Pneumonie – Geschichtliche Entwicklung, Status quo und Ausblick

 

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Zusammenfassung

Die Lungenentzündung (Pneumonie) ist eine der ältesten Erkrankungen der Menschheitsgeschichte mit einer hohen Morbidität und Letalität. Die Einführung der modernen Antibiotikatherapie hat daran nichts geändert, sondern im Gegenteil neue Probleme und Herausforderungen mit sich gebracht. Patienten werden älter und multimorbider, Erreger resistent gegen Antibiotika. Eine verbesserte Diagnostik und die Einführung risikostratifizierter Therapiemaßnahmen hat zu einer Vereinheitlichung der Therapie beigetragen. Impfstrategien haben sich für bestimmte Erreger bewährt. Während jahrzehntelang der Kampf gegen die Erreger im Vordergrund der Pneumoniebehandlung stand, spielt zunehmend die Abwehrlage des Menschen eine Rolle für die Forschung. Die Modulation des Immunsystems gilt als der wesentliche Ansatz, die Herausforderungen der Zukunft in der Infektiologie bewältigen zu können.

Abstract

Pneumonia is one of the oldest and best known diseases in mankind. Morbidity and mortality of this disease are remarkable. This has not been changed with the development of modern antibiotic therapy. On the contrary new challenges have arisen, more elderly and comorbid patients are involved and an increase in antibiotic resistance has appeared. An improvement in diagnosis and the introduction of risk stratification approaches has led to a standardisation in therapy. Vaccination strategies for special pathogens like S. pneumoniae have reduced the burden of disease. For decades research was focused on the development of new antibiotics. The failure of this strategy has directed more attention to the host-pathogen interaction. Modulation of innate immunity is one of the key issues to overcome the future challenges in this field.

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Prof. Dr. Tobias Welte

Klinik für Pneumologie
Medizinische Hochschule Hannover

Carl-Neuberg-Str. 1
30625 Hannover

Email: welte.tobias@mh-hannover.de