DGI:ZNS-Infektionen/Nosokomiale Ventrikulitis und Meningitis/Therapie: Unterschied zwischen den Versionen

← Zum vorherigen Versionsunterschied Zum nächsten Versionsunterschied →

Version vom 17. Juni 2021, 11:46 Uhr

Therapie

Die Fokussanierung steht im Vordergrund, infizierte Kathetersysteme sollten entfernt werden. Begleitend erfolgt eine antibiotische Therapie, die zunächst hauptsächlich auf gram-positive Kokken zielt, begleitend sind Enterobacterales und Pseudomonas spp. zu erfassen. Es sollte bei Erregernachweis eine Deeskalation nach Antibiogramm erfolgen. Die Therapiedauer beträgt i.d.R. 10-14 Tage.

Dosierungsempfehlungen antibiotischer Therapien

intravenöse Applikation ^[1]^[2]


Antibiotikum	Tagesdosis (Beispiel)	Bemerkung
Aztreonam	6-8g (3-4x 2g)
Cefepim	6g (3x 2g)	CI, PI
Cefotaxim	12g (6x 2g)
Ceftazidim	6g (3x 2g)	CI, PI, TDM
Ceftriaxon	4g (2x 2g)
Ciprofloxacin	1200mg (3x 400mg)
Flucloxacillin	12g (6x 2g)	TDM
Fluconazol	800mg (1x tgl.)
Fosfomycin	24g (3x 8g)
Linezolid	1200mg (2x 600mg)	CI, TDM
liposomales Amphotericin B	2-5 mg/kg (1x tgl.)
Meropenem	6g (3x 2g)	CI, PI, TDM
Posaconazol	800mg (2x 400mg)	TDM
Rifampicin	600-1200mg (1-2x tgl.)
Vancomycin	30-60 mg/kg (2-4x tgl.)	CI, TDM
Voriconazol	8 mg/kg (2x tgl.)	TDM

Legende:

CI: kontinuierliche Infusion (engl. continuous infusion)
PI: prolongierte Infusion (engl. prolonged infusion)
TDM: Therapeutisches Drug Monitoring (engl. therapeutic drug monitoring)

intrathekale Applikation ^[1], 32^[3]]


Antibiotikum	Tagesdosis (1x tgl.)	Bemerkung
Gentamicin	4-10mg
Tobramycin	5-10mg
Amikacin	30mg
Colistin	10mg
Daptomycin	5-10mg
Vancomycin	10-20mg
Tigecyclin	1-10mg
Caspofungin	5-10mg

Kalkulierte Therapie

^[1]^[2]]

Vancomycin PLUS Meropenem

Alternative Meropenem: Ceftazidim oder Cefepim (im Falle eines operativen Zugangs durch Schleimhäute PLUS Metronidazol)

Alternative Vancomycin: Linezolid (cave: bakteriostatisch)

Erregerspezifische Therapie

^[1]^[2]]


Erreger	Standardtherapie	Alternativtherapie
Enterobacterales (z.B. Klebsiella spp., E. coli)	Cefotaxim/Ceftriaxon	Cefepim, Meropenem, Ciprofloxacin
Enterobacterales mit induzierbaren AmpC-Betalactamasen (z.B. Enterobacter cloacae) oder ESBL-Bildner	Meropenem	Ciprofloxacin
Pseudomonas aeruginosa	Ceftazidim, Meropenem, Cefepim, ggf. jeweils in Kombination mit FosfomycinColistin (nur bei nachgewiesener Multiresistenz, i.v.+i.t.)	Aztreonam oder Ciprofloxacin
Acinetobacter baumanii	Meropenem	Colistin (i.v.+i.t.)
Staphylococcus spp. (Methicillin-empfindlich)	Flucloxacillinggf. PLUS Fosfomycin, Rifampicin oder Linezolid	Vancomycin
Staphylococcus spp. (Methicillin-resistent)	Vancomycin ggf. PLUS Fosfomycin, Rifampicin oder Linezolid	Linezolid
Candida spp.	liposomales Amphotericin B ggf. PLUS Flucytosin	Voriconazol, bei C. albicans: Fluconazol
Aspergillus spp.	Voriconazol	liposomales Amphotericin B, Posaconazol

Legende: i.v. = intravenös, i.t. = intrathekal

Bei carbapenemresistenten gram-negativen Erregern sollte eine ergänzende intrathekale Therapie erfolgen. Für dieses Therapieregime konnte eine signifikante Reduktion der Sterblichkeit gezeigt werden [33^[4]]. Diese Erkenntnisse konnten noch nicht in die aktuellen Leitlinien aufgenommen werden.

↑ ^1,0 ^1,1 ^1,2 ^1,3 28. Tunkel AR, Hasbun R, Bhimraj A, Byers K, Kaplan SL, Michael Scheld W, van de Beek D, Bleck TP, Garton HJ, Zunt JR: 2017 Infectious Diseases Society of America's Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis. Clin Infect Dis 2017; 64: e34–e65
↑ ^2,0 ^2,1 ^2,2 31. Ambulant erworbene bakterielle (eitrige) Meningoenzephalitis im Erwachsenenalter, AWMF-Registernummer: 030/089 [https://www.awmf.org/leitlinien/detail/ll/030-089.html
↑ 32. Nau R, Blei C, Eiffert H: Intrathecal Antibacterial and Antifungal Therapies. Clin Microbiol Rev 2020; 33(3)
↑ 33. Karvouniaris M, Brotis AG, Tsiamalou P, Fountas KN: The Role of Intraventricular Antibiotics in the Treatment of Nosocomial Ventriculitis/Meningitis from Gram-Negative Pathogens: A Systematic Review and Meta-Analysis. World Neurosurg 2018; 120:e637-e650

[:0-1] 1,0 ^1,1 ^1,2 ^1,3 28. Tunkel AR, Hasbun R, Bhimraj A, Byers K, Kaplan SL, Michael Scheld W, van de Beek D, Bleck TP, Garton HJ, Zunt JR: 2017 Infectious Diseases Society of America's Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis. Clin Infect Dis 2017; 64: e34–e65

[:1-2] 2,0 ^2,1 ^2,2 31. Ambulant erworbene bakterielle (eitrige) Meningoenzephalitis im Erwachsenenalter, AWMF-Registernummer: 030/089 [https://www.awmf.org/leitlinien/detail/ll/030-089.html

[3] 32. Nau R, Blei C, Eiffert H: Intrathecal Antibacterial and Antifungal Therapies. Clin Microbiol Rev 2020; 33(3)

[4] 33. Karvouniaris M, Brotis AG, Tsiamalou P, Fountas KN: The Role of Intraventricular Antibiotics in the Treatment of Nosocomial Ventriculitis/Meningitis from Gram-Negative Pathogens: A Systematic Review and Meta-Analysis. World Neurosurg 2018; 120:e637-e650

[1]

[2]

[3]

[4]

@@ Zeile 7: / Zeile 7: @@
 <span class="ve-pasteProtect" style="mso-ansi-language:
 DE" data-ve-attributes="{&quot;style&quot;:&quot;mso-ansi-language:\nDE&quot;}">intravenöse Applikation </span><span class="ve-pasteProtect" style="mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;mso-ansi-language:DE&quot;}"><span class="ve-pasteProtect" style="mso-no-proof:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-no-proof:yes&quot;}"></span></span><span class="ve-pasteProtect" style="mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;mso-ansi-language:DE&quot;}"><span class="ve-pasteProtect" style="mso-no-proof:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-no-proof:yes&quot;}"></span></span><span class="ve-pasteProtect" style="mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;mso-ansi-language:DE&quot;}"><span class="ve-pasteProtect" style="mso-no-proof:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-no-proof:yes&quot;}"></span></span><ref name=":0"><span style="color: #333333">28. <span class="ve-pasteprotect"><span data-ve-attributes="{&quot;style&quot;:&quot;mso-tab-count:1&quot;}" style="box-sizing: inherit">          <span style="box-sizing: inherit"> </span></span></span>Tunkel AR, Hasbun R, Bhimraj A, Byers K, Kaplan SL, Michael Scheld W, van de Beek D, Bleck TP, Garton HJ, Zunt JR: 2017 Infectious Diseases Society of America's Clinical Practice Guidelines for Healthcare-Associated Ventriculitis and Meningitis. Clin Infect Dis 2017; 64: e34–e65</span></ref><ref name=":1"><span class="ve-pasteprotect">31. <span data-ve-attributes="{&quot;style&quot;:&quot;mso-tab-count:1&quot;}" style="box-sizing: inherit">          <span style="box-sizing: inherit"> </span></span>Ambulant erworbene bakterielle (eitrige) Meningoenzephalitis im Erwachsenenalter, AWMF-Registernummer: 030/089 [</span><span style="color: #333333">https://www.awmf.org/leitlinien/detail/ll/030-089.html</span><span data-ve-attributes="{&quot;style&quot;:&quot;mso-ansi-language:DE&quot;}" style="box-sizing: inherit"><span class="ve-pasteprotect"></span></span></ref>
-{| class="wikitable sortable bs-exportable MsoTable15List1Light" border="0" cellspacing="0" cellpadding="0" style="border-collapse:collapse;mso-yfti-tbllook:1184;mso-padding-alt:5.65pt 5.4pt 5.65pt 5.4pt" data-ve-attributes="{&quot;style&quot;:&quot;border-collapse:collapse;mso-yfti-tbllook:1184;mso-padding-alt:5.65pt 5.4pt 5.65pt 5.4pt&quot;}"
+{| class="wikitable
 |+
-! style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;" class="col-grey-light-bg" width="163" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;&quot;}" |'''Antibiotikum'''
+!Antibiotikum
-! style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;" class="col-grey-light-bg" width="155" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;&quot;}" |'''Tagesdosis (Beispiel)'''
+!Tagesdosis (Beispiel)
-! style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;" class="col-grey-light-bg" width="116" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;&quot;}" |'''Bemerkung'''
+!Bemerkung
-! style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;" class="col-grey-light-bg" width="170" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;&quot;}" |'''Anpassung'''
+!Anpassung
-|- style="mso-yfti-irow:0" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:0&quot;}"
+|-
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;" width="163" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;&quot;}" |Aztreonam
+|Aztreonam
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;" width="155" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;&quot;}" |6-8g (3-4x  2g)
+|6-8g (3-4x 2g)
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;" width="116" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;&quot;}" |
+|-
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;" width="170" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;&quot;}" |
+|Cefepim
-|- style="mso-yfti-irow:1" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:1&quot;}"
+|6g (3x 2g)
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;" width="163" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;&quot;}" |<span class="ve-pasteProtect" style="mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;mso-ansi-language:DE&quot;}">Cefepim</span>
+|CI, PI
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;" width="155" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;&quot;}" |<span class="ve-pasteProtect" style="mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;mso-ansi-language:DE&quot;}">6g (3x 2g)</span>
+|-
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;" width="116" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;&quot;}" |<span class="ve-pasteProtect" style="mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;mso-ansi-language:DE&quot;}">CI, PI</span>
+|Cefotaxim
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;" width="170" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;&quot;}" |
+|12g (6x 2g)
-|- style="mso-yfti-irow:2" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:2&quot;}"
+|-
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;" width="163" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;&quot;}" |Cefotaxim
+|Ceftazidim
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;" width="155" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;&quot;}" |<span class="ve-pasteProtect" style="color: black" data-ve-attributes="{&quot;style&quot;:&quot;color: black&quot;}">12g  (6x 2g)</span>
+|6g (3x 2g)
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;" width="116" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;&quot;}" |
+|CI, PI, TDM
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;" width="170" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;&quot;}" |
+|-
-|- style="mso-yfti-irow:3" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:3&quot;}"
+|Ceftriaxon
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;" width="163" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;&quot;}" |Ceftazidim
+|4g (2x 2g)
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;" width="155" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;&quot;}" |<span class="ve-pasteProtect" style="mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;mso-ansi-language:DE&quot;}">6g (3x 2g)</span>
+|-
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;" width="116" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;&quot;}" |<span class="ve-pasteProtect" style="mso-ansi-language:DE" data-ve-attributes="{&quot;style&quot;:&quot;mso-ansi-language:DE&quot;}">CI, PI, TDM</span>
+|Ciprofloxacin
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;" width="170" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;&quot;}" |
+|1200mg (3x 400mg)
-|- style="mso-yfti-irow:4" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:4&quot;}"
+|-
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;" width="163" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;&quot;}" |Ceftriaxon
+|Flucloxacillin
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;" width="155" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;&quot;}" |4g (2x 2g)
+|12g (6x 2g)
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;" width="116" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;&quot;}" |
+|TDM
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;" width="170" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;&quot;}" |
+|-
-|- style="mso-yfti-irow:5" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:5&quot;}"
+|Fluconazol
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;" width="163" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;&quot;}" |Ciprofloxacin
+|800mg (1x tgl.)
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;" width="155" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;&quot;}" |1200mg (3x 400mg)
+|-
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;" width="116" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;&quot;}" |
+|Fosfomycin
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;" width="170" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;&quot;}" |
+|24g (3x 8g)
-|- style="mso-yfti-irow:6" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:6&quot;}"
+|-
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;" width="163" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;&quot;}" |Flucloxacillin
+|Linezolid
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;" width="155" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;&quot;}" |12g (6x 2g)
+|1200mg (2x 600mg)
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;" width="116" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;&quot;}" |TDM
+|CI, TDM
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;" width="170" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;&quot;}" |
+|-
-|- style="mso-yfti-irow:7" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:7&quot;}"
+|liposomales Amphotericin B
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;" width="163" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;&quot;}" |Fluconazol
+|2-5 mg/kg (1x tgl.)
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;" width="155" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;&quot;}" |800mg (1x tgl.)
+|-
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;" width="116" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;&quot;}" |
+|Meropenem
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;" width="170" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;&quot;}" |
+|6g (3x 2g)
-|- style="mso-yfti-irow:8" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:8&quot;}"
+|CI, PI, TDM
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;" width="163" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;&quot;}" |Fosfomycin
+|-
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;" width="155" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;&quot;}" |24g (3x 8g)
+|Posaconazol
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;" width="116" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;&quot;}" |
+|800mg (2x 400mg)
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;" width="170" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;&quot;}" |
+|TDM
-|- style="mso-yfti-irow:9" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:9&quot;}"
+|-
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;" width="163" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;&quot;}" |Linezolid
+|Rifampicin
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;" width="155" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;&quot;}" |1200mg (2x 600mg)
+|600-1200mg (1-2x tgl.)
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;" width="116" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;&quot;}" |CI, TDM
+|-
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;" width="170" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;&quot;}" |
+|Vancomycin
-|- style="mso-yfti-irow:10" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:10&quot;}"
+|30-60 mg/kg (2-4x tgl.)
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;" width="163" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;&quot;}" |liposomales  Amphotericin B
+|CI, TDM
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;" width="155" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;&quot;}" |2-5 mg/kg  (1x tgl.)
+|-
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;" width="116" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;&quot;}" |
+|Voriconazol
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;" width="170" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;&quot;}" |
+|8 mg/kg (2x tgl.)
-|- style="mso-yfti-irow:11" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:11&quot;}"
+|TDM
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;" width="163" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;&quot;}" |Meropenem
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;" width="155" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;&quot;}" |6g (3x 2g)
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;" width="116" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;&quot;}" |CI, PI, TDM
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;" width="170" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;&quot;}" |
-|- style="mso-yfti-irow:12" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:12&quot;}"
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;" width="163" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;&quot;}" |Posaconazol
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;" width="155" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;&quot;}" |800mg (2x  400mg)
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;" width="116" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;&quot;}" |TDM
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;" width="170" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;&quot;}" |
-|- style="mso-yfti-irow:13" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:13&quot;}"
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;" width="163" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;&quot;}" |Rifampicin
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;" width="155" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;&quot;}" |600-1200mg (1-2x tgl.)
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;" width="116" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;&quot;}" |
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;" width="170" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;&quot;}" |
-|- style="mso-yfti-irow:14" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:14&quot;}"
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;" width="163" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;&quot;}" |Vancomycin
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;" width="155" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;&quot;}" |30-60 mg/kg  (2-4x tgl.)
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;" width="116" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;&quot;}" |CI, TDM
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;" width="170" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;&quot;}" |
-|- style="mso-yfti-irow:15;mso-yfti-lastrow:yes" data-ve-attributes="{&quot;style&quot;:&quot;mso-yfti-irow:15;mso-yfti-lastrow:yes&quot;}"
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;" width="163" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:122.35pt;&quot;}" |Voriconazol
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;" width="155" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:116.45pt;&quot;}" |8 mg/kg (2x tgl.)
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;" width="116" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:87.25pt;&quot;}" |TDM
-| style="border-left-width:1px;border-right-width:1px;border-top-width:1px;border-bottom-width:1px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;" width="170" valign="top" data-ve-attributes="{&quot;style&quot;:&quot;border-left-width:3px;border-right-width:3px;border-top-width:3px;border-bottom-width:3px;border-left-color:#000000;border-right-color:#000000;border-top-color:#000000;border-bottom-color:#000000;width:127.55pt;&quot;}" |
 |}Legende:
-CI: kontinuierliche Infusion (engl. continuous infusion)
+*CI: kontinuierliche Infusion (engl. continuous infusion)
+*PI: prolongierte Infusion (engl. prolonged infusion)
-PI: prolongierte Infusion (engl. prolonged infusion)
+* TDM: Therapeutisches Drug Monitoring (engl. therapeutic drug monitoring)
-TDM: Therapeutisches Drug Monitoring (engl. therapeutic drug monitoring)