Antibakterielle Prophylaxe in der Pädiatrischen
                Hämatologie und Onkologie

Thomas Lehrnbecher; Arne Simon; Hans-Jürgen Laws; Philipp KA Agyeman; Roland A. Ammann; Andishe Attarbaschi; Christoph Berger; Konrad Bochennek; Jennifer Neubert; Fiona Poyer; Max Scheler; Volker Strenger; Simon Vieth; Stefan Zoellner; Andreas H. Groll

doi:10.1055/a-1443-6576

Klin Padiatr 2021; 233(03): 101-106
DOI: 10.1055/a-1443-6576

Übersicht

Antibakterielle Prophylaxe in der Pädiatrischen Hämatologie und Onkologie

Stellungnahme der Gesellschaft für Pädiatrische Onkologie und Hämatologie (GPOH) und der Deutschen Gesellschaft für Pädiatrische Infektiologie (DGPI) zu zwei aktuellen internationalen LeitlinienAntibacterial Prophylaxis in Children and Adolescents Undergoing Therapy for CancerStatement of the Society of Pediatric Oncology and Hematology (GPOH) and of the German Society for Pediatric Infectious Diseases (DGPI) on Two Current International Guidelines

Thomas Lehrnbecher

¹Division of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, Johann Wolfgang Goethe-University, Frankfurt, Germany

,

Arne Simon

²Pediatric Hematology and Oncology, Children’s Hospital Medical Center, University Hospital of Saarland, Homburg, Germany

,

Hans-Jürgen Laws

³Department of Pediatric Oncology, Medical Faculty, Hematology and Clinical Immunology, Centre for Child and Adolescent Health, University of Duesseldorf, Germany

,

Philipp KA Agyeman

⁴Department of Pediatrics, Inselspital, Bern University Hospital, Bern, Switzerland

,

Roland A. Ammann

⁴Department of Pediatrics, Inselspital, Bern University Hospital, Bern, Switzerland

,

Andishe Attarbaschi

⁵Department of Pediatrics and Adolescent Medicine, St. Anna Children’s Hospital, Medical University of Vienna, Pediatric Hematology and Oncology, Vienna, Austria

,

Christoph Berger

⁶Division of Infectious Diseases and Hospital Epidemiology, University Children’s Hospital, Zürich, Switzerland

,

Konrad Bochennek

¹Division of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, Johann Wolfgang Goethe-University, Frankfurt, Germany

,

Jennifer Neubert

³Department of Pediatric Oncology, Medical Faculty, Hematology and Clinical Immunology, Centre for Child and Adolescent Health, University of Duesseldorf, Germany

,

Fiona Poyer

⁵Department of Pediatrics and Adolescent Medicine, St. Anna Children’s Hospital, Medical University of Vienna, Pediatric Hematology and Oncology, Vienna, Austria

,

Max Scheler

⁷Siegburg

,

Volker Strenger

⁸Hospital for Children and Adolescents, Medical University of Graz, Graz, Auistria

,

Simon Vieth

⁹Department of Paediatrics, Pediatric Hematology and Oncology, Christian Albrechts University Kiel, Kiel, Germany

,

Stefan Zoellner

¹⁰Department of Paediatric Haematology and Oncology, University Hospital Essen, Essen, Germany

,

Andreas H. Groll

¹¹Infectious Disease Research Program, Center for Bone Marrow Transplantation, Department of Pediatric Hematology/Oncology, University Children’s Hospital, Muenster, Muenster, Germany

› Institutsangaben

Abstract

Zusammenfassung

Kinder und Jugendliche, die durch eine Krebserkrankung und ihre Therapie immunsupprimiert sind, haben ein hohes Risiko für potentiell lebensbedrohliche Infektionen wie Bakteriämien durch Gram-positive und Gram-negative Erreger. Aus diesem Grunde verabreichen einige Zentren diesen Patienten eine antibakterielle Prophylaxe. Kürzlich wurden 2 Leitlinien zur antibakteriellen Prophylaxe bei Kindern publiziert. Eine dieser Leitlinien wurde durch eine internationale Expertengruppe aus Europa, Nord- und Südamerika sowie Australien erstellt. Die andere Leitlinie wurde durch eine rein europäische Gruppe im Rahmen der achten European Conference on Infections in Leukaemia (ECIL-8) verfasst. In der vorliegenden Übersichtsarbeit stellen die Arbeitsgruppen „Infektionen“ der Gesellschaft für Pädiatrische Onkologie und Hämatologie (GPOH) und „Fieber bei Neutropenie“ der Deutschen Gesellschaft für Pädiatrische Infektiologie (DGPI) die wichtigsten Daten von randomisierten Studien, systematischen Reviews und Meta-Analysen zur antibiotischen Prophylaxe als auch von Untersuchungen zur Resistenzentwicklung vor und diskutieren methodologische Aspekte und jeweiligen Empfehlungen der beiden Leitlinien.

Abstract

Immunocompromised children and adolescents receiving treatment for cancer have an increased risk for potentially life-threatening infectious complications such as blood stream infections with Gram-positive and Gram-negative pathogens. Therefore, several centers for Pediatric Hematology and Oncology administer antibacterial prophylaxis to these patients to lower morbidity and mortality. Two pediatric specific guidelines on antibacterial prophylaxis were recently published. One of these guidelines was drawn up by an international group of pediatric experts of Europe, North and South America and Australia. The other guideline was prepared by an European group convened at the Eighth European Conference on Infections in Leukaemia (ECIL-8). In this review article, the working groups “Infections” of the Society of Pediatric Oncology and Hematology (GPOH) and “Fever in the neutropenic host” of the German Society for Pediatric Infectious Diseases” (DGPI) summarize the available data from randomized studies, systematic reviews and meta-analyses on antibacterial prophylaxis as well of current data on the emergence of resistance and discuss methodological aspects and the recommendations of the two guidelines.

Schlüsselwörter

Kind - Krebserkrankung - Bakteriämie - antibakterielle Prophylaxe - Leitlinie

Key words

Child - cancer - bacteremia - antibacterial prophylaxis - guideline

Volltext

Referenzen

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