DGI:Opportunistische Infektionen/Kryptokokkose/Therapie/Kalkulierte Therapie: Difference between revisions

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=== Kalkulierte Therapie ===
===Kalkulierte Therapie===


{| class="wikitable sortable bs-exportable MsoTableGrid" border="1" cellspacing="0" cellpadding="0" align="left" width="775" style="border-collapse:collapse;mso-table-layout-alt:fixed;"
{| class="wikitable sortable bs-exportable MsoTableGrid" border="1" cellspacing="0" cellpadding="0" align="left" width="775" style="border-collapse:collapse;mso-table-layout-alt:fixed;"
|+
|+
| style="width:99.0pt;" width="132" |<span style="font-size:8.0pt;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:
| style="width:99.0pt;" width="132" |Klinische Situation
  minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
| style="width:92.15pt;" width="123" |Präferenz
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
| style="width:106.5pt;" width="142" |Substanz
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">'''Klinische Situation'''</span>
| style="width:99.25pt;" width="132" |Dosierung
| style="width:92.15pt;" width="123" |<span style="font-size:
| style="width:42.5pt;" width="57" |Dauer
  8.0pt;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:minor-latin;
| style="width:5.0cm;" width="189" |Kommentar
  mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">'''Präferenz'''</span>
| style="width:106.5pt;" width="142" |<span style="font-size:
  8.0pt;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:minor-latin;
  mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">'''Substanz'''</span>
| style="width:99.25pt;" width="132" |<span style="font-size:
  8.0pt;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:minor-latin;
  mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">'''Dosierung'''</span>
| style="width:42.5pt;" width="57" |<span style="font-size:
  8.0pt;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:minor-latin;
  mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">'''Dauer'''</span>
| style="width:5.0cm;" width="189" |<span style="font-size:
  8.0pt;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:minor-latin;
  mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">'''Kommentar'''</span>
|- style="height:167.15ptpx;"
|- style="height:167.15ptpx;"
| rowspan="4" style="width:99.0pt;" width="132" |<span style="font-size:8.0pt;line-height:
| rowspan="4" style="width:99.0pt;" width="132" |Induktionstherapie  
  150%;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:minor-latin;
| rowspan="2" style="width:92.15pt;" width="123" |Therapie  der 1. Wahl
  mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
| style="width:106.5pt;" width="142" |Liposomales Amphotericin B
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
| style="width:99.25pt;" width="132" |1  x 3-4 mg/kg i.v./pro Tag
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Induktionstherapie </span>
| rowspan="2" style="width:42.5pt;" width="57" |≥ 2 Wochen
| rowspan="2" style="width:92.15pt;" width="123" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
| style="width:5.0cm;" width="189" |Cave: Liposmales  Amphotericin B engmaschige Kontrollen von Kalium, Magnesium, Kreatinin und  Hämoglobin.
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Therapie  der 1. Wahl</span>
| style="width:106.5pt;" width="142" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Liposomales</span> [https://abbuch.uk-koeln.de/index.php/Antimykotika#Amphotericin_B.2C_liposomales <span style="color: windowtext">Amphotericin B</span>]
| style="width:99.25pt;" width="132" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">1  x 3-4 mg/kg i.v./pro Tag</span>
| rowspan="2" style="width:42.5pt;" width="57" |'''<span style="font-size:8.0pt;line-height:150%;mso-no-proof:yes">≥ </span>'''2 Wochen
| style="width:5.0cm;" width="189" |<span style="font-size:
  8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:
  minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Cave: Liposmales  Amphotericin B engmaschige Kontrollen von Kalium, Magnesium, Kreatinin und  Hämoglobin.</span>


<span style="font-size:
Falls Flucytosin  nicht mit  liposomalem Amphotericin B kombiniert werden kann, ist auch eine Monotherapie  mit  liposomalem Amphotericin B über 4-6 Wochen oder eine  Kombinationstherapie mit Fluconazol möglich24..
  8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:
  minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Falls Flucytosin  nicht mit <span style="mso-spacerun:yes"> </span>liposomalem</span> [https://abbuch.uk-koeln.de/index.php/Antimykotika#Amphotericin_B.2C_liposomales <span style="color: windowtext">Amphotericin B</span>] <span style="font-size:8.0pt;line-height:150%;
  font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:minor-latin;mso-fareast-font-family:
  Calibri;mso-fareast-theme-font:minor-latin;mso-hansi-theme-font:minor-latin;
  mso-bidi-font-family:Arial;mso-bidi-theme-font:minor-bidi;mso-fareast-language:
  EN-US;mso-no-proof:yes">kombiniert werden kann, ist auch eine Monotherapie  mit <span style="mso-spacerun:yes"> </span>liposomalem</span> [https://abbuch.uk-koeln.de/index.php/Antimykotika#Amphotericin_B.2C_liposomales <span style="color: windowtext">Amphotericin B</span>] <span style="font-size:8.0pt;line-height:150%;
  font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:minor-latin;mso-fareast-font-family:
  Calibri;mso-fareast-theme-font:minor-latin;mso-hansi-theme-font:minor-latin;
  mso-bidi-font-family:Arial;mso-bidi-theme-font:minor-bidi;mso-fareast-language:
  EN-US;mso-no-proof:yes">über 4-6 Wochen oder eine  Kombinationstherapie mit Fluconazol möglich</span><sup><span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">24.</span></sup><span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">.</span>
|- style="height:64.75ptpx;"
|- style="height:64.75ptpx;"
| style="width:106.5pt;" width="142" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
| style="width:106.5pt;" width="142" |Flucytosin
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
| style="width:99.25pt;" width="132" |100  mg/kg aufgteilt in 4 Einzeldosen pro Tag
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
| style="width:5.0cm;" width="189" |Cave: engmaschige Blutbildkontrollen  (Panzytopenie).  
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Flucytosin</span>
| style="width:99.25pt;" width="132" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">100  mg/kg aufgteilt in 4 Einzeldosen pro Tag</span>
| style="width:5.0cm;" width="189" |<span style="font-size:
  8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:
  minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Cave: engmaschige Blutbildkontrollen  (Panzytopenie).</span>


<span style="font-size:
Keine Anwendung von  Brivudin bei Flucytosin.
  8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:
  minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Keine Anwendung von  Brivudin bei Flucytosin.</span>
|- style="height:72.0ptpx;"
|- style="height:72.0ptpx;"
| rowspan="2" style="width:92.15pt;" width="123" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
| rowspan="2" style="width:92.15pt;" width="123" |Therapie  der 2. Wahl
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Therapie  der 2. Wahl</span>


<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
(WHO-Schema20)
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
| style="width:106.5pt;" width="142" |Fluconazol
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
| style="width:99.25pt;" width="132" |1200  mg/Tag*
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">(WHO-Schema<sup>20</sup>)</span>
| rowspan="2" style="width:42.5pt;" width="57" |≥ 2  Wochen
| style="width:106.5pt;" width="142" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
| style="width:5.0cm;" width="189" |*Gemäß der IDSA/CDC  Leitlinie3 kann  auch eine geringer Fluconazoldosis (400-800mg/Tag) in Kombination mit  Flucytosin gewählt werden.
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Fluconazol</span>
| style="width:99.25pt;" width="132" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">1200  mg/Tag*</span>
| rowspan="2" style="width:42.5pt;" width="57" |'''<span style="font-size:8.0pt;line-height:150%;mso-no-proof:yes">≥ </span>'''2 <span style="mso-spacerun:yes"> </span>Wochen
| style="width:5.0cm;" width="189" |<span style="font-size:
  8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:
  minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">*Gemäß der IDSA/CDC  Leitlinie</span><sup><span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">3</span></sup> <span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">kann  auch eine geringer Fluconazoldosis (400-800mg/Tag) in Kombination mit  Flucytosin gewählt werden.</span>


<span style="font-size:
Falls Flucytosin  nicht mit Fluconazol kombiniert werden kann, ist  Monotherapie mit Fluconazol 1200mg/Tag  möglich3.
  8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:
  minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Falls Flucytosin  nicht mit Fluconazol kombiniert werden kann, ist<span style="mso-spacerun:yes"> </span> Monotherapie mit Fluconazol 1200mg/Tag  möglich</span><sup><span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">3</span></sup><span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">.</span>
|- style="height:72.0ptpx;"
|- style="height:72.0ptpx;"
| style="width:106.5pt;" width="142" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
| style="width:106.5pt;" width="142" |Flucytosin
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
| style="width:99.25pt;" width="132" |100  mg/kg aufgteilt in 4 Einzeldosen pro Tag
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
| style="width:5.0cm;" width="189" |Cave: engmaschige Blutbildkontrollen  (Panzytopenie).  
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Flucytosin</span>
| style="width:99.25pt;" width="132" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">100  mg/kg aufgteilt in 4 Einzeldosen pro Tag</span>
| style="width:5.0cm;" width="189" |<span style="font-size:
  8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:
  minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Cave: engmaschige Blutbildkontrollen  (Panzytopenie). <span style="mso-spacerun:yes"> </span></span>


<span style="font-size:
Keine Anwendung von  Brivudin bei Flucytosin.
  8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:
  minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Keine Anwendung von  Brivudin bei Flucytosin.</span>
|- style="height:48.6ptpx;"
|- style="height:48.6ptpx;"
| style="width:99.0pt;" width="132" |<span style="font-size:8.0pt;line-height:
| style="width:99.0pt;" width="132" |Konsolidierungstherapie   
  150%;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:minor-latin;
| style="width:92.15pt;" width="123" |Therapie  der 1. Wahl20
  mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
| style="width:106.5pt;" width="142" |Fluconazol
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
| style="width:99.25pt;" width="132" |800  mg/Tag
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Konsolidierungstherapie  </span>
| style="width:42.5pt;" width="57" |≥ 8  Wochen
| style="width:92.15pt;" width="123" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Therapie  der 1. Wahl<sup>20</sup></span>
| style="width:106.5pt;" width="142" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Fluconazol</span>
| style="width:99.25pt;" width="132" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">800  mg/Tag</span>
| style="width:42.5pt;" width="57" |'''<span style="font-size:8.0pt;line-height:150%;mso-no-proof:yes">≥ </span>'''<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">8  Wochen</span>
| style="width:5.0cm;" width="189" |
| style="width:5.0cm;" width="189" |
|- style="height:55.7ptpx;"
|- style="height:55.7ptpx;"
| style="width:99.0pt;" width="132" |<span style="font-size:8.0pt;line-height:
| style="width:99.0pt;" width="132" |Konsolidierungstherapie   
  150%;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:minor-latin;
| style="width:92.15pt;" width="123" |Therapie  der 2. Wahl17
  mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
| style="width:106.5pt;" width="142" |Itraconazol
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
| style="width:99.25pt;" width="132" |200mg  2 x tgl
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Konsolidierungstherapie  </span>
| style="width:42.5pt;" width="57" |≥ 8  Wochen
| style="width:92.15pt;" width="123" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
| style="width:5.0cm;" width="189" |Bei Itraconazol  sollte ein therapeutisches Drugmonitoring (TDM) durchgeführt werden24.
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Therapie  der 2. Wahl<sup>17</sup></span>
| style="width:106.5pt;" width="142" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Itraconazol</span>
| style="width:99.25pt;" width="132" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">200mg  2 x tgl</span>
| style="width:42.5pt;" width="57" |'''<span style="font-size:8.0pt;line-height:150%;mso-no-proof:yes">≥ </span>'''<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">8  Wochen</span>
| style="width:5.0cm;" width="189" |<span style="font-size:
  8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:
  minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Bei Itraconazol  sollte ein therapeutisches Drugmonitoring (TDM) durchgeführt werden</span><sup><span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">24</span></sup><span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">.</span>
|- style="height:72.0ptpx;"
|- style="height:72.0ptpx;"
| style="width:99.0pt;" width="132" |<span style="font-size:8.0pt;line-height:
| style="width:99.0pt;" width="132" |Erhaltungstherapie  (Sekundärprophylaxe)
  150%;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:minor-latin;
| style="width:92.15pt;" width="123" |Therapie  der 1. Wahl
  mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
| style="width:106.5pt;" width="142" |Fluconazol
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
| style="width:99.25pt;" width="132" |200  mg/Tag
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Erhaltungstherapie  (Sekundärprophylaxe)</span>
| style="width:42.5pt;" width="57" |≥ 12  Monte
| style="width:92.15pt;" width="123" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Therapie  der 1. Wahl</span>
| style="width:106.5pt;" width="142" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Fluconazol</span>
| style="width:99.25pt;" width="132" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">200  mg/Tag</span>
| style="width:42.5pt;" width="57" |'''<span style="font-size:8.0pt;line-height:150%;mso-no-proof:yes">≥ </span>'''<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">12  Monte</span>
| style="width:5.0cm;" width="189" |
| style="width:5.0cm;" width="189" |
|- style="height:72.0ptpx;"
|- style="height:72.0ptpx;"
| style="width:99.0pt;" width="132" |<span style="font-size:8.0pt;line-height:
| style="width:99.0pt;" width="132" |Erhaltungstherapie  (Sekundärprophylaxe)
  150%;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:minor-latin;
| style="width:92.15pt;" width="123" |Therapie  der 2. Wahl3,17
  mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
| style="width:106.5pt;" width="142" |Itraconazol
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
| style="width:99.25pt;" width="132" |200mg  2 x tgl
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Erhaltungstherapie  (Sekundärprophylaxe)</span>
| style="width:42.5pt;" width="57" |≥ 12  Monte
| style="width:92.15pt;" width="123" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
| style="width:5.0cm;" width="189" |Bei Itraconazol  sollte ein therapeutisches Drugmonitoring (TDM) durchgeführt werden24.
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Therapie  der 2. Wahl<sup>3,17</sup></span>
| style="width:106.5pt;" width="142" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Itraconazol</span>
| style="width:99.25pt;" width="132" |<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">200mg  2 x tgl</span>
| style="width:42.5pt;" width="57" |'''<span style="font-size:8.0pt;line-height:150%;mso-no-proof:yes">≥ </span>'''<span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">12  Monte</span>
| style="width:5.0cm;" width="189" |<span style="font-size:
  8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;mso-ascii-theme-font:
  minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:minor-latin;
  mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;mso-bidi-theme-font:
  minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">Bei Itraconazol  sollte ein therapeutisches Drugmonitoring (TDM) durchgeführt werden</span><sup><span style="font-size:8.0pt;line-height:150%;font-family:&quot;Calibri&quot;,sans-serif;
  mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
  minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:Arial;
  mso-bidi-theme-font:minor-bidi;mso-fareast-language:EN-US;mso-no-proof:yes">24.</span></sup>
|}
|}
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Revision as of 14:35, 27 September 2021

Kalkulierte Therapie

Klinische Situation Präferenz Substanz Dosierung Dauer Kommentar
Induktionstherapie Therapie der 1. Wahl Liposomales Amphotericin B 1 x 3-4 mg/kg i.v./pro Tag ≥ 2 Wochen Cave: Liposmales Amphotericin B engmaschige Kontrollen von Kalium, Magnesium, Kreatinin und Hämoglobin.

Falls Flucytosin nicht mit  liposomalem Amphotericin B kombiniert werden kann, ist auch eine Monotherapie mit  liposomalem Amphotericin B über 4-6 Wochen oder eine Kombinationstherapie mit Fluconazol möglich24..

Flucytosin 100 mg/kg aufgteilt in 4 Einzeldosen pro Tag Cave: engmaschige Blutbildkontrollen (Panzytopenie).

Keine Anwendung von Brivudin bei Flucytosin.

Therapie der 2. Wahl

(WHO-Schema20)

Fluconazol 1200 mg/Tag* ≥ 2  Wochen *Gemäß der IDSA/CDC Leitlinie3 kann auch eine geringer Fluconazoldosis (400-800mg/Tag) in Kombination mit Flucytosin gewählt werden.

Falls Flucytosin nicht mit Fluconazol kombiniert werden kann, ist  Monotherapie mit Fluconazol 1200mg/Tag möglich3.

Flucytosin 100 mg/kg aufgteilt in 4 Einzeldosen pro Tag Cave: engmaschige Blutbildkontrollen (Panzytopenie).  

Keine Anwendung von Brivudin bei Flucytosin.

Konsolidierungstherapie Therapie der 1. Wahl20 Fluconazol 800 mg/Tag ≥ 8 Wochen
Konsolidierungstherapie Therapie der 2. Wahl17 Itraconazol 200mg 2 x tgl ≥ 8 Wochen Bei Itraconazol sollte ein therapeutisches Drugmonitoring (TDM) durchgeführt werden24.
Erhaltungstherapie (Sekundärprophylaxe) Therapie der 1. Wahl Fluconazol 200 mg/Tag ≥ 12 Monte
Erhaltungstherapie (Sekundärprophylaxe) Therapie der 2. Wahl3,17 Itraconazol 200mg 2 x tgl ≥ 12 Monte Bei Itraconazol sollte ein therapeutisches Drugmonitoring (TDM) durchgeführt werden24.


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