Infektionsprophylaxe bei neutropenischen Patienten

Infektionen können die Ergebnisse der Therapie hämatologisch-onkologischer Erkrankungen gefährden. Sie stellen eine körperliche und psychische Belastung dar, verlängern die Dauer des Krankenhausaufenthaltes, und verteuern die Therapien erheblich. Infektionen treten häufig in der Phase der Neutropenie nach intensiver Chemotherapie auf. Im vorliegenden Konsensuspapier werden Maßnahmen zur Infektionsprophylaxe bei Neutropenie dargestellt, die als effektiv unter Berücksichtigung von Kosten, Aufwand, Nebenwirkungen, möglicher Nachteile einerseits und den Möglichkeiten moderner therapeutischer Interventionen andererseits gelten können. Im Vordergrund steht dabei die medikamentöse Prophylaxe bei erwachsenen Patienten mit Neutropenie. Der Einsatz hämopoetischer Wachstumsfaktoren, spezielle Maßnahmen bei hämatopoetisch rekonstituierten Patienten nach allogener Stammzelltransplantation/Knochenmarktransplantation (SZT/KMT) sowie die Immunprophylaxe werden hier nicht bewertet. Die Empfehlungen wurden nach systematischen Literaturreviews erarbeitet, in einem nominalen Gruppenprozess wiederholt diskutiert und überarbeitet und am 26.2.2000 verabschiedet. Sie orientieren sich an den Regeln einer evidenzbasierten Medizin, die Darstellung erfolgt hier jedoch in vereinfachter Form (++, empfehlenswert [Evidenztyp I-II]; +, bedingt empfehlenswert [II]; (+), vertretbar [II-IV]; ?, unklar [II-IV]; -, nicht empfehlenswert [II-IV]).

Literatur

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