Akute Infektionen der Hand – Ein Überblick über das Keimspektrum und gängige Antibiotika

Zusammenfassung

Akute Infektionen der Hand können ein schwerwiegendes Krankheitsbild darstellen. Neben der chirurgischen Therapie ist die Etablierung einer antibiotischen Therapie in den meisten Fällen Mittel der ersten Wahl. Die häufigsten vorkommenden Keime sind Staphylococcus aureus sowie verschiedene Streptokokken. Bei Bisswunden ist zusätzlich Pasteurella multocida sehr häufig vertreten. Resistenzen gegen Antibiotika der entsprechenden Keime sind der publizierten Literatur zu Folge im (mittel-)europäischen Raum glücklicherweise selten, sodass Cephalosporine der 1. oder 2. Gruppe sowie Aminopenicilline mit Betalaktamaseinhibitoren die Mittel der Wahl darstellen. Insbesondere bei Begleiterkrankungen oder ungewöhnlicher Ätiologie der Infektion ist jedoch ein breiteres Keimspektrum zu erwarten, sodass eine Gewebeprobe zur Etablierung der optimalen antibiotischen Therapie wertvolle Informationen liefert. Infektionen der Hand sollten in jedem Fall mit besonderer Aufmerksamkeit engmaschig betreut werden, um gravierende Komplikationen zu verhindern. Dies sollte in enger Zusammenarbeit mit den beteiligten Fachdisziplinen sowie Physiotherapeuten erfolgen.

Abstract

Acute infections of the hand can be a pathology with severe consequences. Alongside the surgical therapy, it is necessary to establish a systemic antiinfective therapy as well. The most frequent bacteria in acute hand infections are Staphylococcus aureus and, less frequently, different Streptococci. If the infection is the result of a bite wound, the most frequently found bacterium is Pasteurella multocida. Fortunately, the susceptibility to frequently used antibiotics in the (middle-)European area is quite good – according to the literature, resistances are rare. First line antibiotics are 1st and 2nd generation cephalosporins as well as aminopenicillins in combination with beta-lactamase inhibitors. Especially in multi-morbid patients or infections with unusual aetiology, a broader bacterial spectrum is to be expected. It is very effective to collect a tissue sample or swab for microbiological analysis before the establishment of the antiinfective therapy to gain valuable information about the prospective therapy. Ultimately, hand infections are a pathology to be treated with increased attention to avoid severe complications. A close cooperation with the involved specialties and physiotherapists should be sought to guarantee the best possible outcome.

Schlüsselwörter

Akute Handinfektion - Keimspektrum - Antibiotika - antiinfektive Therapie - Staphylococcus aureus

Key words

Acute hand infection - bacterial spectrum - antibiotics - antiinfective therapy - Staphylococcus aureus

Publication History

Received: 20 January 2021

Accepted: 20 January 2021

Article published online:
16 June 2021

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