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1、头颈外科的抗生素应用（英文PPT）AntibioticsinHeadandNeckSurgeryIntroductionClassificationofwoundsCommonlyusedantibioticsIndicationsforperioperativeantibioticsinheadandnecksurgeryWoundInfectionsLargestgroupofpostooperativeinfectiouscomplicationsofsurgerySecondmostfrequenttypeofnocosomialinfe
2、ctionClassificationofWoundsCleanCleancontaminatedContaminatedDirtyCleanwoundsAssociatedwithanelectivecaseNobreakinaseptictechniqueNoassociatedinflammationInfectionrateof1%to5%CleanContaminatedWoundsOropharyngeal,respiratory,alimentaryorGUtractisenteredundercontrolledcondition
3、sMostheadandnecksurgeriesfallunderthiscategoryInfectionrateis8%to11%ingeneral,althoughmajorheadandneckcaseshavearateof28-87%.ContaminatedWoundsResultafter:SpillagefromtheGItractMajorbreakinsteriletechniqueWithacutenonpurulentinflammationIncludesfreshtraumaticwoundsInfectionra
4、teof15%-17%DirtyWoundsOrganismscausingpost-operativeinfectionarepresentpriortooperationWoundsassociatedwitholdtrauma,anabscess,oraperforatedviscus.Infectionrategreaterthan27%TimingAntibioticsaremosteffectivewhengivenbeforebacteriaentersthebloodstreamortissue.Studieshaveshowna
5、ntibioticshavelesseffectifgivenafter3hoursfrominnoculation.RouteParenteraladministrationisthetraditionalrouteIMinjectionsachievethehighestsustainedlevel.ItisrecommendedincontaminatedcasestoadministerIVandIMloadingdosesfollowedbyacontinuousIVorintermittentIMinjections.Commonly
6、UsedAntibioticsPenicillinsActbycausingabnormalcellwalldevelopmentinactivelydividingbacterialcells.Groupsareasfollows:Naturalpenicillins,penicillinaseresistantpenicillins,aminopenicillins,antipsuedomonalpenicillins,andextendedspectrumpenicillins.NaturalPenicillinsDrugofchoicef
7、orSt.pyogensandSt.pneumoniae,andClostridiaperfringens30%ofisolatesofSt.pneumoniaearepenicillinresistant.OralforminPenV,IMformisPenGSyntheticPenicillinsIncludenafcillin,oxacillin,andmethicillin,cloxacillinanddicloxacillin.UsedwhenS.aureusissuspectedasthesedrugsareresistanttoB-
8、lactamaseSideeffectsincludeinterstitialnephritis,leukopenia,andrever
