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Perioperative Antibiotikaprophylaxe

Perioperative antibiotic prophylaxis

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Zusammenfassung

In Zeiten der zunehmenden Resistenzentwicklung von Bakterien gegenüber antimikrobiellen Substanzen sollte ein großzügiger und potenziell unreflektierter Einsatz von Antibiotika, insbesondere im Bereich der Humanmedizin, sehr kritisch betrachtet werden. Die perioperative Antibiotikaprophylaxe (PAP) steht im Fokus dieses Konflikts, denn sie soll einerseits präemptiv Komplikationsraten durch Keimreduktion leisten; andererseits steht sie im Verdacht, die Selektion resistenter Keime zu fördern, die den Boden für nosokomiale Infektionen bereiten. Im vorliegenden Weiterbildungsbeitrag erfolgt eine kritische Auseinandersetzung mit diesem Thema; hierbei dienen die aktuelle S1-Leitlinie des Arbeitskreises „Krankenhaus- und Praxishygiene“ (Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften, AWMF) 2012 und die Empfehlungen der Paul-Ehrlich-Gesellschaft 2010 als Grundlagen.

Abstract

In times of growing bacterial resistance against antimicrobiotic drugs the broad prescription of antibiotics in human medicine must be carefully considered. The perioperative antibiotic treatment is in the center of that conflict. On the one hand an efficient pathogen reduction for the preemptive treatment of infectious complications is desired but on the other hand it is suspected that this promotes the selection of multiresistant pathogens which could lead to an increase of more complicated nosocomial infections. The aim of this article is a critical appraisal of this subject on the basis of the 2012 guidelines of the German working group of Hygiene in Hospital and Practice (AWMF) and the 2010 recommendations of the Paul-Ehrlich-Gesellschaft.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. F. Reutter, D.A. Reuter, H. Hilgarth, A.M. Heilek, M.S. Goepfert und M.A. Punke geben an, dass kein Interessenkonflikt besteht. Der Beitrag enthält keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Zentrum für Anästhesiologie und Intensivmedizin, Klinik und Poliklinik für Anästhesiologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland

    F. Reutter, D.A. Reuter, A.M. Heilek, M.S. Goepfert &  M.A. Punke

  2. Apotheke, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland

    H. Hilgarth

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  1. F. Reutter
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  2. D.A. Reuter
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  3. H. Hilgarth
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  4. A.M. Heilek
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  5. M.S. Goepfert
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  6. M.A. Punke
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Correspondence to M.A. Punke.

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Reutter, F., Reuter, D., Hilgarth, H. et al. Perioperative Antibiotikaprophylaxe. Anaesthesist 63, 73–86 (2014). https://doi.org/10.1007/s00101-013-2282-7

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