{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:33:43Z","timestamp":1740126823984,"version":"3.37.3"},"reference-count":85,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Padiatr"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Die Kombination von Vancomycin und Piperacillin\/Tazobactam (V+P\/T) kommt in der\n                    empirischen Therapie von schweren Infektionen zum Einsatz, insbesondere, wenn\n                    patientenseitige Risikofaktoren wie Immunsuppression oder Kolonisation mit\n                    multiresistenten Erregern vorliegen. Die Nephrotoxizit\u00e4t von Vancomycin ist\n                    bekannt, das Risiko der Nephrotoxizit\u00e4t wird durch adaptierte Dosierungen sowie\n                    therapeutisches Drug-Monitoring vermindert. Piperacillin\/Tazobactam (P\/T) kann\n                    sehr selten eine interstitielle Nephritis ausl\u00f6sen. Die Resultate retrospektiver\n                    Kohortenstudien bei Kindern zeigen \u00fcberwiegend eine geringe, klinisch wenig\n                    relevante, additive Nephrotoxizit\u00e4t (definiert als Kreatinin-Anstieg im Serum)\n                    beider Substanzen. Pr\u00e4klinische Studien und eine prospektive Studie mit\n                    erwachsenen Patienten, die weitere Nierenretentionsparameter sowie das klinische\n                    Outcome untersuchten, zeigten keinen Zusammenhang zwischen einer Therapie mit\n                    V+P\/T und akuter Nierenfunktionseinschr\u00e4nkung. Aufgrund der Limitationen der\n                    vorhandenen Publikationen sprechen sich die Arbeitsgruppe ABS der DGPI und die\n                    Experten der GPN nicht gegen den Einsatz von P\/T plus Vancomycin aus. Dennoch\n                    sollte durch den zeitlich restriktiven Einsatz der Kombination V+P\/T die\n                    Exposition gegen\u00fcber V+P\/T und ein m\u00f6gliches Nephrotoxizit\u00e4tsrisiko minimiert\n                    werden. Auch die alternativ infrage kommenden Substanzen sind dabei sowohl im\n                    Hinblick auf ihr antimikrobielles Spektrum, auf m\u00f6gliche Nebenwirkungen sowie\n                    auf den durch sie ausge\u00fcbten Selektionsdruck kritisch zu hinterfragen.\n                    Indikationen f\u00fcr den empirischen sowie gezielten Einsatz von P\/T und V+P\/T\n                    sollten in Zusammenarbeit mit dem lokalen ABS-Team in hausinternen Leitlinien\n                    festgelegt werden. Wird die Kombinationstherapie V+P\/T verwendet, sollte eine\n                    \u00fcber das Serum-Kreatinin hinausgehende sowohl laborchemische (BGA, Cystatin C)\n                    als auch klinische \u00dcberwachung (Bilanzierung, Blutdruck) der Nierenfunktion\n                    erfolgen.<\/jats:p>","DOI":"10.1055\/a-2244-7698","type":"journal-article","created":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T23:45:00Z","timestamp":1709941500000},"page":"280-288","source":"Crossref","is-referenced-by-count":0,"title":["Potentielle Nephrotoxizit\u00e4t der Kombinationstherapie von Vancomycin\n                    und Piperacillin-Tazobactam: Empfehlungen der AG ABS der DGPI unter Beteiligung\n                    von Experten der GPN"],"prefix":"10.1055","volume":"236","author":[{"given":"Luise","family":"Martin","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr P\u00e4diatrie m.S. Pneumologie, Immunologie und Intensivmedizin,\n                    Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of Freie Universit\u00e4t\n                    Berlin, Humboldt- Universit\u00e4t zu Berlin, and Berlin Institute of Health, Berlin,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alenka","family":"Pecar","sequence":"additional","affiliation":[{"name":"Kinderklinik und Kinderpoliklinik im Dr. von Haunerschen Kinderspital,\n                    Klinikum der Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeliz","family":"Baltaci","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr P\u00e4diatrische Onkologie und H\u00e4matologie, Universit\u00e4tsklinikum\n                    des Saarlandes und Medizinische Fakult\u00e4t der Universit\u00e4t des Saarlandes,\n                    Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9558-3330","authenticated-orcid":false,"given":"Arne","family":"Simon","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr P\u00e4diatrische Onkologie und H\u00e4matologie, Universit\u00e4tsklinikum\n                    des Saarlandes und Medizinische Fakult\u00e4t der Universit\u00e4t des Saarlandes,\n                    Homburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Kohl","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Kinder- und Jugendmedizin, Abteilung f\u00fcr\n                    Kindernephrologie, Uniklinik K\u00f6ln, K\u00f6ln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominik","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr P\u00e4diatrie m. S. Gastroenterologie, Nephrologie und\n                    Stoffwechselmedizin, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin, corporate member of\n                    Freie Universit\u00e4t Berlin, Humboldt- Universit\u00e4t zu Berlin, and Berlin Institute\n                    of Health, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes","family":"Forster","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Hygiene und Mikrobiologie, Julius-Maximilians-Universit\u00e4t\n                    W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,3,8]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1111\/ped.13463","article-title":"Pediatric acute kidney injury induced by concomitant vancomycin and\n                    piperacillin\u2013tazobactam","volume":"60","author":"M 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