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Pneumologie 2008; 62(7): 411-422
DOI: 10.1055/s-2008-1038139
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© Georg Thieme Verlag Stuttgart · New York

Therapie der ambulant erworbenen Pneumonie

Therapy of Community Acquired PneumoniaD.  Drömann1 , B.  Schaaf1
  • 1Medizinische Klinik III, Universitätsklinikum Schleswig-Holstein Campus Lübeck
Further Information

Publication History

Publication Date:
07 July 2008 (online)

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See also:

Therapie der ambulant erworbenen PneumoniePneumologie 2008; 62(12): 744-744
DOI: 10.1055/s-2008-1038294

Zusammenfassung

Die ambulant erworbene Pneumonie ist die wichtigste Infektionskrankheit in Deutschland und damit ein bedeutender Faktor im Gesundheitswesen. Da zu Beginn der Erkrankung der Erreger meist nicht bekannt ist, kann initial nur empirisch therapiert werden. Eine frühzeitige Diagnosesicherung, gefolgt von einer adäquaten Therapie, bessert die Prognose des Patienten.

Variablen für die Auswahl des Antibiotikums sind Schwere der Erkrankung, Pathogenität des Erregers, Alter und Begleiterkrankungen des Patienten, Ort der Behandlung sowie Art und Zahl antibiotischer Vortherapien. Im Hinblick auf eine Antibiotikaresistenz wurden steigende Resistenzraten von S. pneumoniae gegenüber Makrolidantibiotika in Deutschland beobachtet. Mithilfe einfacher Scores ist eine zuverlässige Unterscheidung von Patienten mit niedrigem und hohem Letalitätsrisiko möglich. Entsprechend ist eine risikoadaptierte Therapie, bei der eine Monotherapie mit klassischen Beta-Laktam-Antibiotika für Patienten mit geringem Risiko einer breiter wirksamen Kombinationstherapie in der Hochrisikogruppe gegenübersteht, sinnvoll. Der Artikel gibt einen Überblick über die wichtigsten Empfehlungen der deutschen Leitlinie und diskutiert neue Erkenntnisse der letzten Jahre.

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PD Dr. med. Bernhard Schaaf

Medizinische Klinik III, Universitätsklinikum Schleswig-Holstein, Campus Lübeck

Ratzeburger Allee 160

23538 Lübeck

Email: schaaf@uni-luebeck.de

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