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1、預防性抗生素& 合理使用抗生素賴定國門診抗生素使用情形合理有需要才用抗生素使用抗生素時,病例上應說明用藥的理由及預期效果一般明顯急性感冒不可使用抗生素抗生素使用期間合理如有異常時應於病歷上說明抗生素使用種類合理抗生素使用劑量合理並有考慮病人體重及腎臟機能PathogenAntibioticsoffirstchoiceStaphylococcusaureusorS.epidermidisNon-penicillinaseproducingPenicillinaseproducingMethicillin
2、-resistantStreptococciGroupA,C,GGroupBEnterococcusPenicillinOxacillinorNafcillinVancomycinPenicillinPenicillinPenicillin(orampicillin)AntibioticsofchoiceforcommonpathogenPathogenAntibioticsoffirstchoiceNeiseriagonorhoeaeNeiseriameningitidesMoraxellaList
3、eriamonocytogenesBacteroidesspp.B.fragilisstrainEnterobactersppE.coliCeftriaxoneorcefiximeorciprofloxacinPenicillinGTMP-SMXAmipcillinwithorwithoutgentamycinPenicillinGorclindamycinMetronidazoleImipenemormeropenemTMP-SMXorciprofloxacinAntibioticsofchoice
4、forcommonpathogenDiagnosisDurationofTherapyMeningococcalmeningitisPneumoncoccalmeningitisH.InfluenzaetypeBmeningitisStreptococcalgroupApharyngitisOtitismediaBacterialsinusistisPneumococcalpneumoniaGram-negativepneumoniaMycoplasmapneumoniaLegionellapneum
5、oniaEndocarditisViridansstreptococciStaphylococcalPeritonitisEpticarthritisosteomyelitis7-1010-1410-14107-1010-14?optimal?2114212828-4210-1414-2128-42預估肌干酸濾清率Ccr(140-age)xweight/72xserumcreatinine女性:85%理想體重:男性:50kg+2.3kg/inchover5feet女性:45.5kg+2.3kg/inc
6、hover5feet肥胖病人使用理想體重評估CcrClassicStreptocccalPharyngitisViralPharyngitisSeasonAgeSymptomsSignLaterwinterorearlyspring5-11yrSuddenonsetSorethroat,maybesevereHeadacheAbdominalpain,nausea,VomitingPharyngealerythemaandexudatesTender,enlargedantcervicalnodesP
7、alatalpetechiaeTonsillarhypertrophyScarletfeverrashAbsenceofcough,rhinitis,Hoarseness,conjunctivitis,anddiarrheaAllseasonsAllagesOnsetvariesSorethroat,oftenmildFevervariesMyalgia,arthralgiaAbdpainCharacteristicenanthemsOftenhavecough,rhinitis,hoarseness
8、,conjunctivitis,ordiarrheaDifferentiatingfeaturesofpharyngitiscausedbygroupAstreptococciandvirusesClinicalPracticeGuidelinesCompendiumIllness/pathogenIndicationforantibiotictreatmentTreatmentAntibioticAcutebacterialsinusitisStrep
