Pneumologie 2021; 75(09): 665-729
DOI: 10.1055/a-1497-0693
Leitlinie

Behandlung von erwachsenen Patienten mit ambulant erworbener Pneumonie – Update 2021[*]

S3-Leitlinie der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin (DGP), der Paul-Ehrlich-Gesellschaft für Chemotherapie (PEG), der Deutschen Gesellschaft für Infektiologie (DGI), der Deutschen Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN), der Gesellschaft für Virologie (GfV), des Kompetenznetzwerks CAPNETZ, der Deutschen Gesellschaft für Allgemeinmedizin (DEGAM), der Deutschen Gesellschaft für Geriatrie (DGG), der Deutschen Gesellschaft für Palliativmedizin (DGP), der Österreichischen Gesellschaft für Pneumologie (ÖGP), der Österreichischen Gesellschaft für Infektionskrankheiten und Tropenmedizin (ÖGIT), der Schweizerischen Gesellschaft für Pneumologie (SGP) und der Schweizerischen Gesellschaft für Infektiologie (SGInf)Management of Adult Community-Acquired Pneumonia and Prevention – Update 2021Guideline of the German Respiratory Society (DGP), the Paul-Ehrlich-Society for Chemotherapy (PEG), the German Society for Infectious Diseases (DGI), the German Society of Medical Intensive Care and Emergency Medicine (DGIIN), the German Viological Society (DGV), the Competence Network CAPNETZ, the German College of General Practitioneers and Family Physicians (DEGAM), the German Society for Geriatric Medicine (DGG), the German Palliative Society (DGP), the Austrian Society of Pneumology Society (ÖGP), the Austrian Society for Infectious and Tropical Diseases (ÖGIT), the Swiss Respiratory Society (SGP) and the Swiss Society for Infectious Diseases Society (SSI)
S. Ewig
 1   Thoraxzentrum Ruhrgebiet, Kliniken für Pneumologie und Infektiologie, EVK Herne und Augusta-Kranken-Anstalt Bochum
,
M. Kolditz
 2   Universitätsklinikum Carl-Gustav Carus, Klinik für Innere Medizin 1, Bereich Pneumologie, Dresden
,
M. Pletz
 3   Universitätsklinikum Jena, Institut für Infektionsmedizin und Krankenhaushygiene, Jena
,
A. Altiner
 4   Universitätsmedizin Rostock, Institut für Allgemeinmedizin, Rostock
,
W. Albrich
 5   Kantonsspital St. Gallen, Klinik für Infektiologie/Spitalhygiene
,
D. Drömann
 6   Universitätsklinikum Schleswig-Holstein, Medizinische Klinik III – Pulmologie, Lübeck
,
H. Flick
 7   Medizinische Universität Graz, Universitätsklinik für Innere Medizin, Klinische Abteilung für Lungenkrankheiten, Graz
,
S. Gatermann
 8   Ruhr Universität Bochum, Abteilung für Medizinische Mikrobiologie, Bochum
,
S. Krüger
 9   Kaiserswerther Diakonie, Florence Nightingale Krankenhaus, Klinik für Pneumologie, Kardiologie und internistische Intensivmedizin, Düsseldorf
,
W. Nehls
10   Helios Klinikum Erich von Behring, Klinik für Palliativmedizin und Geriatrie, Berlin
,
M. Panning
11   Universitätsklinikum Freiburg, Department für Medizinische Mikrobiologie und Hygiene, Freiburg
,
J. Rademacher
12   Medizinische Hochschule Hannover, Klinik für Pneumologie, Hannover
,
G. Rohde
13   Universitätsklinikum Frankfurt, Medizinische Klinik I, Pneumologie und Allergologie, Frankfurt/Main
,
J. Rupp
14   Universitätsklinikum Schleswig-Holstein, Klinik für Infektiologie und Mikrobiologie, Lübeck
,
B. Schaaf
15   Klinikum Dortmund, Klinik für Pneumologie, Infektiologie und internistische Intensivmedizin, Dortmund
,
H.-J. Heppner
16   Lehrstuhl Geriatrie Universität Witten/Herdecke, Helios Klinikum Schwelm, Klinik für Geriatrie, Schwelm
,
R. Krause
17   Medizinische Universität Graz, Universitätsklinik für Innere Medizin, Klinische Abteilung für Infektiologie, Graz
,
S. Ott
18   St. Claraspital Basel, Pneumologie, Basel, und Universitätsklinik für Pneumologie, Universitätsspital Bern (Inselspital) und Universität Bern
,
T. Welte
12   Medizinische Hochschule Hannover, Klinik für Pneumologie, Hannover
,
M. Witzenrath
19   Charité, Universitätsmedizin Berlin, Medizinische Klinik mit Schwerpunkt Infektiologie und Pneumologie, Berlin
› Author Affiliations

Zusammenfassung

Die vorliegende Leitlinie umfasst ein aktualisiertes Konzept der Behandlung und Prävention von erwachsenen Patienten mit ambulant erworbener Pneumonie und löst die bisherige Leitlinie aus dem Jahre 2016 ab.

Sie wurde entsprechend den Maßgaben zur Methodologie einer S3-Leitlinie erarbeitet und verabschiedet. Hierzu gehören eine systematische Literaturrecherche und -bewertung, die strukturierte Diskussion der aus der Literatur begründbaren Empfehlungen sowie eine Offenlegung und Bewertung möglicher Interessenskonflikte.

Die Leitlinie zeichnet sich aus durch eine Zentrierung auf definierte klinische Situationen, eine aktualisierte Maßgabe der Schweregradbestimmung sowie Empfehlungen zu einer individualisierten Auswahl der initialen antimikrobiellen Therapie.

Die Empfehlungen zielen gleichzeitig auf eine strukturierte Risikoevaluation als auch auf eine frühzeitige Bestimmung des Therapieziels, um einerseits bei kurativem Therapieziel die Letalität der Erkrankung zu reduzieren, andererseits bei palliativem Therapieziel eine palliative Therapie zu eröffnen.

Abstract

The present guideline provides a new and updated concept of the management of adult patients with community-acquired pneumonia. It replaces the previous guideline dating from 2016.

The guideline was worked out and agreed on following the standards of methodology of a S3-guideline. This includes a systematic literature search and grading, a structured discussion of recommendations supported by the literature as well as the declaration and assessment of potential conflicts of interests.

The guideline has a focus on specific clinical circumstances, an update on severity assessment, and includes recommendations for an individualized selection of antimicrobial treatment.

The recommendations aim at the same time at a structured assessment of risk for adverse outcome as well as an early determination of treatment goals in order to reduce mortality in patients with curative treatment goal and to provide palliation for patients with treatment restrictions.

* Verabschiedet von den Vorständen der beteiligten Fachgesellschaften am 21. 04. 2021




Publication History

Article published online:
01 July 2021

© 2021. Thieme. All rights reserved.

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