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Einsatzmöglichkeiten von Cephalosporinen der 2. Generation in der perioperativen Antibiotikaprophylaxe in der Chirurgie

Cephalosporins for perioperative prophylaxis

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Zusammenfassung

Die perioperative Antibiotikaprophylaxe hat sich unter anderem in der kolorektalen Chirurgie, der Gallenchirurgie und der Gefäßchirurgie bewährt. Die zur Prophylaxe verwendeten Antibiotika sollten gegen die bei diesen Operationen in Wundinfektionen am häufigsten gefundenen Keime wirksam sein. Dieses sind Staphylokokken, Streptokokken undEscherichia coli. Diese Keime werden durch das Wirkungsspektrum der Cephalosporine der 2. Generation erfaßt. Gegen Anaerobier sollte in der kolorektalen Chirurgie zusätzlich ein anaerobier-wirksames Antibiotikum verabreicht werden. Resistenzentwicklungen wurden in den letzten Jahren nicht beobachtet. Mit der zur Prophylaxe empfohlenen Dosierung (1,5 g bis 2 g je nach Präparat) ist ein ausreichender Serumspiegel für ca. drei Stunden gewährleistet, bei länger andauernden Operationen muß nachdosiert werden. Die perioperative Antibiotikaprophylaxe mit einer Einzeldosis eines Cephalosporins der 2. Generation hat sich als wirksam, sicher und kostengünstig erwiesen.

Summary

Perioperative antibiotic prophylaxis has proven to prevent infections in a variety of surgical interventions such as colorectal, biliary and vascular surgery. The antimicrobial spectrum of an antibiotic used for perioperative prophylaxis should includeStaphylococcus spp.,Streptococcus spp. andEscherichia coli which are among the most frequent pathogens isolated from surgical infections. Second generation cephalosporins provide appropriate activity against these microorganisms. In colorectal surgery, combination with an anti-anaerobic agent is mandatory. During the past few years no major resistance development has been observed against second generation cephalosporins which are used at a dosage of 1.5 to 2 g. A single dose may provide sufficient serum levels for approximately three hours. Prolonged surgical procedures need an additional dose. Single dose prophylaxis with a second generation cephalosporin appears to be an appropriate strategy for infection prevention in surgery with regard to efficiency, safety and costs.

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  1. Chirurgische Universitätsklinik, Josef-Schneider-Straße 2, D-97080, Würzburg

    R. Engemann

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Engemann, R. Einsatzmöglichkeiten von Cephalosporinen der 2. Generation in der perioperativen Antibiotikaprophylaxe in der Chirurgie. Infection 21 (Suppl 1), S17–S20 (1993). https://doi.org/10.1007/BF01710339

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