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03.03.2022 | Cholangitis | Schwerpunkt: Infektiologische Probleme in der Gastroenterologie

Bakterielle hepatobiliäre Infektionen

Erregerspektrum, antimikrobielle Resistenzentwicklung und aktuelle Therapiekonzepte

verfasst von: Univ.-Prof. Dr. med. Tony Bruns, Univ.-Prof. Dr. med. Andreas Stallmach

Erschienen in: Die Innere Medizin | Ausgabe 4/2022

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Zusammenfassung

Aszendierende Cholangitiden und pyogene Leberabszesse sind akut fieberhaft verlaufende bakterielle hepatobiliäre Erkrankungen. Sie treten heutzutage häufig bei Patienten mit strukturellen Veränderungen des Gallenwegssystems auf und werden mithilfe der Kombination aus interventionellen Drainageverfahren und antimikrobieller Therapie behandelt. Während in der Vergangenheit gramnegative Enterobacterales als führende Ursache identifiziert wurden, haben Gallenwegsinterventionen und Antibiotikaexpositionen zur Zunahme von Enterokokkenspezies und Extended-spectrum-β-Lactamase(ESBL)-bildenden Enterobacterales beigetragen. Der behandelnde Internist muss bei der Wahl einer geeigneten empirischen Therapie neben pharmakokinetischen Aspekten und Schweregrad der Erkrankung auch lokale und individuelle Risikofaktoren für eine antimikrobielle Resistenz berücksichtigen, um die Wahrscheinlichkeit eines Therapieversagens zu reduzieren.

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Titel: Bakterielle hepatobiliäre Infektionen
Erregerspektrum, antimikrobielle Resistenzentwicklung und aktuelle Therapiekonzepte
verfasst von: Univ.-Prof. Dr. med. Tony Bruns
Univ.-Prof. Dr. med. Andreas Stallmach
Publikationsdatum: 03.03.2022
Verlag: Springer Medizin
Schlagwörter: Cholangitis
Antibiotika
Carbapeneme
Vancomycin
Metronidazol
Erschienen in: Die Innere Medizin / Ausgabe 4/2022
Print ISSN: 2731-7080
Elektronische ISSN: 2731-7099
DOI: https://doi.org/10.1007/s00108-022-01277-0

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