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Antiinfektiva während der Schwangerschaft und im Wochenbett

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Infektionserkrankungen der Schwangeren und des Neugeborenen

Zusammenfassung

Bakterielle Infektionen können nicht nur die Mutter gefährden, sondern auch den Verlauf der Schwangerschaft komplizieren. Falls bei einer Schwangeren eine medikamentöse antiinfektive Behandlung erforderlich ist, richtet sich diese primär nach der Empfindlichkeit der zu erwartenden Keime. Nach heutigem Kenntnisstand hat sich keines der länger eingeführten Antiinfektiva als ernsthaft entwicklungstoxisch für den Embryo oder Feten gezeigt. Zwar wurden von einzelnen Autoren Signale erörtert, die z. B. auf eine leicht erhöhte Rate von Herzseptumdefekten und Pylorusstenosen nach Behandlung der Mutter mit Erythromycin im 1. Trimenon hindeuteten, doch konnte ein solcher Verdacht bisher nicht erhärtet werden. Wie bei anderen Erkrankungen auch sollten nicht nur während einer Gravidität, sondern auch wegen einer häufig ungeplant entstehenden Schwangerschaft generell im gebärfähigen Alter ausreichend erprobte Arzneimittel bevorzugt werden. Neue Medikamente sind den älteren oft keineswegs überlegen und ihre Verträglichkeit für das Ungeborene ist nicht zu beurteilen. Antibiotika der ersten Wahl sind in allen Phasen der Schwangerschaft Penicilline und Cephalosporine. Als Alternative, z. B. bei Allergie, stehen Makrolide zur Verfügung. Im Fall von vital bedrohlichen Infektionen, insbesondere mit Problemkeimen, kann eine Therapie mit schlechter erprobten oder für die Schwangerschaft suspekten Antibiotika erforderlich werden. Dabei überwiegt der therapeutische Nutzen in den meisten Fällen das potenzielle Risiko für das ungeborene Kind.

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  1. Pharmakovigilanz- und Beratungszentrum für Embryonaltoxikologie, Charité-Universitätsmedizin Berlin, Spandauer Damm 130, Haus 10, 14050, Berlin, Deutschland

    Stephanie Padberg & Christof Schaefer PD Dr. med.

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  1. Stephanie Padberg
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  1. Klinik u. Poliklinik f. Frauenheilkunde, und Geburtshilfe, Ludwig-Maximilians-Universität München, Maistraße 11, München, 80337, Germany

    Klaus Friese

  2. Klinikum Innenstadt, Klinik für Geburtshilfe, Ludwig-Maximilians-Universität München, Maistr. 11, München, 80337, Germany

    Ioannis Mylonas

  3. Neonato. im Perinatalzen. Großhadern, Dr. von Haunerschen Kinderspital, Universitätsklinikum München, Marchioninistr. 15, München, 81377, Germany

    Andreas Schulze

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Padberg, S., Schaefer, C. (2013). Antiinfektiva während der Schwangerschaft und im Wochenbett. In: Friese, K., Mylonas, I., Schulze, A. (eds) Infektionserkrankungen der Schwangeren und des Neugeborenen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-78325-1_11

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