Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Die Anaesthesiologie
Erschienen in: Die Anaesthesiologie 11/2019

25.09.2019 | Multiresistente Erreger | CME

Neue Antibiotika bei schweren Infektionen durch multiresistente Erreger

Definitive Therapie und Eskalation

verfasst von: Dr. D. C. Richter, T. Brenner, A. Brinkmann, B. Grabein, M. Hochreiter, A. Heininger, D. Störzinger, J. Briegel, M. Pletz, M. A. Weigand, C. Lichtenstern

Erschienen in: Die Anaesthesiologie | Ausgabe 11/2019

Einloggen, um Zugang zu erhalten

Zusammenfassung

Multiresistente Erreger führen häufig zum Therapieversagen etablierter antimikrobieller Regime. Nach einer Zeit des Ungleichgewichts zwischen dem Auftreten/der Ausbreitung von Resistenzmechanismen und der Entwicklung neuer Präparate wurden nun einige neue Präparate zugelassen; viele weitere befinden sich in klinischer Erprobung. Sie wirken gegen spezifische Resistenzmechanismen/Erreger besonders effektiv und sollten der definitiven Therapie eines isolierten Erregers vorbehalten sein. In Ermangelung von Alternativen haben Reserveantibiotika wie Aztreonam oder Colistin in den letzten Jahren eine Renaissance erlebt. Sie werden in speziellen infektiologischen Szenarien wieder eingesetzt sowie in Kombination mit neuen Substanzen klinisch getestet. Trotz Einführung und Entwicklung neuer Substanzen wird die Resistenzausbildung auch diese irgendwann (zumindest teilweise) unwirksam machen. Daher muss ihr Einsatz gemäß dem Antibiotic oder Infectious Diseases Stewardship erfolgen.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Abdul-Aziz MH et al (2016) Is prolonged infusion of piperacillin/tazobactam and meropenem in critically ill patients associated with improved pharmacokinetic/pharmacodynamic and patient outcomes? An observation from the Defining Antibiotic Levels in Intensive care unit patients (DALI) cohort. J Antimicrob Chemother 71(1):196–207PubMedCrossRef
2.
Roberts JA et al (2016) Continuous versus Intermittent Beta-lactam Infusion in Severe Sepsis: A Meta-analysis of Individual Patient Data From Randomized Trials. Am J Respir Crit Care Med 6:681CrossRef
3.
Vardakas KZ et al (2018) Prolonged versus short-term intravenous infusion of antipseudomonal β‑lactams for patients with sepsis: a systematic review and meta-analysis of randomised trials. Lancet Infect Dis 18(1):108–120PubMedCrossRef
4.
Cristallini S et al (2016) A new regimen for continuous infusion of vancomycin in critically ill patients. Antimicrob Agents Chemother (Bethesda) 60(8):4750CrossRef
5.
Brinkmann A et al (2018) Therapeutisches Drug Monitoring und individualisierte Dosierung von Antibiotika bei der Sepsis. Med Klin Intensivmed Notfallmed 113:82CrossRef
6.
Roberts JA, Kumar A, Lipman J (2017) Right dose, right now: customized drug dosing in the critically ill. Crit Care Med 45(2):331–336PubMedCrossRef
7.
Roberts JA et al (2014) Individualised antibiotic dosing for patients who are critically ill: challenges and potential solutions. Lancet Infect Dis 14(6):498–509PubMedPubMedCentralCrossRef
8.
9.
10.
Brinkmann A et al (2018) S2k-Leitlinie der PEG zur kalkulierten parenteralen Initialtherapie bakterieller Erkrankungen bei Erwachsenen. Anaesthesist 67(12):936–949PubMedCrossRef
11.
12.
13.
14.
Gastmeier P et al (2014) Dramatic increase in vancomycin-resistant enterococci in Germany. J Antimicrob Chemother 69(6):1660–1664PubMedCrossRef
15.
Swabb EA (1985) Review of the clinical pharmacology of the monobactam antibiotic aztreonam. Am J Med 78(2):11–18PubMedCrossRef
16.
Ramsey C, MacGowan AP (2016) A review of the pharmacokinetics and pharmacodynamics of aztreonam. J Antimicrob Chemother 71(10):2704PubMedCrossRef
17.
Soriano F et al (1996) Correlation of pharmacodynamic parameters of five beta-lactam antibiotics with therapeutic efficacies in an animal model. Antimicrob Agents Chemother (Bethesda) 40(12):2686–2690CrossRef
18.
19.
Biedenbach DJ et al (2015) In vitro activity of aztreonam-avibactam against a global collection of gram-negative pathogens from 2012–2013. Antimicrob Agents Chemother 59(7):4239PubMedPubMedCentralCrossRef
20.
21.
Ehmann DE et al (2012) Avibactam is a covalent, reversible, non-β-lactam β‑lactamase inhibitor. Proc Natl Acad Sci USA 109(29):11663–11668PubMedPubMedCentralCrossRef
22.
Singh R et al (2015) Pharmacokinetics/pharmacodynamics of a β-lactam and β‑lactamase inhibitor combination: a novel approach for aztreonam/avibactam. J Antimicrob Chemother 70(9):2618PubMedCrossRef
23.
Crandon JL, Nicolau DP (2013) Human simulated studies of aztreonam and aztreonam-avibactam to evaluate activity against challenging gram-negative organisms, including metallo-β-lactamase producers. Antimicrob Agents Chemother (Bethesda) 57(7):3299–3306CrossRef
24.
Davis SD, Iannetta A, Wedgwood RJ (1971) Activity of colistin against Pseudomonas aeruginosa: inhibition by calcium. J Infect Dis 124(6):610–612PubMedCrossRef
25.
26.
Falagas ME, Kasiakou SK, Saravolatz LD (2005) Colistin: the revival of polymyxins for the management of multidrug-resistant gram-negative bacterial infections. Clin Infect Dis 40(9):1333–1341PubMedCrossRef
27.
Koch-Weser J et al (1970) Adverse effects of sodium colistimethatemanifestations and specific reaction rates during 317 courses of therapy. Ann Intern Med 72(6):857–868PubMedCrossRef
28.
Markou N et al (2003) Intravenous colistin in the treatment of sepsis from multiresistant Gram-negative bacilli in critically ill patients. Crit Care 7(5):R78PubMedPubMedCentralCrossRef
29.
Coly-Mycin M (2002) Parenteral (package insert). Monarch Pharmaceuticals, Bristol
30.
Michalopoulos A et al (2005) Aerosolised colistin for the treatment of nosocomial pneumonia due to multidrugresistant Gram-negative bacteria in patients without cystic fibrosis. Clin Microbiol Infect 11:335CrossRef
31.
Liu Y‑Y et al (2016) Emergence of plasmid-mediated colistin resistance mechanism MCR‑1 in animals and human beings in China: a microbiological and molecular biological study. Lancet Infect Dis 16(2):161–168PubMedCrossRef
32.
Hasman H, Hammerum AM, Hansen F, Hendriksen RS, Olesen B, Agersø Y, Zankari E, Leekitcharoenphon P, Stegger M, Kaas RS, Cavaco LM, Hansen DS, Aarestrup FM, Skov RL (2015) Detection of mcr-1 encoding plasmid-mediated colistin-resistant Escherichia coli isolates from human bloodstream infection and imported chicken meat, Denmark 2015. Euro Surveill 20(49):pii=30085. 10.2807/1560-7917.ES.2015.20.49.30085CrossRef
33.
Arcilla MS et al (2016) Dissemination of the mcr‑1 colistin resistance gene. Lancet Infect Dis 16(2):147–149PubMedCrossRef
34.
Webb HE et al (2016) Dissemination of the mcr‑1 colistin resistance gene. Lancet Infect Dis 16(2):144–145PubMedCrossRef
35.
Tse H, Yuen K‑Y (2016) Dissemination of the mcr‑1 colistin resistance gene. Lancet Infect Dis 16(2):145–146PubMedCrossRef
36.
Liapikou A, Cilloniz C, Torres A (2015) Ceftobiprole for the treatment of pneumonia: a European perspective. Drug Des Devel Ther 9:4565–4572PubMedPubMedCentral
37.
Awad SS et al (2014) A phase 3 randomized double-blind comparison of ceftobiprole medocaril versus ceftazidime plus linezolid for the treatment of hospital-acquired pneumonia. Clin Infect Dis 59(1):51–61PubMedPubMedCentralCrossRef
38.
Corey GR et al (2010) Integrated analysis of CANVAS 1 and 2: phase 3, multicenter, randomized, double-blind studies to evaluate the safety and efficacy of ceftaroline versus vancomycin plus aztreonam in complicated skin and skin-structure infection. Clin Infect Dis 51(6):641–650PubMedCrossRef
39.
Dryden M et al (2016) A Phase III, randomized, controlled, non-inferiority trial of ceftaroline fosamil 600 mg every 8 h versus vancomycin plus aztreonam in patients with complicated skin and soft tissue infection with systemic inflammatory response or underlying comorbidities. J Antimicrob Chemother 71(12):3575–3584PubMedPubMedCentralCrossRef
40.
File TM et al (2010) Integrated analysis of FOCUS 1 and FOCUS 2: randomized, doubled-blinded, multicenter phase 3 trials of the efficacy and safety of ceftaroline fosamil versus ceftriaxone in patients with community-acquired pneumonia. Clin Infect Dis 51(12):1395–1405PubMedCrossRef
41.
Zhong NS et al (2015) Ceftaroline fosamil versus ceftriaxone for the treatment of Asian patients with community-acquired pneumonia: a randomised, controlled, double-blind, phase 3, non-inferiority with nested superiority trial. Lancet Infect Dis 15(2):161–171PubMedCrossRef
42.
Kiang TK, Wilby KJ, Ensom MH (2015) A critical review on the clinical pharmacokinetics, pharmacodynamics, and clinical trials of ceftaroline. Clin Pharmacokinet 54(9):915–931PubMedCrossRef
43.
Guervil DJ et al (2016) Ceftaroline fosamil as first-line versus second-line treatment for acute bacterial skin and skin structure infections (ABSSSI) or community-acquired bacterial pneumonia (CABP). J Chemother 28(3):180–186PubMedCrossRef
44.
Lipsky BA et al (2015) Ceftaroline fosamil for treatment of diabetic foot infections: the CAPTURE study experience. Diabetes Metab Res Rev 31(4):395–401PubMedCrossRef
45.
Jongsma K, Joson J, Heidari A (2013) Ceftaroline in the treatment of concomitant methicillin-resistant and daptomycin-non-susceptible Staphylococcus aureus infective endocarditis and osteomyelitis: case report. J Antimicrob Chemother 68(6):1444–1445PubMedCrossRef
46.
Tattevin P et al (2014) Salvage treatment of methicillin-resistant staphylococcal endocarditis with ceftaroline: a multicentre observational study. J Antimicrob Chemother 69(7):2010–2013PubMedCrossRef
47.
Lin JC et al (2013) The use of ceftaroline fosamil in methicillin-resistant Staphylococcus aureus endocarditis and deep-seated MRSA infections: a retrospective case series of 10 patients. J Infect Chemother 19(1):42–49PubMedCrossRef
48.
Ho TT et al (2012) Methicillin-resistant Staphylococcus aureus bacteraemia and endocarditis treated with ceftaroline salvage therapy. J Antimicrob Chemother 67(5):1267–1270PubMedCrossRef
49.
Paladino JA et al (2014) Use of ceftaroline after glycopeptide failure to eradicate meticillin-resistant Staphylococcus aureus bacteraemia with elevated vancomycin minimum inhibitory concentrations. Int J Antimicrob Agents 44(6):557–563PubMedCrossRef
50.
51.
52.
Falagas ME et al (2017) Activity of cefiderocol (S-649266) against carbapenem-resistant Gram-negative bacteria collected from inpatients in Greek hospitals. J Antimicrob Chemother 72(6):1704–1708PubMedCrossRef
53.
Castanheira M et al (2014) Mutation-driven beta-lactam resistance mechanisms among contemporary ceftazidime-nonsusceptible Pseudomonas aeruginosa isolates from U.S. hospitals. Antimicrob Agents Chemother 58(11):6844–6850PubMedPubMedCentralCrossRef
54.
Solomkin J et al (2015) Ceftolozane/tazobactam plus metronidazole for complicated intra-abdominal infections in an era of multidrug resistance: results from a randomized, double-blind, phase 3 trial (ASPECT-cIAI). Clin Infect Dis 60(10):1462–1471PubMedPubMedCentralCrossRef
55.
Huntington JA et al (2016) Efficacy of ceftolozane/tazobactam versus levofloxacin in the treatment of complicated urinary tract infections (cUTIs) caused by levofloxacin-resistant pathogens: results from the ASPECT-cUTI trial. J Antimicrob Chemother 71(7):2014–2021PubMedCrossRef
56.
Wagenlehner FM et al (2015) Ceftolozane-tazobactam compared with levofloxacin in the treatment of complicated urinary-tract infections, including pyelonephritis: a randomised, double-blind, phase 3 trial (ASPECT-cUTI). Lancet 385(9981):1949–1956PubMedCrossRef
57.
Mushtaq S, Warner M, Livermore DM (2010) In vitro activity of ceftazidime+ NXL104 against Pseudomonas aeruginosa and other non-fermenters. J Antimicrob Chemother 65(11):2376–2381PubMedCrossRef
58.
Livermore DM (2002) Multiple mechanisms of antimicrobial resistance in Pseudomonas aeruginosa: our worst nightmare? Clin Infect Dis 34(5):634–640PubMedCrossRef
59.
Keepers TR et al (2014) Bactericidal activity, absence of serum effect, and time-kill kinetics of ceftazidime-avibactam against β‑lactamase-producing Enterobacteriaceae and Pseudomonas aeruginosa. Antimicrob Agents Chemother (Bethesda) 58(9):5297CrossRef
60.
Torrens G et al (2016) Activity of ceftazidime-avibactam against clinical and isogenic laboratory pseudomonas aeruginosa isolates expressing combinations of most relevant β‑Lactam resistance mechanisms. Antimicrob Agents Chemother (Bethesda) 60(10):6407–6410CrossRef
61.
Mazuski JE et al (2016) Efficacy and safety of ceftazidime-avibactam plus metronidazole versus meropenem in the treatment of complicated intra-abdominal infection: results from a randomized, controlled, double-blind, phase 3 program. Clin Infect Dis 62(11):1380–1389PubMedPubMedCentralCrossRef
62.
Lucasti C et al (2013) Comparative study of the efficacy and safety of ceftazidime/avibactam plus metronidazole versus meropenem in the treatment of complicated intra-abdominal infections in hospitalized adults: results of a randomized, double-blind, Phase II trial. J Antimicrob Chemother 68(5):1183–1192PubMedCrossRef
63.
Wagenlehner FM et al (2016) Ceftazidime-avibactam versus doripenem for the treatment of complicated urinary tract infections, including acute pyelonephritis: RECAPTURE, a phase 3 randomized trial program. Clin Infect Dis 63(6):754PubMedPubMedCentralCrossRef
64.
Vazquez JA et al (2012) Efficacy and safety of ceftazidime–avibactam versus imipenem–cilastatin in the treatment of complicated urinary tract infections, including acute pyelonephritis, in hospitalized adults: results of a prospective, investigator-blinded, randomized study. Current Medical Research and Opinion 28(12):1921–1931PubMedCrossRef
65.
Torres A et al (2017) Ceftazidime-avibactam versus meropenem in nosocomial pneumonia, including ventilator-associated pneumonia (REPROVE): a randomised, double-blind, phase 3 non-inferiority trial. Lancet Infect Dis 18(3):285PubMedCrossRef
66.
Jayol A et al (2017) Ceftazidime/avibactam alone or in combination with aztreonam against colistin-resistant and carbapenemase-producing Klebsiella pneumoniae. J Antimicrob Chemother 73(2):542–544CrossRef
67.
Mojica MF et al (2016) Successful treatment of bloodstream infection due to metallo-β-lactamase-producing Stenotrophomonas maltophilia in a renal transplant patient. Antimicrob Agents Chemother 60(9):5130–5134PubMedPubMedCentralCrossRef
68.
69.
Tängdén T et al (2014) Evaluation of double-and triple-antibiotic combinations for VIM-and NDM-producing Klebsiella pneumoniae by in vitro time-kill experiments. Antimicrob Agents Chemother (Bethesda) 58(3):1757–1762CrossRef
70.
Cheng A et al (2015) Excess mortality associated with colistin-tigecycline compared with colistin-carbapenem combination therapy for extensively drug-resistant acinetobacter baumannii bacteremia: a multicenter prospective observational study. Crit Care Med 43(6):1194–1204PubMedCrossRef
71.
Blizzard TA et al (2014) Discovery of MK-7655, a β-lactamase inhibitor for combination with Primaxin. Bioorg Med Chem Lett 24(3):780–785PubMedCrossRef
72.
Lapuebla A et al (2015) Activity of imipenem with relebactam against Gram-negative pathogens from New York City. Antimicrob Agents Chemother 59(8):5029–5031PubMedPubMedCentralCrossRef
73.
Lapuebla A et al (2015) Activity of meropenem combined with RPX7009, a novel β‑lactamase inhibitor, against Gram-negative clinical isolates in New York City. Antimicrob Agents Chemother (Bethesda) 59(8):4856–4860CrossRef
74.
75.
Sims M et al (2017) Prospective, randomized, double-blind, Phase 2 dose-ranging study comparing efficacy and safety of imipenem/cilastatin plus relebactam with imipenem/cilastatin alone in patients with complicated urinary tract infections. J Antimicrob Chemother 72:2616–2626. https://​doi.​org/​10.​1093/​jac/​dkx139 CrossRefPubMed
76.
77.
Kaye KS et al (2018) Effect of meropenem-vaborbactam vs piperacillin-tazobactam on clinical cure or improvement and microbial eradication in complicated urinary tract infection: the TANGO I randomized clinical trial. JAMA 319(8):788–799PubMedPubMedCentralCrossRef
78.
79.
Durkin MJ, Corey GR (2014) New developments in the management of severe skin and deep skin structure infections-focus on tedizolid. Ther Clin Risk Manag 11:857–862
80.
Moran GJ et al (2014) Tedizolid for 6 days versus linezolid for 10 days for acute bacterial skin and skin-structure infections (ESTABLISH-2): a randomised, double-blind, phase 3, non-inferiority trial. Lancet Infect Dis 14(8):696–705PubMedCrossRef
81.
Prokocimer P et al (2013) Tedizolid phosphate vs linezolid for treatment of acute bacterial skin and skin structure infections: the ESTABLISH‑1 randomized trial. JAMA 309(6):559–569PubMedCrossRef
82.
Scott LJ (2015) Dalbavancin: a review in acute bacterial skin and skin structure infections. Drugs 75(11):1281–1291PubMedCrossRef
83.
Roberts KD, Sulaiman RM, Rybak MJ (2015) Dalbavancin and oritavancin: an innovative approach to the treatment of gram-positive infections. Pharmacotherapy 35(10):935–948PubMedCrossRef
84.
85.
Boucher HW et al (2014) Once-weekly dalbavancin versus daily conventional therapy for skin infection. N Engl J Med 370(23):2169–2179PubMedCrossRef
86.
Raad I et al (2005) Efficacy and safety of weekly dalbavancin therapy for catheter-related bloodstream infection caused by gram-positive pathogens. Clin Infect Dis 40(3):374–380PubMedCrossRef
87.
Kmeid J, Kanafani ZA (2015) Oritavancin for the treatment of acute bacterial skin and skin structure infections: an evidence-based review. Core Evid 10:39PubMedPubMedCentral
88.
Corey GR et al (2015) Single-dose oritavancin versus 7–10 days of vancomycin in the treatment of gram-positive acute bacterial skin and skin structure infections: the SOLO II noninferiority study. Clin Infect Dis 60(2):254–262PubMedCrossRef
89.
Corey GR et al (2014) Single-dose oritavancin in the treatment of acute bacterial skin infections. N Engl J Med 370(23):2180–2190PubMedCrossRef
90.
Liu F, Myers AG (2016) Development of a platform for the discovery and practical synthesis of new tetracycline antibiotics. Curr Opin Chem Biol 32:48–57PubMedCrossRef
91.
92.
Zhanel GG et al (2016) Review of eravacycline, a novel fluorocycline antibacterial agent. Drugs 76(5):567–588PubMedCrossRef
93.
94.
95.
96.
Zmarlicka MT, Nailor MD, Nicolau DP (2015) Impact of the New Delhi metallo-beta-lactamase on beta-lactam antibiotics. Infect Drug Resist 8:297PubMedPubMedCentral
97.
98.
99.
Connolly LE et al (2015) Baseline pathogens and patient outcomes in a phase 2 study comparing Plazomicin (ACHN-490) to Levofloxacin in complicated urinary tract infection (cUTI) including acute Pyelonephritis (AP). 25th ECCMID. European Society of Clinical Microbiology and Infectious Diseases
100.
101.
102.
Landman D et al (2010) Activity of a novel aminoglycoside, ACHN-490, against clinical isolates of Escherichia coli and Klebsiella pneumoniae from New York City. J Antimicrob Chemother 65(10):2123–2127PubMedCrossRef
103.
Sutcliffe JA (2011) Antibiotics in development targeting protein synthesis. Ann N Y Acad Sci 1241(1):122–152PubMedCrossRef
104.
Galani I et al (2012) Activity of plazomicin (ACHN-490) against MDR clinical isolates of klebsiella pneumoniae, escherichia coli, and enterobacter spp. from Athens, Greece. J Chemother 24(4):191–194PubMedPubMedCentralCrossRef
105.
106.
Cloutier DJ et al (2017) Plazomicin versus meropenem for complicated urinary tract infection and acute pyelonephritis: diagnosis-specific results from the Phase 3 EPIC study. In: Open Forum Infect Dis
107.
108.
Connolly LE, Jubb A, Keeffe B (2017) Plazomicin is associated with improved survival and safety compared to colistin in serious carbapenem-resistant Enterobacteriaceae (CRE) infections: results of the CARE study. In: Annual meeting of the American Society of Microbiology
Metadaten
Titel
Neue Antibiotika bei schweren Infektionen durch multiresistente Erreger
Definitive Therapie und Eskalation
verfasst von
Dr. D. C. Richter
T. Brenner
A. Brinkmann
B. Grabein
M. Hochreiter
A. Heininger
D. Störzinger
J. Briegel
M. Pletz
M. A. Weigand
C. Lichtenstern
Publikationsdatum
25.09.2019
Verlag
Springer Medizin
Erschienen in
Die Anaesthesiologie / Ausgabe 11/2019
Print ISSN: 2731-6858
Elektronische ISSN: 2731-6866
DOI
https://doi.org/10.1007/s00101-019-00646-z

Weitere Artikel der Ausgabe 11/2019

Die Anaesthesiologie 11/2019 Zur Ausgabe

Allgemeinanästhesie

Algorithmus zur Vermeidung neuromuskulärer Restblockaden

Originalien

Analgesic efficacy of erector spinae plane block in percutaneous nephrolithotomy

Journal Club

Beatmung und Sauerstofftherapie

Kasuistiken

Awake craniotomy in a super obese patient using high flow nasal cannula oxygen therapy (HFNC)

Erratum

Erratum zu: Erreger, Resistenzmechanismen und etablierte Therapieoptionen bei Infektionen durch multiresistente Erreger

Kasuistiken

Tracheoesophageal fistula following button battery ingestion in an infant

Neu im Fachgebiet AINS

23.04.2024 | Appendizitis | Nachrichten

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 | Leitsymptom Rückenschmerzen | Nachrichten

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 | Operationsvorbereitung | Nachrichten

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 | Pankreaskarzinom | Nachrichten

S3-Leitlinie zu Pankreaskrebs aktualisiert
weitere anzeigen

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

hier abonnieren