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Dialyse aktuell 2018; 22(09): 411-414
DOI: 10.1055/a-0656-7107
Schwerpunkt | Dialyse
© Georg Thieme Verlag KG Stuttgart · New York

Update: Infektiöse Komplikationen der Peritonealdialyse

Was ist bei Antibiotikatherapie zu beachten?
Daniel Kitterer
Klinik für Nieren-, Hochdruck- und Autoimmunerkrankungen, Klinikum Stuttgart
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Publication History

Publication Date:
23 November 2018 (online)

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Zusammenfassung

Infektiöse Komplikationen stellen weiterhin eine wichtige Komplikation der Peritonealdialyse (PD) dar. Durch technische Entwicklungen der letzten Jahrzehnte sind heutzutage Peritonitisraten möglich, die unter 0,5 Ereignissen pro Jahr (kleiner als 1 Ereignis pro 24 Monate) liegen. Die Vermeidung von Exit-site-Infektionen und die perioperative Single-Shot-Antibiotikagabe stellen weitere Möglichkeiten dar, um Peritonitiden bei PD-Patienten zu vermeiden. Bei der Antibiotikaauswahl müssen lokale Resistenzen sowie koagulasenegative Staphylokokken mit Methicillin-/Oxacillinresistenz beachtet werden. Gramnegative Keime mit Resistenzen gegen Cephalosporine stellen weiterhin erfreulicherweise eine Ausnahme dar. Sollten solche Keime zu einer Peritonitis führen, kommen Carbapeneme intraperitoneal als Alternative in Frage.

 

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