BV um eine Dysbiose der Scheidenmilieus handelt ist eine spezifische Therapie eines Erregers meist nicht sinnvoll. Die Therapie mittels Metronidazol oder alternativ einer lokalen Therapie mittels einer Clindamycin-haltigen Vaginalcreme sind in der Regel ausreichend. Beachtung sollten Schwangere mit einem hohen Risiko für eine Frühgeburt erfahren.
==Kalkulierte Therapie der bakteriellen Vaginose==
mso-yfti-tbllook:1184;mso-padding-alt:0cm 5.4pt 0cm 5.4pt"
{| class="MsoTableGrid" border="1" cellspacing="0" cellpadding="0" style="border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;" data-ve-attributes="{&quot;style&quot;:&quot;border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;&quot;}"
| style="width:116.8pt;" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:116.8pt;&quot;}" |Diagnose
| style="width:116.8pt;" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:116.8pt;&quot;}" |Substanz
| style="width:116.8pt;" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:116.8pt;&quot;}" |Dosierung
| style="width:116.85pt;" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:116.85pt;&quot;}" |Dauer
|- style="mso-yfti-irow:1" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}"
| style="width:116.8pt;" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:116.8pt;&quot;}" |BV außerhalb der Schwangerschaft
| style="width:116.8pt;" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:116.8pt;&quot;}" |Metronidazol
''<span class="ve-pasteProtect" style="font-size:10.0pt" data-ve-attributes="{&quot;style&quot;:&quot;font-size:10.0pt&quot;}">alternativ</span>''
 
Clindamycin
| style="width:116.8pt;" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:116.8pt;&quot;}" |2x/500 mg p.o.
5g 2%ige Vaginalcreme
| style="width:116.85pt;" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:116.85pt;&quot;}" |7 Tage
|- style="mso-yfti-irow:2;mso-yfti-lastrow:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2;mso-yfti-lastrow:yes&quot;}"
| style="width:116.8pt;" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:116.8pt;&quot;}" |BV während der Schwangerschaft
| style="width:116.8pt;" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:116.8pt;&quot;}" |Metronidazol
''<span class="ve-pasteProtect" style="font-size:10.0pt" data-ve-attributes="{&quot;style&quot;:&quot;font-size:10.0pt&quot;}">alternativ</span>''
 
Clindamycin
 
''<span class="ve-pasteProtect" style="font-size:10.0pt" data-ve-attributes="{&quot;style&quot;:&quot;font-size:10.0pt&quot;}">oder</span>''
 
Clindamycin
| style="width:116.8pt;" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:116.8pt;&quot;}" |2x/500 mg p.o.
5g 2%ige Vaginalcreme
 
2 x 300 mg p.o.
| style="width:116.85pt;" width="156" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:116.85pt;&quot;}" |7 Tage
|}CAVE: bei Hochrisikopatientinnen mit Frühgeburt in der Anamnese muss eine Prophylaxe als systemische Gabe erfolgen.
 
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">b) <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">   </span></span>Bartholinitis
 
Zunächst erfolgt im frühen Stadium eine konservative Therapie mit lokalen Maßnahmen wie Kühlen sowie einer Antiphlogistischen und Analgetischen Mitteln.
 
Erst schwerere Verläufe werden mit einer Kombinationstherapie aus Amoxicillin und Metronidazol therapiert. Kommt es zu einer Abszessbildung ist eine chirurgische Intervention (Marsupialisation) notwendig. Bei Nachweis von Chlamydien muss diese Therapie entsprechend angepasst werden.
==Kalkulierte Therapie weiterer Erkrankungen/Infektionen==
mso-yfti-tbllook:1184;mso-padding-alt:0cm 5.4pt 0cm 5.4pt"
{| class="MsoTableGrid" border="1" cellspacing="0" cellpadding="0" style="border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;" data-ve-attributes="{&quot;style&quot;:&quot;border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;&quot;}"
| style="width:106.1pt;" width="141" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:106.1pt;&quot;}" |Diagnose
| style="width:5.0cm;" width="189" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:5.0cm;&quot;}" |Substanz
| style="width:148.8pt;" width="198" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:148.8pt;&quot;}" |Dosierung
| style="width:70.6pt;" width="94" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:70.6pt;&quot;}" |Dauer
|- style="mso-yfti-irow:1" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}"
| style="width:106.1pt;" width="141" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:106.1pt;&quot;}" |Vulvitis pustulosa
| style="width:5.0cm;" width="189" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:5.0cm;&quot;}" |Cefuroxim
''<span class="ve-pasteProtect" style="font-size:10.0pt" data-ve-attributes="{&quot;style&quot;:&quot;font-size:10.0pt&quot;}">alternativ:</span>''
 
Clindamycin
| style="width:148.8pt;" width="198" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:148.8pt;&quot;}" |''3 x 500mg p.o.''
''2 x 300mg p.o.''
| style="width:70.6pt;" width="94" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:70.6pt;&quot;}" |5 Tage
|- style="mso-yfti-irow:2" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2&quot;}"
| style="width:106.1pt;" width="141" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:106.1pt;&quot;}" |Furunkel/Karbunkel
| style="width:5.0cm;" width="189" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:5.0cm;&quot;}" |''i.d.R. keine antibiotische Therapie  notwendig''
falls doch:
 
Cefuroxim
 
''<span class="ve-pasteProtect" style="font-size:10.0pt" data-ve-attributes="{&quot;style&quot;:&quot;font-size:10.0pt&quot;}">alternativ:</span>''
 
Clindamycin
| style="width:148.8pt;" width="198" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:148.8pt;&quot;}" |3 x 500mg p.o.
2 x 300mg p.o
| style="width:70.6pt;" width="94" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:70.6pt;&quot;}" |5 Tage
|- style="mso-yfti-irow:3" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:3&quot;}"
| style="width:106.1pt;" width="141" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:106.1pt;&quot;}" |Vulvitis durch
A-Streptokokken
| style="width:5.0cm;" width="189" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:5.0cm;&quot;}" |Penicillin V oder
Amoxicillin oder
 
Cefpodoxim
 
''<span class="ve-pasteProtect" style="font-size:10.0pt" data-ve-attributes="{&quot;style&quot;:&quot;font-size:10.0pt&quot;}">alternativ</span>'':
 
Clindamycin
| style="width:148.8pt;" width="198" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:148.8pt;&quot;}" |3 x 1 Mio bis 1,5 Mio IE p.o.
3 x 1000mg p.o.
 
2 x 200mg p.o.
 
2 x 300mg p.o.
| style="width:70.6pt;" width="94" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:70.6pt;&quot;}" |10 Tage
10 Tage
 
7 - 10Tage
 
10 Tage
|- style="mso-yfti-irow:4" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:4&quot;}"
| style="width:106.1pt;" width="141" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:106.1pt;&quot;}" |Erythrasma
| style="width:5.0cm;" width="189" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:5.0cm;&quot;}" |Imidazol-Derivat lokal
Tetracyclin lokal
| style="width:148.8pt;" width="198" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:148.8pt;&quot;}" |
| style="width:70.6pt;" width="94" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:70.6pt;&quot;}" |
|- style="mso-yfti-irow:5" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:5&quot;}"
| style="width:106.1pt;" width="141" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:106.1pt;&quot;}" |Bartholinitis
''<span class="ve-pasteProtect" style="color: red" data-ve-attributes="{&quot;style&quot;:&quot;color: red&quot;}">nur bei schweren  Verläufen</span>''
| style="width:5.0cm;" width="189" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:5.0cm;&quot;}" |Amoxicillin
''plus''
 
Metronidazol
 
''bei Gonokokken-Nachweis''
 
Ceftriaxon
| style="width:148.8pt;" width="198" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:148.8pt;&quot;}" |3 x 2000 mg p.o.
2 x 500 mg p.o.
 
1 x 2000 mg i.v.
| style="width:70.6pt;" width="94" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:70.6pt;&quot;}" |7 Tage
7 Tage
|- style="mso-yfti-irow:6" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:6&quot;}"
| style="width:106.1pt;" width="141" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:106.1pt;&quot;}" |Kolpitis
- Trichomoniasis
| style="width:5.0cm;" width="189" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:5.0cm;&quot;}" |Metronidazol
| style="width:148.8pt;" width="198" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:148.8pt;&quot;}" |1 x 2000mg p.o.
| style="width:70.6pt;" width="94" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:70.6pt;&quot;}" |1 Tag
|- style="mso-yfti-irow:7" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:7&quot;}"
| style="width:106.1pt;" width="141" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:106.1pt;&quot;}" |Kolpitis
- ohne Erregernachweis
| style="width:5.0cm;" width="189" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:5.0cm;&quot;}" |Clindamycin
| style="width:148.8pt;" width="198" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:148.8pt;&quot;}" |5g 2%ige Vaginalcreme
| style="width:70.6pt;" width="94" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:70.6pt;&quot;}" |1 Tag
|- style="mso-yfti-irow:8" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:8&quot;}"
| style="width:106.1pt;" width="141" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:106.1pt;&quot;}" |Kolpitis
- A-Streptokokken
| style="width:5.0cm;" width="189" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:5.0cm;&quot;}" |Penicillin V oder
Amoxicillin oder
 
Cefpodoxim
 
''<span class="ve-pasteProtect" style="font-size:10.0pt" data-ve-attributes="{&quot;style&quot;:&quot;font-size:10.0pt&quot;}">alternativ</span>'':
 
Clindamycin
| style="width:148.8pt;" width="198" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:148.8pt;&quot;}" |3 x 1 Mio bis 1,5 Mio IE p.o.
3 x 1000mg p.o.
 
2 x 200mg p.o.
 
2 x 300mg p.o.
| style="width:70.6pt;" width="94" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:70.6pt;&quot;}" |10 Tage
10 Tage
 
7 - 10Tage
 
10 Tage
|- style="mso-yfti-irow:9;mso-yfti-lastrow:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:9;mso-yfti-lastrow:yes&quot;}"
| style="width:106.1pt;" width="141" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:106.1pt;&quot;}" |
| style="width:5.0cm;" width="189" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:5.0cm;&quot;}" |
| style="width:148.8pt;" width="198" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:148.8pt;&quot;}" |
| style="width:70.6pt;" width="94" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:70.6pt;&quot;}" |
|}<span class="berschrift1Zchn ve-pasteProtect"><span class="ve-pasteProtect" style="font-size:20.0pt;line-height:115%" data-ve-attributes="{&quot;style&quot;:&quot;font-size:20.0pt;line-height:115%&quot;}">Prophylaxe / Prävention</span></span>
 
mso-yfti-tbllook:1184;mso-padding-alt:0cm 5.4pt 0cm 5.4pt"
{| class="MsoTableGrid" border="1" cellspacing="0" cellpadding="0" style="border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;" data-ve-attributes="{&quot;style&quot;:&quot;border-collapse:collapse;border:none;mso-border-alt:solid black .5pt;&quot;}"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |Erkrankung/Infektion
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |Prophylaxe/Prävention
|- style="mso-yfti-irow:1" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |Erythrasma
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>gute Körperhygiene
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>keine zu enge Kleidung
 
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Haut trocken halten
 
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Gewichtsreduktion
|- style="mso-yfti-irow:2" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2&quot;}"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |Bakterielle Vaginose
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Ausschluss einer BV vor Einlage einer Intrauterinspirale
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Großzügige perioperative Prophylaxe
 
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>
 
Das Risiko für eine Frühgeburt oder  einen Spätabort kann durch folgende Maßnahmen reduziert werden:
 
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Ausschluss einer BV vor einer geplanten Gravidität
 
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Screening auf eine BV im ersten Trimenon
|- style="mso-yfti-irow:3;mso-yfti-lastrow:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:3;mso-yfti-lastrow:yes&quot;}"
| style="width:233.6pt;" width="311" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.6pt;&quot;}" |Bartholinitis
| style="width:233.65pt;" width="312" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;width:233.65pt;&quot;}" |<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Ausreichende Hygiene
<span class="ve-pasteProtect" style="mso-list:Ignore" data-ve-attributes="{&quot;style&quot;:&quot;mso-list:Ignore&quot;}">- <span class="ve-pasteProtect" style="font:7.0pt &quot;Times New Roman&quot;" data-ve-attributes="{&quot;style&quot;:&quot;font:7.0pt \&quot;Times New Roman\&quot;&quot;}">       </span></span>Wischrichtung nach Toilettengang von vorne nach  hinten
|}<span class="berschrift1Zchn ve-pasteProtect"><span class="ve-pasteProtect" style="font-size:20.0pt;
line-height:115%" data-ve-attributes="{&quot;style&quot;:&quot;font-size:20.0pt;\nline-height:115%&quot;}">Weiterführende Literatur & Hilfestellungen</span></span>
 
Mendling, Werner. ''Vaginose, Vaginitis, Zervizitis und Salpingitis''. Berlin, Heidelberg: Springer Medizin Verlag Heidelberg, 2006


Petersen, Eiko E. ''Infektionen in Gynäkologie und Geburtshilfe: Lehrbuch und Atlas''. 5., neu Bearbeitete und Erweiterte Auflage. Stuttgart New York: Georg Thieme Verlag, 2011
*Papilloma-Viren
*Herpes-Viren
*Candida albicans
*Trichomonas vaginalis
*A-Streptokokken
*Staph. aureus
*Ohne Keimnachweis
|}<br />

Latest revision as of 14:42, 18 March 2022

Generell ist zu sagen, dass es sich bei gynäkologischen Infektionen meist um eine Mischinfektion handelt. Häufig spielen Bakterien der Darm- und Hautflora eine wichtige Rolle. Es kommen allerdings auch häufig Viren, Pilze und Protozoen vor.


Erkrankung/Infektion Erreger
Vulvitis pustulosa / Furunkel / Karbunkel Meist Staph. aureus
Bakterielle Vaginose Dysbiose zu Ungunsten H2O2 bildender Laktobazillen zu Gunsten von
  • Gardnerella vaginalis
  • Anaerobier
  • Mykoplasmen

ß-hämolysierende Streptokokken der Gruppe A

  • Streptococcus pyogenes
Bartholinitis Darmbakterien
Erythrasma Corynebacterium minutissimum
Kolpitis Mögliche Erreger:
  • Papilloma-Viren
  • Herpes-Viren
  • Candida albicans
  • Trichomonas vaginalis
  • A-Streptokokken
  • Staph. aureus
  • Ohne Keimnachweis


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