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Die Leitlinie Allergieprävention auf dem Prüfstand

The revised guideline on Primary Allergy Prevention

  • Leitthema
  • Published:
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Im vorliegenden Beitrag werden die wichtigsten Empfehlungen der im Jahr 2009 überarbeiteten AWMF-S3-Leitlinie „Allergieprävention“ dargestellt sowie die aktuelle Diskussion um die neuen Aspekte dieser Leitlinie. So wird aktuell keine Reduktion des Hausstaubmilbengehaltes als primärpräventive Maßnahme mehr empfohlen. Neu sind auch die Empfehlungen zur Vermeidung von Übergewicht und zur Minimierung der Exposition gegenüber Luftschadstoffen im Innen- und Außenraum. Nach der aktuellen Leitlinie gibt es keine Hinweise dafür, dass eine Verzögerung der Beikosteinführung über den vollendeten vierten Lebensmonat hinaus einen allergiepräventiven Effekt hat. Daher kann auch bei Kindern mit erhöhtem familiärem Allergierisiko nach dem vollendeten vierten Monat Beikost eingeführt werden. Die Kernaussagen zur Vermeidung der Tabakrauchexposition, der Empfehlung, nach Möglichkeit über vier Monate voll zu Stillen, der Vermeidung eines schimmelpilzfördernden Innenraumklimas, der Impfung nach Empfehlungen der STIKO und der Vermeidung felltragender Tiere (insbesondere Katzen) bei Risikokindern sind unverändert geblieben.

Abstract

The recommendations of the revised guideline Primary Allergy Prevention published in 2009 are summarized and discussed. The updated guidelines do not further recommend reducing house dust mite allergen exposure as a measure of primary prevention. New suggestions include the avoidance of overweight, and reduction of the exposure to indoor and/or outdoor air pollutants. In line with the current guidelines, there is no scientific evidence that prolonged introduction of solid food is an allergy-preventive measure. Consequently, even children with a family history of atopy can introduce solid foods at the beginning of the 5th month. The recommendations on avoiding environmental tobacco smoke, breast feeding over 4 months, avoiding a mold-promoting indoor climate, vaccination according to current recommendations, and avoidance of furry pets (especially cats) in risk babies have remained unchanged.

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Danksagung

Der Autor dankt Frau Dr. Claudia Voss für die kritische Durchsicht des Manuskriptes.

Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: Der Autor hat eine klinische Studie zum Effekt von Präbiotika in der primären Allergieprävention durchgeführt, die von der Firma Infektopharm (Heppenheim, Deutschland) unterstützt wurde.

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  1. Klinik für Kinder- und Jugendmedizin, Schwerpunkt Kinderpneumologie, Universität zu Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    M.V. Kopp

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Correspondence to M.V. Kopp.

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Kopp, M. Die Leitlinie Allergieprävention auf dem Prüfstand. Bundesgesundheitsbl. 55, 338–342 (2012). https://doi.org/10.1007/s00103-011-1431-x

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