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Krankenhaushygiene up2date 2021; 16(02): 187-201
DOI: 10.1055/a-1173-5813
Antiinfektiva

Therapeutisches Drug Monitoring (TDM) in der antiinfektiven Therapie – von der Theorie zur Praxis

Alexander Brinkmann
,
Anka Röhr
,
Daniel Richter
,
Ute Chiriac
,
Otto Roman Frey
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Die Medusa-Studie zeigte, dass in Deutschland nur etwa 58 % der Patienten mit schwerer Sepsis und septischem Schock eine adäquate Antibiotikatherapie erhielten [1], die einen klaren Überlebensvorteil von 11 % bot. Neben eines septischen Schocks und multiresistenter Erreger (MRE) ist eine inadäquate Antibiotikatherapie bei septischen Patienten eine unabhängige Variable der Gesamtmortalität [2].
Kernaussagen

  • Das Messen von Serumkonzentrationen im Rahmen eines therapeutischen Drug Monitorings/Managements kann den diagnostischen Blick verfeinern und die antiinfektive Therapie optimiere.

  • Mit TDM lassen sich UAWs und Arzneimittelinteraktionen verhindern.

  • Neben der kontinuierlichen Applikation, die aus unserer Sicht eine Messung der Arzneistoffkonzentrationen zwingend voraussetzt, kann alternativ die prolongierte Applikation von β-Lactam-Antibiotika über einen Zeitraum von 3–4 h zur Optimierung der Therapie beitragen.

  • Vor allem die Antibiotikatherapie bei Intensivpatienten ist heute sicher mehr als nur eine Frage der richtigen Substanz und einer zeitnahen Applikation.



Publication History

Article published online:
18 May 2021

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