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Antiinfektive Therapie

  • Chapter
Verbrennungschirurgie

Zusammenfassung

Eine gestörte Hautbarrierefunktion mit reduzierter Immunkompetenz führt bei Verbrennungspatienten häufig zu Infektionen, die unbehandelt lebensgefährdend sind. Bakterielle Infektionen aus der endogenen Flora oder der Umwelt dominieren. Opportunisten wie Pilzinfektionen nach einer antibakteriellen Therapie stellen eine vitale Bedrohung dar. In der Diagnostik werden klinische, laborchemische und mikrobiologische Parameter erhoben. Maßgeblich ist die Unterscheidung zwischen Kontamination und Infektion. Nach Auswahl eines Antibiotikums sollte die veränderte Pharmakokinetik beim Verbrennungspatienten berücksichtigt werden. Der Nutzen für eine längerfristige antibiotische Prophylaxe ist nicht evident. Leichte Infektionen beim stabilen klinischen Zustand sind engmaschig zu beobachten, während bei schwerer Infektion die internationalen Sepsisleitlinien und das Tarragona-Prinzip empfohlen werden. Systemische Infektionen mit Hefepilzen müssen frühzeitig erkannt werden. Das Nebenwirkungsprofil der begrenzten antimykotischen Auswahl trägt zur schlechten Prognose bei Pilzinfektionen bei.

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Author information

Authors and Affiliations

  1. Klinik für Anästhesiologie und operative Intensivmedizin Bereichsleitender Oberarzt Intensivmedizin, Universität Witten/Herdecke Kliniken der Stadt Köln gGmbH Krankenhaus Merheim, Ostmerheimerstraße 200, D-51109, Köln

    Dr. med. Andreas Hohn

  2. Klinik für Anästhesiologie, Intensiv-, Palliativ- und Schmerztherapie, BG-Universitätsklinikum Bergmannsheil Bochum Ruhr-Universität-Bochum, Bürkle-de-la-Camp-Platz 1, D-44789, Bochum

    Dr. med. Peter K. Zahn

  3. Klinik für Anästhesiologie und operative Intensivmedizin, Universität Witten/Herdecke Kliniken der Stadt Köln gGmbH Krankenhaus Merheim, Ostmerheimerstraße 200, D-51109, Köln

    Prof. Dr. med. Samir G. Sakka EDIC, DEAA

  4. Klinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgiezentrum Operatives Referenzzentrum für Gliedmaßentumoren Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil Bochum, Ruhr-Universität-Bochum, Bürkle-de-la-Camp-Platz 1, D-44789, Bochum

    Dr. med. Bassem D. Mikhail M. Sc.

Authors
  1. Dr. med. Andreas Hohn
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  2. Dr. med. Peter K. Zahn
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  3. Prof. Dr. med. Samir G. Sakka EDIC, DEAA
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  4. Dr. med. Bassem D. Mikhail M. Sc.
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Editor information

Editors and Affiliations

  1. BG-Universitätsklinikum Bergmannsheil Bochum, Bochum, Deutschland

    Marcus Lehnhardt

  2. Unfallkrankenhaus Berlin, Berlin, Deutschland

    Bernd Hartmann

  3. Klinikum Nürnberg, Nürnberg, Deutschland

    Bert Reichert

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Hohn, A., Zahn, P.K., Sakka, S.G., Mikhail, B.D. (2016). Antiinfektive Therapie. In: Lehnhardt, M., Hartmann, B., Reichert, B. (eds) Verbrennungschirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54444-6_16

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  • DOI: https://doi.org/10.1007/978-3-642-54444-6_16

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  • Online ISBN: 978-3-642-54444-6

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