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Antibiotikaassoziierte Diarrhö

Antibiotic-associated diarrhea

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Zusammenfassung

Die antibiotikaassoziierte Diarrhö und insbesondere die Clostridium-difficile-assoziierte Diarrhö sind relevante Erkrankungen, die in den letzten Jahren an Zahl und Schwere der Fälle zugenommen haben. Ursächlich hierfür scheint neben dem vermehrten Einsatz von Antibiotikatherapien auch eine Zunahme hypervirulenter Clostridium-difficile-Stämme zu sein. Therapeutisch können die etablierten Standardantibiotika Metronidazol und Vancomycin eingesetzt werden, die sich in der Effektivität nicht signifikant unterscheiden. Neue therapeutische Optionen wie das Schmalspektrumantibiotikum Fidaxomicin stehen kurz vor der Zulassung. Aufgrund der zunehmenden Erkrankungsschwere, nicht zuletzt aber auch aus gesundheitsökonomischen Gesichtspunkten, sollte eine Antibiotikatherapie nur nach strenger Indikationsstellung durchgeführt und die Behandlungsdauer minimiert werden. Zur Prophylaxe ist eine begleitende probiotische Therapie mit Laktobazillen zu erwägen. Die strenge Einhaltung hygienischer Maßnahmen wie die Isolierung des erkrankten Patienten und eine gründliche Desinfektion sind die Basis präventiver Maßnahmen.

Abstract

The number of cases and severity of antibiotic-associated diarrhea and in particular also Clostridium difficile-associated diarrhea has risen in recent years. This seems to be on the one hand due to the increased use of antibiotics therapy and on the other due to the increase of hypervirulent Clostridium difficile-strains. The widely applied and well established antibiotics metronidazole and vancomycin can be used as therapy; both of them are similarly effective. There are also newer therapeutic options such as fidaxomicin which will come on the market soon. Due to the increasing severity of the disease leading to higher therapy costs in general it is recommended that antibiotics are only prescribed for a minimum duration and are only used in cases where no alternative cure can be applied. Latest research suggests a concomitant therapy of probiotics containing lactobacilli as a preventive option. Following strict rules of hygiene such as the isolation of infected patients and thorough disinfection measures form the basis for disease prevention in general.

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  1. Gastroenterologie und Hepatologie, Medizinische Klinik 1, Johann-Wolfgang-Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Deutschland

    J. Hausmann &  O. Schröder

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  1. J. Hausmann
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  2. O. Schröder
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Correspondence to O. Schröder.

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Hausmann, J., Schröder, O. Antibiotikaassoziierte Diarrhö. Gastroenterologe 7, 220–227 (2012). https://doi.org/10.1007/s11377-011-0601-6

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