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Antibiotic Stewardship am Beispiel der Staphylococcus aureus Bakteriämie

  • S. WeisEmail author
  • A. Kimmig
  • S. Hagel
  • M. W. Pletz
Leitthema

Zusammenfassung

Weltweit zunehmende Antibiotikaresistenzen erschweren die Behandlung von Patienten mit bakteriellen Infektionen. Eine wesentliche Ursache wird dem unkritischen Einsatz von Antibiotika im stationären und ambulanten Bereich sowie in der Landwirtschaft zugeschrieben. Antibiotic-Stewardship(ABS)-Programme, die inzwischen auch vom Gesetzgeber gefordert werden, sollen der Ausbreitung von Antibiotikaresistenzen entgegenwirken. Grundpfeiler des ABS sind multidisziplinäre Teams, die v. a. in Krankenhäusern eingesetzt werden, um entsprechende ABS-Maßnahmen zu implementieren. Eine wesentliche Strategie dabei sind ABS-Visiten/-Konsile. Die Staphylococcus (S.) aureus Bakteriämie nimmt im Rahmen des ABS eine Sonderstellung ein: Für keine andere Infektion konnte so klar belegt werden, dass infektiologische Konsile, die hier u. a. auch die Deeskalation einer empirischen Breitspektrumtherapie auf Schmalspektrum-β-Laktame beinhalten, die Letalität deutlich reduzieren. In diesem Übersichtsartikel werden die Bedeutung von ABS-Visiten/‑Konsilen bei der Behandlung von S. aureus Bakteriämien vorgestellt.

Schlüsselwörter

Infektion Antibiotikaresistenz MRSA Blutkultur Mortalität 

Antibiotic stewardship and Staphylococcus aureus Bacteremia

Abstract

Rates of antibiotic resistance are increasing worldwide and impact on the treatment of patients with bacterial infections. A broad and uncritical application in inpatient and outpatient settings as well as in agriculture has been recognized as the main driving force. Antibiotic stewardship (ABS) programs aim at countering this worrisome development using various direct interventions such as infectious disease counseling. Blood stream infections caused by Staphylococcus (S.) aureus are severe infections associated with high mortality rates. ABS interventions such as de-eskalation of the antibiotic regimen or application of narrow-spectrum beta-lactam antibiotics can significantly reduce mortality rates. In this review, we discuss the importance of ABS programs and infectious disease counseling for the treatment of S. aureus blood stream infection.

Keywords

Infection Drug resistance, bacterial  MRSA Blood culture Mortality 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

S. Weis hat Vortragshonorare von der MSD SHARP & DOHME GMBH und der InfectoPharm Arzneimittel und Consilium GmbH erhalten. S. Hagel hat Vortragshonorare von der Pfizer Deutschland GmbH, der MSD SHARP & DOHME GMBH und der AstraZeneca GmbH erhalten. M. W. Pletz hat an nationalen und internationalen Advisory Boards der Pfizer Deutschland GmbH, der Novartis Pharma GmbH, von Basilea Pharmaceutica Ltd und Cubist Pharmaceuticals teilgenommen und Vortragshonorare dieser Firmen erhalten. A. Kimmig gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH 2017

Authors and Affiliations

  • S. Weis
    • 1
    • 2
    • 3
    Email author
  • A. Kimmig
    • 1
  • S. Hagel
    • 1
    • 2
  • M. W. Pletz
    • 1
    • 2
  1. 1.Zentrum für Infektionsmedizin und KrankenhaushygieneUniversitätsklinikum JenaJenaDeutschland
  2. 2.Center for Sepsis Control and CareUniversitätsklinikum JenaJenaDeutschland
  3. 3.Klinik für Anästhesiologie und IntensivmedizinUniversitätsklinikum JenaJenaDeutschland

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