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. 2020 Mar 26:8:Doc18.
doi: 10.3205/id000062. eCollection 2020.

Calculated parenteral initial treatment of bacterial infections: Microbiology

Michael Kresken  1   2 , Béatrice Grabein  3 , Karsten Becker  4 , Eberhard Straube  5 , Thomas A Wichelhaus  6 , Birgit Willinger  7
Affiliations

Calculated parenteral initial treatment of bacterial infections: Microbiology

Michael Kresken et al. GMS Infect Dis. .

Abstract
in English, German

This is the second chapter of the guideline "Calculated initial parenteral treatment of bacterial infections in adults - update 2018" in the 2nd updated version. The German guideline by the Paul-Ehrlich-Gesellschaft für Chemotherapie e.V. (PEG) has been translated to address an international audience. Preliminary microbiological findings regarding the patient and their immediate environment are crucial for the calculation of treatment with antibiotics in each case, as well as the resistance situation of the ward on which the patient is being cared for. If such data is not available, regional or supra-regional data can be used as a fallback. This chapter describes the methods of susceptibility testing, informs about the resistance situation in Germany and describes the main resistance mechanisms of bacterial pathogens against antibiotics. Further, the chapter informs about collateral damage of antibiotics as well as medical measures against increasing resistance.

Dies ist das zweite Kapitel der von der Paul-Ehrlich-Gesellschaft für Chemotherapie e.V. (PEG) herausgegebenen S2k Leitlinie „Kalkulierte parenterale Initialtherapie bakterieller Erkrankungen bei Erwachsenen – Update 2018“ in der 2. aktualisierten Fassung.Entscheidend für die Kalkulation einer Therapie mit Antibiotika im Einzelfall sind vorausgehende mikrobiologische Befunde des Patienten selbst und seiner unmittelbaren Umgebung sowie die Resistenzsituation der Abteilung, in der der Patient versorgt wird. Sind solche Daten nicht verfügbar, kann auf regionale oder überregionale Daten zurückgegriffen werden. Dieses Kapitel beschreibt die Methoden der Empfindlichkeitsprüfung, informiert über die überregionale Resistenzsituation in Deutschland und beschreibt die wichtigsten Resistenzmechanismen bakterieller Krankheitserreger gegen Antibiotika. Ferner informiert das Kapitel über Kollateralschäden von Antibiotika sowie medizinische Maßnahmen gegen die zunehmende Resistenz.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Table 1
Table 1. Reasons for discrepancies between antibiogram and outcome of clinical therapy
Table 2
Table 2. Information on the resistance situation in important bacterial pathogens
See this image and copyright information in PMC

References

    1. The International Organization for Standardization (ISO) ISO 20776-1:2006: Clinical laboratory testing and in vitro diagnostic test systems – Susceptibility testing of infectious agents and evaluation of performance of antimicrobial susceptibility test devices – Part 1: Reference method for testing the in vitro activity of antimicrobial agents against rapidly growing aerobic bacteria involved in infectious diseases. Geneva: 2006. Available from: http://www.iso.org/iso/home/store/catalogue_tc/catalogue_detail.htm?csnu....
    1. The International Organization for Standardization (ISO) ISO 20776-2:2007: Clinical laboratory testing and in vitro diagnostic test systems – Susceptibility testing of infectious agents and evaluation of performance of antimicrobial susceptibility test devices – Part 2: Evaluation of performance of antimicrobial susceptibility test devices. Geneva: 2007. Available from: http://www.iso.org/iso/catalogue_detail.htm?csnumber=41631.
    1. German Medical Association. Guideline of the German Medical Association for the Quality Assurance of Laboratory Medical Examinations – According to the decision of the board of the German Medical Association dated 11.04.2014 and 20.06.2014. Dtsch Arztebl. 2014;111(38):A1583–A1618.
    1. Robert-Koch-Institute. ARS – Antibiotic Resistance Surveillance. [Timestamp 2016 Aug 22]. Available from: https://ars.rki.de.
    1. Bodmann KF, Kresken M, Grabein B, Dohmen PM, Wilke M. Kalkulierte parenterale Initialtherapie bakterieller Infektionen: Einführung und Antibiotika. [Calculated parenteral initial treatment of bacterial infections: Introduction and antibiotics]. GMS Infect Dis. 2020;8:Doc19. doi: 10.3205/id000063. (Ger). - DOI - PMC - PubMed

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