Therapie bakterieller Infektionen in der pädiatrischen Onkologie

Zusammenfassung

Ohne den sachkundigen Einsatz von Antibiotika kann das Ziel einer intensiveren Chemotherapie und letztlich eines verbesserten Langzeitüberlebens in der pädiatrischen Onkologie nicht erreicht werden. Während der Granulozytopenie und auch zwischen den intensiven Chemotherapien können bakterielle Infektionen die Lebensqualität des Patienten beeinträchtigen, das Leben des Patienten akut gefährden und den Ressourcenverbrauch im Rahmen der erforderlichen supportiven Behandlung massiv erhöhen. Der unkritische und nicht standardisierte Umgang mit Antibiotika kann den Patienten unnötigerweise mit Nebenwirkungen belasten und zur Selektion resistenter Bakterienspezies führen. Die vorliegende Arbeit enthält Empfehlungen der Arbeitsgruppe „Infektionen bei immunsupprimierten Kindern” der Deutschen Gesellschaft für Pädiatrische Infektiologie (DGPI) und der Deutschen Gesellschaft für Pädiatrische Onkologie und Hämatologie (GPOH) zur gezielten Therapie mit Antibiotika, insoweit sie für die Behandlung pädiatrisch-onkologischer Patienten von Interesse sind.

Abstract

Increased dose intensity and a better long term survival can not be reached in pediatric oncology without the judicious use of antibiotics. During periods with profound neutropenia and between intensive chemotherapy cycles are bacterial infections capable of disturbing the patients' quality of life; they may cause an acute life threatening situation and lead to a substantial increase in expenditures and consumption of ressources in supportive care. The non-judicious use of antibacterials may face the patient to an increased risk of adverse events and fosters the selection of resistant bacteria. This article provides the recommendations of the Infectious Diseases Working Party of the German Society for Pediatric Infectious Diseases (DGPI) and the German Society for Pediatric Hematology/Oncology (GPOH) for antibacterial therapy in pediatric oncology patients based upon the available literature and the clinical experience of the authors.

Schlüsselwörter

Antibiotika - bakterielle Infektionen - pädiatrische Onkologie

Key words

antibiotics - bacterial infection - pediatric oncology

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