Antibiotics课件.pptVIP

Antibiotics 新光醫院感染科 黃建賢 Questions before routinely usage of antibiotics Is an antibiotic indicated (viral infection, fungal infection, local infection Have appropriated specimens obtained (Gram stain, acid fast stain, culture) What infection is likely; What organism is likely Hand book of antibiotics. Richard. ER Questions before routinely usage of antibiotics Antibiotics; What is best; drug of choice, pharmacokinetics, toxicology, cost, narrow spectrum, bactericidal or bacteriostatic Combination therapy (synergy, competition) Host factors (steroid, diabetes, HIV, uremia, liver cirrhosis) The best route of administration (oral, IV, IM, local) Questions before routinely usage of antibiotics Appropriate dose (elder, renal failure, liver cirrhosis, low body weight) Modification after culture data returned (pneumonia: pneumococcus, Staphylococcus, Klebsiella, Hemophilus) The optimal duration of treatment (urinary tract infection, pyelonephritis, renal abscess) Resistance of drug (vancomycin; linezolid) GPC GPC GPB GNB GNB Antibiotics Beta-lactam Penicillin Cephalosporin Monobactam Carbapenem Cephamycin Aminoglycosides Tetracyclines Fluoroquinolones Lincosamines Macrolides Glycopeptides Nitroimidazoles Azoles Polyenes Beta-lactam Monobactam Aztreonam Carbapenem Imipenem Meropenem Cephamycin Cefmetazole Flomoxef Beta-lactamase-inhibitor Clavunic acid Augmentin Timentin Sulbactam Unasyn Tazobactam Tazocin Other antibiotics Aminoglycosides Gentamicin Tobramycin Isepamicin Amikacin Tetracyclines Tetracycline Minocycline Doxycycline Fluoroquinolones Ofloxacin Levofloxacin Norfloxacin Ciprofloxacin Lomefloxacin Lincosamine Clindamycin Other antibiotics Macrolides Erythromycin Clarithromycin Azithromycin Glycopeptides Vancomycin Teicoplanin Nitroimidazole Metronidazole Azoles Ketoconazole Fluconazole Itraconazole Polyenes Amphotericin B Nystatin Other antibiotics Chloramphenicol Chloramphenicol Gyrase inhibitors Nalidic acid, Quinolones Sulfonamides Trimethoprim-sulfameth