title: [Diagnosis, prevention and treatment of infections of bacterial, fungal and viral origin in immunocompromised patients].
abstract: Infections in immunocompromised patients are mostly caused by potentially pathogenic bacteria, yeasts, fungi and viruses. The predominant agents of bacterial infections are Enterobacteriaceae, Pseudomonas aeruginosa and staphylococci. Several randomized studies have shown that the incidence of infections caused by these bacteria can significantly be reduced by means of antimicrobial decontamination. In case of suspected or proven bacterial infections immediate empirical antibiotic therapy is mandatory. For this therapy a two drug combination of bactericidal broadspectrum antibiotics is recommended, generally a combination of an aminoglycoside and a betalactam antibiotic. The causative agents of fungal infections are mostly species of Candida and Aspergillus, less frequently zygomycetes and Cryptococcus neoformans. For the prophylaxis of fungal infections nystatin, amphotericin B and ketoconazole have been applied. The efficiency of these methods is still controversial. The drug of choice for the treatment of fungal infections is amphotericin B which can be combined with 5- fluorocytosin in case of infections with Candida, Aspergillus and Cryptococcus. Infections with herpes viruses mostly occur in patients with an impaired cellular immunity. As antiviral prophylaxis with CMV-hyperimmune serum and acyclovir for HSV- and VZV-infections should be considered in transplantation of bone marrow and other organs. Acyclovir is also very active in the treatment of manifest infections with HSV and VZV.
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy* / Q000276:immunology; D004359:Drug Therapy, Combination; D006801:Humans; D007121:Immunocompetence; D007165:Immunosuppression Therapy; D009181:Mycoses / Q000188:drug therapy* / Q000276:immunology; D009369:Neoplasms / Q000276:immunology*; D014777:Virus Diseases / Q000188:drug therapy* / Q000276:immunology
chemical_list: D000900:Anti-Bacterial Agents
vernacular_title: Diagnostik, Prävention und Behandlung von Infekten bakterieller, mykotischer und viraler Genese bei abwehrgeschwächten Patienten.