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Erkrankungen des Pankreas pp 39–43Cite as

Antibiotikatherapie – selektive Darmdekontamination, was hat sich bei der akuten Pankreatitis bewährt?

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Zusammenfassung

Antibiotika sind bei der schweren akuten Pankreatitis ein elementarer Bestandteil der Therapie. Allerdings sind die Indikationen für ihren Einsatz nach wie vor nicht bis ins Detail geklärt. Gesichert ist, dass die milde akute Pankreatitis keiner Antibiotikaprophylaxe bedarf. Ebenfalls gesichert ist, dass bei infizierten Pankreasnekrosen Breitspektrumantibiotika neben einer chirurgischen oder interventionellen Drainage essenzieller Bestandteil der Therapie sind. Bei der schweren akuten Pankreatitis hat es sich bewährt, anhand bestimmter klinischer Kriterien zu entscheiden, ob Antibiotika gegeben werden. Eine klinische Verschlechterung des Patienten im Verlauf mit ansteigenden laborchemischen Entzündungsparametern oder progredientem Organversagen rechtfertigt die Gabe von Breitspektrumantibiotika, auch wenn der eindeutige wissenschaftliche Beweis für eine positive Beeinflussung des Verlaufes nicht erbracht ist.

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Authors and Affiliations

  1. Allgemein- und Viszeralchirurgie, St. Anna – Virngrundklinik Ellwangen, Dalkinger Straße 8–12, 73479, Ellwangen, Deutschland

    Rainer Isenmann

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  1. Rainer Isenmann
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Correspondence to Rainer Isenmann .

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Editors and Affiliations

  1. Abt. Allgemeine- und Visceralchirurgie, Universitätsklinikum Ulm, Germany

    Hans G. Beger

  2. Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Heidelberg, Germany

    Markus W. Büchler

  3. Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Halle, Sachsen-Anhalt, Germany

    Henning Dralle

  4. Klinik und Poliklinik für Innere Medizin, Universitätsmedizin Greifswald, Germany

    Markus M. Lerch

  5. und Hepatologie (KGHI), Universitätsklinikum Magdeburg, Germany

    Peter Malfertheiner

  6. FB Gastroenterologie und Hepatologie, Universitätsklinikum Leipzig, Sachsen, Germany

    Joachim Mössner

  7. ehemals Klinikum der Stadt Ludwigshafen gGmbH, Rheinland-Pfalz, Germany

    Jürgen F. Riemann

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Isenmann, R. (2013). Antibiotikatherapie – selektive Darmdekontamination, was hat sich bei der akuten Pankreatitis bewährt?. In: Beger, H., et al. Erkrankungen des Pankreas. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37964-2_7

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  • DOI: https://doi.org/10.1007/978-3-642-37964-2_7

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-37963-5

  • Online ISBN: 978-3-642-37964-2

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