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Dtsch Med Wochenschr 2015; 140(01): 42-45
DOI: 10.1055/s-0040-100428
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© Georg Thieme Verlag KG Stuttgart · New York

Vancomycin-resistente Enterokokken: Welche Therapieoptionen gibt es?

Treatment options for serious infections caused by vancomycin-resistant enterococci
Nico T. Mutters
1   Deutsches Zentrum für Infektionsforschung (DZIF) Heidelberg, Universitätsklinikum Heidelberg
2   Department für Infektiologie, Medizinische Mikrobiologie und Hygiene, Universitätsklinikum Heidelberg
,
Guido Werner
3   Fachgebiet Nosokomiale Infektionserreger und Antibiotikaresistenzen, Nationales Referenzzentrum für Staphylokokken und Enterokokken, Abt. Infektionskrankheiten, Robert Koch-Institut, Bereich Wernigerode
,
Evelina Tacconelli
4   Deutsches Zentrum für Infektionsforschung (DZIF) Tübingen, Translational Unit for Healthcare-associated Infections, Universitätsklinikum Tübingen
5   Infektiologie, Abteilung Innere Medizin I, Universitätsklinikum Tübingen
,
Alexander Mischnik
1   Deutsches Zentrum für Infektionsforschung (DZIF) Heidelberg, Universitätsklinikum Heidelberg
2   Department für Infektiologie, Medizinische Mikrobiologie und Hygiene, Universitätsklinikum Heidelberg
› Author Affiliations
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Publication History

Publication Date:
12 January 2015 (online)

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Zusammenfassung

Komplizierte Infektionen durch Vancomycin-resistente Enterokokken (VRE) sind ein großes therapeutischs Problem. Zur Therapie kommen da nur wenige Reservesubstanzen in Frage. Resistenzen gegenüber den Reserveantibiotika wurden allerdings mittlerweile auch beschrieben. Von den zugelassenen Substanzen ist Linezolid das am häufigsten eingesetzte Antibiotikum. Für die Therapiealternative Tigecyclin liegen insbesondere bei lebensbedrohlichen Verläufen wie Sepsis oder Endokarditis wenige klinische Daten vor. Daptomycin ist eine Alternative, die jedoch für Enterokokken-Infektionen in Deutschland nicht zugelassen ist. In der vorliegenden Arbeit wird der Stellenwert der verschiedenen Therapieoptionen im klinischen Alltag auf Basis vorhandener Daten kritisch dargestellt.

Abstract

Complicated infections caused by vancomycin-resistant enterococci (VRE) represent a therapeutic challenge, since adequate treatment options are limited and antibiotic resistance to the available agents has already been described. The most frequently used antibiotic in VRE treatment is linezolid. Tigecycline is an alternative to linezolid, however, clinical data for severe infections such as sepsis or endocarditis are scarce. Daptomycin on the one hand is an option but has not yet been approved for the treatment of enterococcal infections in Germany on the other hand. The present review critically evaluates the clinical significance of the antibiotics in question for VRE therapy based on existing data.

Schlüsselwörter

VRE - Daptomycin - Tigecyclin - Linezolid

Key Words

daptomycin - tigecycline - linezolid
 

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