S2k-Leitlinie zur Diagnostik, Prävention und Therapie der Tuberkulose im Kindes- und Jugendalter

C. Feiterna-Sperling; F. Brinkmann; C. Adamczick; F. Ahrens; M. Barker; C. Berger; L. D. Berthold; M. Bogyi; U. von Both; T. Frischer; W. Haas; P. Hartmann; D. Hillemann; F. W. Hirsch; K. Kranzer; F. Kunitz; E. Maritz; A. Pizzulli; N. Ritz; R. Schlags; T. Spindler; S. Thee; K. Weizsäcker

doi:10.1055/s-0043-116545

Pneumologie 2017; 71(10): 629-680
DOI: 10.1055/s-0043-116545

Leitlinie

S2k-Leitlinie zur Diagnostik, Prävention und Therapie der Tuberkulose im Kindes- und Jugendalter^[*]

Eine Leitlinie unter Federführung der Deutschen Gesellschaft für Pädiatrische Infektiologie (DGPI) e. V.Consensus-Based Guidelines for Diagnosis, Prevention and Treatment of Tuberculosis in Children and AdolescentsA Guideline on Behalf of the German Society for Pediatric Infectious Diseases (DGPI)

Autor*innen

C. Feiterna-Sperling

¹Charité – Universitätsmedizin Berlin, Klinik für Pädiatrie m. S. Pneumologie und Immunologie, Berlin
F. Brinkmann

²Universitätskinderklinik der Ruhr-Universität Bochum, Abteilung für Pädiatrische Pneumologie/CF-Zentrum, Bochum

Autor*innen

C. Adamczick

³Monvia Gesundheitszentrum, Wallisellen, Schweiz
F. Ahrens

⁴Altonaer Kinderkrankenhaus, Hamburg
M. Barker

⁵Kinderklinik Heckeshorn, Abt. für Pädiatrische Pneumologie und Allergologie, HELIOS Klinikum Emil von Behring, Berlin
C. Berger

⁶Universitäts-Kinderspital Zürich, Eleonorenstiftung, Abteilung für Infektiologie und Spitalhygiene, Zürich, Schweiz
L. D. Berthold

⁷Medizinische Hochschule Hannover, Abteilung für Pädiatrische Radiologie, Hannover
M. Bogyi

⁸Sigmund Freud University Vienna, Wilhelminenspital, Wien, Österreich
U. von Both

⁹Klinikum der Universität München, Dr. von Haunersches Kinderspital, Abt. für pädiatrische Infektiologie, München
T. Frischer

⁸Sigmund Freud University Vienna, Wilhelminenspital, Wien, Österreich
W. Haas

¹⁰Abteilung für Infektionsepidemiologie, Fachgebiet respiratorisch übertragbare Erkrankungen des Robert Koch-Instituts (RKI), Berlin
P. Hartmann

¹¹Institut für Medizinische Mikrobiologie, Immunologie und Hygiene (IMMIH), Uniklinik Köln

¹²Labor Dr. Wisplinghoff, Köln
D. Hillemann

¹³Forschungszentrum Borstel, Diagnostische Mykobakteriologie, Borstel
F. W. Hirsch

¹⁴Universitätsklinikum Leipzig, Abteilung für Kinderradiologie, Leipzig
K. Kranzer

¹³Forschungszentrum Borstel, Diagnostische Mykobakteriologie, Borstel
F. Kunitz

¹⁵Bezirksamt Lichtenberg von Berlin, Gesundheitsamt, Zentrum für tuberkulosekranke und -gefährdete Menschen, Berlin
E. Maritz

¹⁶Kinderarztpraxis Freiburg, Freiburg
A. Pizzulli

¹⁷Schwerpunktpraxis für Allergologie und Lungenheilkunde im Kindes- und Jugendalter, Berlin
N. Ritz

¹⁸Universitäts-Kinderspital beider Basel, Abt. für Infektiologie, Vakzinologie und pädiatrische Pharmakologie, Basel, Schweiz
R. Schlags

¹⁹Lungenzentrum Süd-West, Klinik für pädiatrische Pneumologie und Allergologie, Fachkliniken Wangen, Waldburg-Zeil Kliniken, Wangen
T. Spindler

¹⁹Lungenzentrum Süd-West, Klinik für pädiatrische Pneumologie und Allergologie, Fachkliniken Wangen, Waldburg-Zeil Kliniken, Wangen
S. Thee

¹Charité – Universitätsmedizin Berlin, Klinik für Pädiatrie m. S. Pneumologie und Immunologie, Berlin
K. Weizsäcker

²⁰Charité – Universitätsmedizin Berlin, Klinik für Geburtsmedizin, Berlin

Abstract

Zusammenfassung

Aktuelle epidemiologische Daten zeigen in den letzten Jahren einen Anstieg der Tuberkulose im Kindes- und Jugendalter. Es findet sich zudem auch in Deutschland ein Anstieg von Infektionen mit gegenüber Tuberkulosemedikamenten resistenten Erregern. In diesem Zusammenhang stellt die Diagnose, Prävention und Therapie der Tuberkulose vor allem im Kindesalter eine Herausforderung dar.

Leitlinien für die Diagnostik und Therapie der Tuberkulose im Erwachsenenalter können nicht generell auf das Kindesalter übertragen werden, da hier relevante altersabhängige Unterschiede bzgl. der Krankheitsprogression, Krankheitsmanifestation, Unterschiede in der Anwendung von diagnostischen Maßnahmen und der Therapie bestehen.

Unter Federführung der Deutschen Gesellschaft für Pädiatrische Infektiologie (DGPI) e. V. wurde die S2k-Leitlinie für die Diagnostik, Prävention und Therapie der Tuberkulose im Kindes- und Jugendalter verfasst, um die adäquate Versorgung von Kindern und Jugendlichen mit Tuberkulose-Exposition, Infektion oder Erkrankung nach neuesten wissenschaftlichen Erkenntnissen zu sichern.

Aktualisierte Dosierungsempfehlungen berücksichtigen die altersabhängige Pharmakokinetik in der Therapie der medikamentensensiblen, aber auch resistenten Tuberkulose. Darüber hinaus werden die Themen perinatale Exposition und Erkrankung sowie die im Kindesalter häufigeren extrapulmonalen Manifestationsformen gesondert behandelt.

Abstract

Recently, epidemiological data shows an increase of childhood tuberculosis in Germany. In addition to this, drug resistant tuberculosis becomes more frequent. Therefore, diagnosis, prevention and therapy in childhood and adolescence remain a challenge. Adult guidelines do not work for children, as there are age specific differences in manifestation, risk of progression and diagnostic as well as therapeutic pathways.

The German Society for Pediatric Infectious Diseases (DGPI) has initiated a consensus-based (S2k) process and completed a paediatric guideline in order to improve and standardize care for children and adolescents with tuberculosis exposure, infection or disease.

Updated dosage recommendations take age dependant pharmacokinetics in the treatment of drug sensitive but also drug resistant tuberculosis in account. In addition to this, there is a detailed chapter on perinatal exposure and disease as well as extrapulmonary manifestations.

Volltext

Referenzen

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S2k-Leitlinie zur Diagnostik, Prävention und Therapie der Tuberkulose im Kindes- und Jugendalter[*]

Autor*innen

Autor*innen

S2k-Leitlinie zur Diagnostik, Prävention und Therapie der Tuberkulose im Kindes- und Jugendalter^[*]