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Intensivmedizinische Aspekte der Antibiotikatherapie

Die Anästhesiologie

Part of the book series: Springer Reference Medizin ((SRM))

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Zusammenfassung

Während viele Maßnahmen in der Intensivmedizin supportiv sind, ermöglichen Antibiotika eine kausale Therapie. Die Auswahl erfolgt jedoch meist vor dem mikrobiologischen Nachweis, sodass sich die kalkulierte Therapie an den wahrscheinlichsten Erregern orientieren muss. Deutliche regionale Unterschiede bedingen, dass für viele Infektionen zwar ein typisches, aber nicht allgemein gültiges Erregerspektrum angegeben werden kann.

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Literatur

  1. Beaucaire C (2000) Does once-daily dosing prevent nephrotoxicity in all Aminoglykosides equally? Clin Microbiol Infect 6:357–362

    Article  CAS  PubMed  Google Scholar 

  2. Blot SI, Pea F, Lipman J (2014) The effect of pathophysiology on pharmacokinetics in the critically ill patient – concepts appraised by the example of antimicrobial agents. Adv Drug Deliv Rev. 2014 Nov 20:77:3–11

    Google Scholar 

  3. Bodmann KF, Grabein B und die Expertenkommission der Paul-Ehrlich-Gesellschaft für Chemotherapie e.V. (2010) Empfehlungen zur kalkulierten parenteralen Initialtherapie bakterieller Erkrankungen bei Erwachsenen – Update 2010, ISBN 978-3-00-031623-4. www.p-e-g.org

  4. Brunkhorst FM, Oppert M, Marx G et al (2012) Effect of empirical treatment with Moxifloxacin and Meropenem vs Meropenem on sepsis-related organ dysfunction in patientes with severe sepsis. JAMA 307:2390–2399

    Article  CAS  PubMed  Google Scholar 

  5. Bundesgesundheitsblatt Hygienemaßnahmen bei Infektionen oder Besiedlung mit multiresistenten gramnegativen Stäbchen (2012) Bundesgesundheitsbl-Gesundheitsforsch-Gesundheitsschutz 55:1311–1354

    Google Scholar 

  6. Bundesgesundheitsblatt Prävention der nosokomialen Pneumonie (2013) Bundesgesundheitsbl-Gesundheitsforsch-Gesundheitsschutz 56:1578–1590

    Google Scholar 

  7. CDC (2004) CDC-Guidelines Morbid Mortal Weekly Report 53: RR 3

    Google Scholar 

  8. CDC (2011) Guidelines for the prevention of intravascular catheter-related infections, HICPAC guidelines, CDC. www.cdc.gov

  9. Chastre J et al (2003) The PneumA Trial Group. Comparison of 8 vs 15 days of antibiotic therapy for ventilator-associated pneumonia in adults. A randomized trial. JAMA 290:2588–2598

    Article  CAS  PubMed  Google Scholar 

  10. Chien JW, Johnson JL (2000) Viral pneumonias. Infection in the immunocompromised host. Postgrad Med 107:67–80

    Google Scholar 

  11. Climo MW, Yokoe DS, Warren DK et al (2013) Effect of daily chlorhexidine bathing on hospital-acquired infection. N Engl J Med 368:533–542

    Article  CAS  PubMed  Google Scholar 

  12. Cunha BA (1999) Fever in the intensive care unit. Intensive Care Med 25:648–651

    Article  CAS  PubMed  Google Scholar 

  13. Dahlhoff K, Abele-Horn M, Andreas S et al (2012) Epidemiologie, Diagnostik und Therapie erwachsener Patienten mit nosokomialer Pneumonie. Pneumologie 66:707–765

    Article  Google Scholar 

  14. de Gans J, von de Beek D (2001) The European dexamethasone in adulthood bacterial meningitis study investigators. N Engl J Med 347:1549–5649

    Article  Google Scholar 

  15. Dettenkofer M, Wilson C, Gratwohl A et al (2009) Skin disinfection with octenidine dihydrochloride for central venous catheter site care: a double-blind, randomized, controlled trial. J Compil Europ Soc Clin Microbio Infect Disea 50:691–703

    Google Scholar 

  16. Fabregas N, Ewig S, Torres A et al (1999) Clinical diagnosis of ventilator-associated pneumonia revised: comparative validation using immediate post-mortem lung biopsies. Thorax 54:867–873

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Gastmeier P, Sohr D, Geffers C et al (2005) Mortality risk factors with nosocomial Staphylococcus aureus infections in intensive care units: results from the German nosocomial infection surveillance system (KISS). Infection 33:50–55

    Article  CAS  PubMed  Google Scholar 

  18. Geiss HK (1999) Nosocomial sinusitis (editorial). Intensive Care Med 25:1037–1039

    Article  CAS  PubMed  Google Scholar 

  19. Höffken G, Lorenz J, Kern W et al (2009) Epidemiologie, Diagnostik, antimikrobielle Therapie und Management von erwachsenen Patienten mit ambulant erworbenen unteren Atemwegsinfektionen sowie ambulant erworbener Pneumonie – Update 2009. S3-Leitlinie der Paul-Ehrlich-Gesellschaft für Chemotherapie e.V., der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin, der Deutschen Gesellschaft für Infektiologie und vom Kompetenznetzwerk CAPNETZ. Pneumologie 63:e1–e68

    Google Scholar 

  20. Holzapfel L, Chastang C, Demingeon G et al (1999) A randomized study assessing the systematic search for maxillary sinusitis in nasotracheally mechanically ventilated patients. Influence of nosocomial maxillary sinusitis on the occurrence of ventilator-associated pneumonia. Am J Respir Crit Care Med 159:695–701

    Article  CAS  PubMed  Google Scholar 

  21. Huang SS, Septimus E, Kleinman K et al (2013) Targeted versus universal decolonization to prevent ICU infection. N Engl J Med 368:2255–2265

    Article  CAS  PubMed  Google Scholar 

  22. Johanson WG, Pierce AK, Sanford JP, Thomas GD (1972) Nosocomial respiratory infections with Gram-negative bacilli. The significance of colonization of the respiratory tract. Ann Intern Med 77:701–706

    Article  PubMed  Google Scholar 

  23. Kollef MH, Hamilton CW, Montgomery AB (2013) Aerosolized antibiotics: do they add to the treatment of pneumonia? Curr Opin Infect Dis 26:538–544

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Kollef MH, Sherman G, Ward S, Fraser VJ (1999) Inadequate antimicrobial treatment of infections. Chest 115:462–474

    Article  CAS  PubMed  Google Scholar 

  25. Krueger WA, Bulitta J, Kinzig-Schippers M et al (2005) Evaluation by Monte Carlo simulation of the pharmacokinetics of two doses of meropenem administered intermittently or as a continuous infusion in healthy volunteers. Antimicrob Agents Chemother 49:1881–1889

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Krueger WA, Lenhart F-P, Neeser G et al (2002–2003) Influence of combined intravenous and topical antibiotic prophylaxis on the incidence of infections, organ dysfunctions, and mortality in critically ill surgical patients. A prospective, stratified, randomized, double-blind, placebo-controlled clinical trial. Am J Respir Crit Care Med 166:1029–1037

    Google Scholar 

  27. Krueger WA, Ruckdeschel G, Unertl K (1997) Influence of intravenously administered ciprofloxacin on aerobic intestinal microflora and fecal drug levels when administered simultaneously with sucralfate. Antimicrob Agents Chemother 41:1725–1730

    CAS  PubMed  PubMed Central  Google Scholar 

  28. Krueger WA, Ruckdeschel G, Unertl K (1999) Elimination of fecal Enterobacteriaceae by intravenous ciprofloxacin is not inhibited by concomitant sucralfate – a microbiological and pharmacokinetic study in patients. Infection 27:335–340

    Article  CAS  PubMed  Google Scholar 

  29. Krueger WA, Unertl KE (2000) Die geschichtliche Entwicklung der Intensivmedizin in Deutschland. Zeitgenössische Betrachtungen Anästhesist 49:743–751

    Article  CAS  Google Scholar 

  30. Krueger WA, Unertl KE (2002) Selective decontamination of the digestive tract: current status. Curr Opin Crit Care 8:139–144

    Article  PubMed  Google Scholar 

  31. Kumar A, Roberts D, Wood KE et al (2006) Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 34:1589–1596

    Article  PubMed  Google Scholar 

  32. Lee CS, Doi Y (2014) Therapy of infections due to carbapenem-resistant gram-negative pathogens. Infect Chemother 46:149–164

    Article  PubMed  PubMed Central  Google Scholar 

  33. Lemmen SW, Engels I, Daschner FD (1997) Serum bactericidal activity of ceftazidime administered as continuous infusion of 3 g over 24 h vs. intermittent bolus infusion of 2 g against Pseudomonas aeruginosa in healthy volunteers. J Antimicrob Chemother 39:841–842

    Article  CAS  PubMed  Google Scholar 

  34. Le Moal G, Lemerre D, Grollier G et al (1999) Nosocomial sinusitis with isolation of anaerobic bacteria in ICU patients. Intensive Care Med 25:1066–1071

    Article  PubMed  Google Scholar 

  35. Lindsay E, Bradley NS, Colgan R et al (2005) Infectious diseases society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis 40:643–654. www.journals.uchicago.edu/CID/journal/issues/v40n5/35309/35309.text.html

    Article  Google Scholar 

  36. Liu C, Bayer A, Cosgrove SE et al (2011) Clinical practice guidelines by the infectious diseases society of America for the treatment of methicilin-resistant Staphylococcus aureus infection in adults and children. Clin Infect Dis 52:1–38

    Article  Google Scholar 

  37. Maki DG, Weise CE, Sarafin HW (1977) A semiquantitative culture method for identifying intravenous-catheter-related infection. N Engl J Med 196:1305–1309

    Article  Google Scholar 

  38. Marik PE (2001) Aspiration pneumonitis and aspiration pneumonia. N Engl J Med 344:665–671

    Article  CAS  PubMed  Google Scholar 

  39. Marra AR, Edmond MB, Forbes BA et al (2006) Time to blood culture positivity as a predictor of clinical outcome of Staphylococcus aureus bloodstream infection. J Clin Microbiol 44:1342–1346

    Article  PubMed  PubMed Central  Google Scholar 

  40. Marschall J, Mermel LA, Fakih M et al (2014) Strategies to prevent central line-associated bloodstream infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol 35:753–771

    Article  PubMed  Google Scholar 

  41. Meduri GU, Mauldin GL, Wunderink RG et al (1994) Causes of fever and pulmonary densities in patients with clinical manifestations of ventilator-associated pneumonia. Chest 106:221–235

    Article  CAS  PubMed  Google Scholar 

  42. Mermel LA, Farr BM, Sherertz RJ et al (2001) Guidelines for the management of intravascular catheter-related infections. Clin Infect Dis 32:1249–1272

    Article  CAS  PubMed  Google Scholar 

  43. Mutters NT, Mersch-Sundermann V, Mutters R et al (2013) Kontrolle von Vancomycin-resistenten Enterokokken im Krankenhaus. Dtsch Ärztebl 110:725–731

    Google Scholar 

  44. Nobre V, Harbarth S, Graf JD, Rohner P, Pugin J (2008) Use of procalcitonin to shorten antibiotic treatment duration in septic patients: a randomized trial. Am J Respir Crit Care Med 177:498–505

    Article  CAS  PubMed  Google Scholar 

  45. Paul M, Benuri-Silbiger I, Soares-Weiser K, Leibovici L (2004) Beta lactam monotherapy versus beta lactam-aminoglycoside combination therapy for sepsis in immunocompetent patients: systematic review and meta-analysis of randomised trials. BMJ 328:668

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Richards MJ, Edwards JR, Culver DH, Gaynes RP (1999) Nosocomial infections in medical intensive care units in the United States. National nosocomial infections surveillance system. Crit Care Med 27:887–892

    Article  CAS  PubMed  Google Scholar 

  47. Roberts JA, Abdul-Aziz MH, Lipman J et al (2014) Individualised antibiotic dosing for patients who are critically ill: challenges and potential solutions. Lancet Infect Dis 14:498–509

    Article  PubMed  PubMed Central  Google Scholar 

  48. Roberts JA, Paratz J, Paratz E, Krueger WA, Lipman J (2007) Continuous infusion of beta-lactam antibiotics in severe infections: a review of its role. Int J Antimicrob Agents 30:11–18

    Article  CAS  PubMed  Google Scholar 

  49. Scheithauer S, Lewalter L, Schröder J et al (2014) Reduction of central venous line-associated bloodstream infection rates by using a chlorhexidine-containing dressing. Infection 42:155–159

    Article  CAS  PubMed  Google Scholar 

  50. Scheithauer S, Manemann AK, Krüger S et al (2010) Impact of herpes simplex virus detection in respiratory specimens of patients with suspected viral pneumonia. Infection 38:401–405

    Article  CAS  PubMed  Google Scholar 

  51. Schwaber MJ, Nacon-Venezia S, Kaye KS et al (2006) Clinical and economie impact of bacteremia with extended spectrum beta lactamase producin Enterobacteriaceae. Antimicrob Agents Chemother 50:1257–1262

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Stevens DL, Bisno AL, Chambers HF et al (2005) Practice guidelines for the diagnosis and management of skin and soft-tissue infections. Clin Infect Dis 41:1373–1406

    Article  PubMed  Google Scholar 

  53. Talmor M, Li P, Barie PS (1997) Acute paranasal sinusitis in critically ill patients: guidelines for prevention, diagnosis, and treatment. Clin Infect Dis 25:1441–1446

    Article  CAS  PubMed  Google Scholar 

  54. The Canadian Critical care Trials Group (2006) A randomized trial of diagnostic techniques for ventilator-associated pneumonia. N Engl J Med 355:2619–2630

    Article  Google Scholar 

  55. Timsit JF, Mimoz O, Mourvillier B et al (2012) Randomized controlled trial of chlorhexidine dressing and highly adhesive dressing for preventing catheter-related infections in critically ill adults. Am J Respir Crit Care Med 186:1272–1278

    Article  CAS  PubMed  Google Scholar 

  56. Tumbarello M, Pascale GD, Trecarichi EM et al (2013) Effect of aerosolized colistin as adjunctive treatment on the outcomes of micobiologically documented ventilator-associated pneumonia caused by colistin-only susceptible gram-negative bacteria. Chest 144:1768–1775

    Article  CAS  PubMed  Google Scholar 

  57. Tunkel AR, Hartman BJ, Kaplan SL et al (2004) Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 39:1267–1284

    Article  PubMed  Google Scholar 

  58. Weinstein RA (1986) Endemic emergence of resistance of cephalosporin-resistant enterobacter: relation to prior therapy. Infect Control 7:120–123

    Article  CAS  PubMed  Google Scholar 

  59. Wunderink RG, Niedermann MS, Kollef MH et al (2012) Linezolid in methicillin-resistant Staphylococcus aureus nosocomial pneumonia: a randomized, controlled study. Clin Infect Dis 54:621–629

    Article  CAS  PubMed  Google Scholar 

  60. Wunderink RG, Woldenberg LS, Zeiss J et al (1992) The radiologic diagnosis of autopsy-proven ventilator-associated pneumonia. Chest 101:458–463

    Article  CAS  PubMed  Google Scholar 

  61. Dulhunty JM, Roberts JA, Joshua SD et al. (2015) A multicenter randomized trial of continuous versus intermittend β-lactam infusion in severe sepsis. Am J Respir Crit Care Med 192:1298–1305

    Google Scholar 

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Lemmen, S., Lewalter, K., Krüger, W. (2015). Intensivmedizinische Aspekte der Antibiotikatherapie. In: Rossaint, R., Werner, C., Zwißler, B. (eds) Die Anästhesiologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45539-5_139-1

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  • DOI: https://doi.org/10.1007/978-3-662-45539-5_139-1

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Chapter history

  1. Latest

    Intensivmedizinische Aspekte der Antibiotikatherapie
    Published:
    15 March 2018

    DOI: https://doi.org/10.1007/978-3-662-45539-5_139-2

  2. Original

    Intensivmedizinische Aspekte der Antibiotikatherapie
    Published:
    20 April 2017

    DOI: https://doi.org/10.1007/978-3-662-45539-5_139-1