DGI:Knochen-, Gelenks- und Protheseninfektionen/Periprothetische Infektionen/Therapie/Erregerspezifische Therapie: Difference between revisions
imported>Fuhrmanns No edit summary |
imported>Brinkery No edit summary |
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Die Therapie der periprothetischen Infektion sollte möglichst gezielt '''Erreger-bezogen''' erfolgen ([[ | Die Therapie der periprothetischen Infektion sollte möglichst gezielt '''Erreger-bezogen''' erfolgen. | ||
(Bitte bei allen Empfehlungen Resistenztestung beachten.) | |||
{| class="wikitable sortable mw-collapsible MsoTableGrid jquery-tablesorter" border="1" cellspacing="0" cellpadding="0" width="888" style="box-sizing: inherit; border-collapse: collapse; border-spacing: 0px; background-color: rgb(248, 249, 250); font-size: 14px; color: rgb(34, 34, 34); margin: 1em 0px; border: none; font-family: "Open Sans", Roboto, arial, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;" data-ve-attributes="{"style":"box-sizing: inherit; border-collapse: collapse; border-spacing: 0px; background-color: rgb(248, 249, 250); font-size: 14px; color: rgb(34, 34, 34); margin: 1em 0px; border: none; font-family: \"Open Sans\", Roboto, arial, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"}" | |||
| style="width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="151" valign="top" data-ve-attributes="{"style":"width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |<span class="ve-pasteProtect" style="box-sizing: inherit; font-size: 9pt;" data-ve-attributes="{"style":"box-sizing: inherit; font-size: 9pt;"}">'''Erreger'''</span> | |||
| style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |<span class="ve-pasteProtect" style="box-sizing: inherit; font-size: 9pt;" data-ve-attributes="{"style":"box-sizing: inherit; font-size: 9pt;"}">'''Präferenz'''</span> | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |<span class="ve-pasteProtect" style="box-sizing: inherit; font-size: 9pt;" data-ve-attributes="{"style":"box-sizing: inherit; font-size: 9pt;"}">'''Substanz'''</span> | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |<span class="ve-pasteProtect" style="box-sizing: inherit; font-size: 9pt;" data-ve-attributes="{"style":"box-sizing: inherit; font-size: 9pt;"}">'''Dosierung'''</span> | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |<span class="ve-pasteProtect" style="box-sizing: inherit; font-size: 9pt;" data-ve-attributes="{"style":"box-sizing: inherit; font-size: 9pt;"}">'''Kommentar'''</span> | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| rowspan="13" style="width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="151" valign="top" data-ve-attributes="{"style":"width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Staphylococcus aureus | |||
und andere Staphylokokken, | |||
Oxacillin-sensibel | |||
| rowspan="2" style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Intravenöse Initialtherapie | |||
1. Wahl | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Flucloxacillin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |6 x 2 g i.v. | |||
| rowspan="2" style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" | | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |oder | |||
Cefazolin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |3 x 2 g i.v. | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| rowspan="2" style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Alternative bei schwerer Allergie | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Vancomycin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |* | |||
| rowspan="2" style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |*[[:Datei:DGI:Infoblatt Vancomycin RGU.pdf]] | |||
<nowiki>**</nowiki> hohe Dosis off-label, Expertenmeinung | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |oder | |||
Daptomycin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |1 x 8 – 10** mg/kg i.v. | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| rowspan="2" style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |bei Fremdmaterial-assoziierter Infektion | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |<span class="ve-pasteProtect" style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}">plus</span><span class="ve-pasteProtect" style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}">Rifampicin</span> | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |1 x 600 mg i.v. bzw. | |||
2 x 450 mg p.o. | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |wegen sehr guter Bioverfügbarkeit orale Gabe bevorzugen | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |alternativ | |||
plus | |||
Fosfomycin <span class="ve-pasteProtect" style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}"> </span> | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |3 x 5 g i.v. | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" | | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| rowspan="4" style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Orale Anschlusstherapie | |||
''ohne'' Fremdmaterial | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Cotrimoxazol | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |3 x 960 mg p.o | |||
| rowspan="4" style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |'''Cave:''' wegen schlechter Bioverfügbarkeit orale Betalaktame meiden. | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |oder | |||
Clindamycin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |3 x 600 mg p.o | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |oder | |||
Doxycyclin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |2 x 100 mg p.o. | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |oder | |||
Levofloxacin | |||
plus | |||
Rifampicin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |2 x 500 mg p.o. | |||
plus | |||
2 x 450 mg p.o. | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| rowspan="3" style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Orale Anschlusstherapie | |||
bei ''Fremdmaterial''-assoziierter Infektion | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Cotrimoxazol | |||
plus | |||
Rifampicin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |3 x 960 mg p.o. | |||
plus | |||
2 x 450 mg p.o. | |||
| rowspan="3" style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |möglichst keine Kombination von Rifampicin mit Clindamycin oder Linezolid | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |oder | |||
Doxycyclin | |||
plus | |||
Rifampicin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |2 x 100 mg p.o. | |||
plus | |||
2 x 450 mg p.o. | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |oder | |||
Levofloxacin | |||
plus | |||
Rifampicin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |2 x 500 mg p.o. | |||
plus | |||
2 x 450 mg p.o. | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| rowspan="5" style="width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="151" valign="top" data-ve-attributes="{"style":"width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Staphylococcus aureus | |||
und andere Staphylokokken, | |||
Oxacillin-resistent | |||
| rowspan="2" style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Intravenöse Initialtherapie | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Vancomycin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |* | |||
| rowspan="2" style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |*[[:Datei:DGI:Infoblatt Vancomycin RGU.pdf]] | |||
<nowiki>**</nowiki> hohe Dosis off-label, Expertenmeinung | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |oder | |||
Daptomycin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |1 x 8 – 10** mg/kg i.v. | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| rowspan="2" style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |bei ''Fremdmaterial''-assoziierter Infektion | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |<span class="ve-pasteProtect" style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}">plus</span><span class="ve-pasteProtect" style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}">Rifampicin</span> | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |1 x 600 mg i.v. bzw. | |||
2 x 450 mg p.o. | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |wegen sehr guter Bioverfügbarkeit orale Gabe bevorzugen | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |alternativ | |||
plus | |||
Fosfomycin <span class="ve-pasteProtect" style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}"> </span> | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |3 x 5 g i.v. | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" | | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Orale Anschlusstherapie | |||
| colspan="3" style="width:432.35pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="576" valign="top" data-ve-attributes="{"style":"width:432.35pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |s.oben | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| rowspan="4" style="width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="151" valign="top" data-ve-attributes="{"style":"width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Enterococcus spp., | |||
Ampicillin-sensibel | |||
| style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Intravenöse Initialtherapie | |||
1.Wahl | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Ampicillin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |6 x 2 g i.v. | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" | | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| rowspan="2" style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Alternativen | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Vancomycin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |'''*''' | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |*[[:Datei:DGI:Infoblatt Vancomycin RGU.pdf]] | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |oder | |||
Daptomycin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |1 x 10 - 12 mg/kg <span class="mw-lingo-term ve-pasteProtect" data-lingo-term-id="56d721ccadb8bbfd8b47390d82a6ea4b" data-hasqtip="0" style="box-sizing: inherit; border-bottom: 1px dotted rgb(187, 187, 255); cursor: default;" data-ve-attributes="{"style":"box-sizing: inherit; border-bottom: 1px dotted rgb(187, 187, 255); cursor: default;"}">KG</span> i.v. | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |hohe Dosis off-label, Expertenmeinung | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Orale Anschlusstherapie | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Amoxicillin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |3 x 1 g p.o. | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" | | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| rowspan="3" style="width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="151" valign="top" data-ve-attributes="{"style":"width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Enterococcus spp., | |||
Ampicillin-resistent | |||
| rowspan="2" style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Intravenöse Initialtherapie | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Vancomycin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |'''*''' | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |*[[:Datei:DGI:Infoblatt Vancomycin RGU.pdf]] | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |oder | |||
Daptomycin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |1 x 10 - 12 mg/kg <span class="mw-lingo-term ve-pasteProtect" data-lingo-term-id="56d721ccadb8bbfd8b47390d82a6ea4b" data-hasqtip="1" style="box-sizing: inherit; border-bottom: 1px dotted rgb(187, 187, 255); cursor: default;" data-ve-attributes="{"style":"box-sizing: inherit; border-bottom: 1px dotted rgb(187, 187, 255); cursor: default;"}">KG</span> i.v. | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |hohe Dosis off-label, Expertenmeinung | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Orale Anschlusstherapie | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Linezolid | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |2 x 600 mg p.o. | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Linezolid max. 28 Tage zugelassen | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| rowspan="2" style="width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="151" valign="top" data-ve-attributes="{"style":"width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Streptokokken | |||
| style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Intravenöse Initialtherapie | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Benzylpenicillin (Penicillin G) | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |<span class="ve-pasteProtect" style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}">4 x 5 Mio I.E. i.v. </span> | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" | | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Orale Anschlusstherapie | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Amoxicillin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |<span class="ve-pasteProtect" style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}">3 x 1 g p.o.</span> | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" | | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| rowspan="3" style="width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="151" valign="top" data-ve-attributes="{"style":"width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Enterobakterien | |||
| rowspan="2" style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Intravenöse Initialtherapie | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Ampicillin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |6 x 2 g i.v. | |||
| rowspan="2" style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" | | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Ceftriaxon | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |1 x 2 g i.v. | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Orale Anschlusstherapie | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Ciprofloxacin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |2 x 750 mg p.o | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" | | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| rowspan="3" style="width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="151" valign="top" data-ve-attributes="{"style":"width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Pseudomonas aeruginosa | |||
| rowspan="2" style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Intravenöse Initialtherapie | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Piperacillin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |4 x 4 g i.v. | |||
| rowspan="2" style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Bei Pseudomonas-Infektionen immer hohe Dosis verwenden. | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |oder | |||
Ceftazidim | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |3 x 2 g i.v. | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Orale Anschlusstherapie | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Ciprofloxacin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |2 x 750 mg p.o. | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" | | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| rowspan="2" style="width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="151" valign="top" data-ve-attributes="{"style":"width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Candida spp. | |||
''<span class="ve-pasteProtect" style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}">''' '''</span>'' | |||
| style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Intravenöse Initialtherapie | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Caspofungin | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Tag 1: <span class="ve-pasteProtect" style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}"> </span>1 x 70 mg i.v., | |||
danach: 1 x 50 mg i.v. <span class="ve-pasteProtect" style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}"> <span class="ve-pasteProtect"> </span></span><span class="mw-lingo-term ve-pasteProtect" data-lingo-term-id="56d721ccadb8bbfd8b47390d82a6ea4b" data-hasqtip="2" style="box-sizing: inherit; border-bottom: 1px dotted rgb(187, 187, 255); cursor: default;" data-ve-attributes="{"style":"box-sizing: inherit; border-bottom: 1px dotted rgb(187, 187, 255); cursor: default;"}">KG</span> ≤ 80 kg | |||
bzw. 1 x 70 mg i.v. <span class="ve-pasteProtect" style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}"> </span> <span class="mw-lingo-term ve-pasteProtect" data-lingo-term-id="56d721ccadb8bbfd8b47390d82a6ea4b" data-hasqtip="3" style="box-sizing: inherit; border-bottom: 1px dotted rgb(187, 187, 255); cursor: default;" data-ve-attributes="{"style":"box-sizing: inherit; border-bottom: 1px dotted rgb(187, 187, 255); cursor: default;"}">KG</span> > 80 kg | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" | | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Orale Anschlusstherapie | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Fluconazol | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |<span class="ve-pasteProtect" style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}">Einmalig 1 x 800 mg p.o.,</span><span class="ve-pasteProtect" style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}">weiter mit 1 x 400 mg p.o.</span> | |||
| style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" | | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| rowspan="2" style="width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="151" valign="top" data-ve-attributes="{"style":"width:113.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Mycobacterium tuberculosis | |||
| style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Initialtherapie 2 Monate | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |<span class="ve-pasteProtect" style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}">Isoniazid (in Kombi mit Pyridoxin)</span>plus Rifampicin plus Pyrazinamid plus Ethambutol | |||
| style="width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="189" valign="top" data-ve-attributes="{"style":"width:5cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |s. Dosierungsempfehlung Link Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose | |||
| rowspan="2" style="width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="265" valign="top" data-ve-attributes="{"style":"width:7cm;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" | | |||
|- style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}" | |||
| style="width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="161" valign="top" data-ve-attributes="{"style":"width:120.5pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |Anschlusstherapie | |||
| style="width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);" width="123" valign="top" data-ve-attributes="{"style":"width:92.15pt;box-sizing:inherit;padding:0.2em 0.4em;border:1px solid rgb(162, 169, 177);"}" |<span class="ve-pasteProtect" style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}">Isoniazid (in Kombi mit Pyridoxin)</span><span class="ve-pasteProtect" style="box-sizing: inherit;" data-ve-attributes="{"style":"box-sizing: inherit;"}">plus R</span>ifampicin | |||
|} | |||
Bezüglich Substanz und Therapiedauer fehlten randomisierte Studien, die Empfehlungen beruhen auf den vorhandenen Leitlinien, die sich überwiegend auf Expert:innenmeinungen bzw. Ableitungen von ähnlichen Infektionsfoci beziehen. Eine erste randomisierte Studie aus 2021 favorisiert eine 12-wöchige Therapie ('''cave''' überwiegend DAIR). | |||
Bei Prothesenerhalt sollte die Therapie eine biofilmaktive Substanz enthalten (z.B. Rifampicin bzw. Fosfomycin i.v. bei Staphylokokken). | Bei Prothesenerhalt sollte die Therapie eine biofilmaktive Substanz enthalten (z.B. Rifampicin bzw. Fosfomycin i.v. bei Staphylokokken). | ||
Bei zusätzlichem Nachweis einer '''Endokarditis''' sollte die Antibiotikatherapie entsprechend der Endokarditis-Leitlinien erfolgen und anschließend entsprechend der o.g. Empfehlungen zur Therapie der periprothetischen Infektion verlängert werden (s. orale Anschlusstherapie). | Bei zusätzlichem Nachweis einer '''Endokarditis''' sollte die Antibiotikatherapie entsprechend der Endokarditis-Leitlinien erfolgen und anschließend entsprechend der o.g. Empfehlungen zur Therapie der periprothetischen Infektion verlängert werden (s. orale Anschlusstherapie). | ||
Revision as of 14:59, 17 January 2022
Die Therapie der periprothetischen Infektion sollte möglichst gezielt Erreger-bezogen erfolgen.
(Bitte bei allen Empfehlungen Resistenztestung beachten.)
| Erreger | Präferenz | Substanz | Dosierung | Kommentar |
| Staphylococcus aureus
und andere Staphylokokken, Oxacillin-sensibel |
Intravenöse Initialtherapie
1. Wahl |
Flucloxacillin | 6 x 2 g i.v. | |
| oder
Cefazolin |
3 x 2 g i.v. | |||
| Alternative bei schwerer Allergie | Vancomycin | * | *Datei:DGI:Infoblatt Vancomycin RGU.pdf
** hohe Dosis off-label, Expertenmeinung | |
| oder
Daptomycin |
1 x 8 – 10** mg/kg i.v. | |||
| bei Fremdmaterial-assoziierter Infektion | plusRifampicin | 1 x 600 mg i.v. bzw.
2 x 450 mg p.o. |
wegen sehr guter Bioverfügbarkeit orale Gabe bevorzugen | |
| alternativ
plus Fosfomycin |
3 x 5 g i.v. | |||
| Orale Anschlusstherapie
ohne Fremdmaterial |
Cotrimoxazol | 3 x 960 mg p.o | Cave: wegen schlechter Bioverfügbarkeit orale Betalaktame meiden. | |
| oder
Clindamycin |
3 x 600 mg p.o | |||
| oder
Doxycyclin |
2 x 100 mg p.o. | |||
| oder
Levofloxacin plus Rifampicin |
2 x 500 mg p.o.
plus 2 x 450 mg p.o. | |||
| Orale Anschlusstherapie
bei Fremdmaterial-assoziierter Infektion |
Cotrimoxazol
plus Rifampicin |
3 x 960 mg p.o.
plus 2 x 450 mg p.o. |
möglichst keine Kombination von Rifampicin mit Clindamycin oder Linezolid | |
| oder
Doxycyclin plus Rifampicin |
2 x 100 mg p.o.
plus 2 x 450 mg p.o. | |||
| oder
Levofloxacin plus Rifampicin |
2 x 500 mg p.o.
plus 2 x 450 mg p.o. | |||
| Staphylococcus aureus
und andere Staphylokokken, Oxacillin-resistent |
Intravenöse Initialtherapie | Vancomycin | * | *Datei:DGI:Infoblatt Vancomycin RGU.pdf
** hohe Dosis off-label, Expertenmeinung |
| oder
Daptomycin |
1 x 8 – 10** mg/kg i.v. | |||
| bei Fremdmaterial-assoziierter Infektion | plusRifampicin | 1 x 600 mg i.v. bzw.
2 x 450 mg p.o. |
wegen sehr guter Bioverfügbarkeit orale Gabe bevorzugen | |
| alternativ
plus Fosfomycin |
3 x 5 g i.v. | |||
| Orale Anschlusstherapie | s.oben | |||
| Enterococcus spp.,
Ampicillin-sensibel |
Intravenöse Initialtherapie
1.Wahl |
Ampicillin | 6 x 2 g i.v. | |
| Alternativen | Vancomycin | * | *Datei:DGI:Infoblatt Vancomycin RGU.pdf | |
| oder
Daptomycin |
1 x 10 - 12 mg/kg KG i.v. | hohe Dosis off-label, Expertenmeinung | ||
| Orale Anschlusstherapie | Amoxicillin | 3 x 1 g p.o. | ||
| Enterococcus spp.,
Ampicillin-resistent |
Intravenöse Initialtherapie | Vancomycin | * | *Datei:DGI:Infoblatt Vancomycin RGU.pdf |
| oder
Daptomycin |
1 x 10 - 12 mg/kg KG i.v. | hohe Dosis off-label, Expertenmeinung | ||
| Orale Anschlusstherapie | Linezolid | 2 x 600 mg p.o. | Linezolid max. 28 Tage zugelassen | |
| Streptokokken | Intravenöse Initialtherapie | Benzylpenicillin (Penicillin G) | 4 x 5 Mio I.E. i.v. | |
| Orale Anschlusstherapie | Amoxicillin | 3 x 1 g p.o. | ||
| Enterobakterien | Intravenöse Initialtherapie | Ampicillin | 6 x 2 g i.v. | |
| Ceftriaxon | 1 x 2 g i.v. | |||
| Orale Anschlusstherapie | Ciprofloxacin | 2 x 750 mg p.o | ||
| Pseudomonas aeruginosa | Intravenöse Initialtherapie | Piperacillin | 4 x 4 g i.v. | Bei Pseudomonas-Infektionen immer hohe Dosis verwenden. |
| oder
Ceftazidim |
3 x 2 g i.v. | |||
| Orale Anschlusstherapie | Ciprofloxacin | 2 x 750 mg p.o. | ||
| Candida spp.
|
Intravenöse Initialtherapie | Caspofungin | Tag 1: 1 x 70 mg i.v.,
danach: 1 x 50 mg i.v. KG ≤ 80 kg bzw. 1 x 70 mg i.v. KG > 80 kg |
|
| Orale Anschlusstherapie | Fluconazol | Einmalig 1 x 800 mg p.o.,weiter mit 1 x 400 mg p.o. | ||
| Mycobacterium tuberculosis | Initialtherapie 2 Monate | Isoniazid (in Kombi mit Pyridoxin)plus Rifampicin plus Pyrazinamid plus Ethambutol | s. Dosierungsempfehlung Link Deutsches Zentralkomitee zur Bekämpfung der Tuberkulose | |
| Anschlusstherapie | Isoniazid (in Kombi mit Pyridoxin)plus Rifampicin | |||
Bezüglich Substanz und Therapiedauer fehlten randomisierte Studien, die Empfehlungen beruhen auf den vorhandenen Leitlinien, die sich überwiegend auf Expert:innenmeinungen bzw. Ableitungen von ähnlichen Infektionsfoci beziehen. Eine erste randomisierte Studie aus 2021 favorisiert eine 12-wöchige Therapie (cave überwiegend DAIR).
Bei Prothesenerhalt sollte die Therapie eine biofilmaktive Substanz enthalten (z.B. Rifampicin bzw. Fosfomycin i.v. bei Staphylokokken).
Bei zusätzlichem Nachweis einer Endokarditis sollte die Antibiotikatherapie entsprechend der Endokarditis-Leitlinien erfolgen und anschließend entsprechend der o.g. Empfehlungen zur Therapie der periprothetischen Infektion verlängert werden (s. orale Anschlusstherapie).