(精选)头颈外科的抗生素应用(英文课件)Antibiotics in Head and Neck Surgery教学课件.ppt

Indications for Antimicrobial Treatment Otologic Surgery Postoperative use of ototopical antimicrobial drops reduces the incidence of otorrhea after tympanostomy tube insertion Studies show a reduction from 16.4% to 8% when Cortisporin drops are used from 1 to 5 days postop Antibiotics in Head and Neck Surgery Department of Otolaryngology UTMB Resident Physician:Karen L. Stierman, M.D. Faculty Physician: Ronald W. Deskin, M.D. Introduction Classification of wounds Commonly used antibiotics Indications for perioperative antibiotics in head and neck surgery Wound Infections Largest group of postooperative infectious complications of surgery Second most frequent type of nocosomial infection Considerations for the use of antibiotic therapy Risk of developing wound infection classification of wound host and local factors Cost of therapy 1992 cost of treating a wound infection $36,000 Side effects and development of resistance Resistance to Antibiotic Therapy Virtually all bacterial pathogens have the ability to acquire resistance to antibiotic therapy This problem is more common in nocosomial pathogens such as VRE and MRSA More recently, community acquired pathogens have developed resistant strains Resistant Strept. Pnuemoniae Resistance to penicillin is found in 30 to 70% of isolates depending on the hospital Some strains are also found to be resistant to one of the following: cephalosporins, Bactrim, chloramphenicol,or a macrolide Children are more likely than adults to be infected with strains resistant to chloramphenicol, erythromycin or Bactrim Classification of Wounds Clean Clean contaminated Contaminated Dirty Clean wounds Associated with an elective case No break in aseptic technique No associated inflammation Infection rate of 1% to 5% Timing Antibiotics are most effective when given before bacteria enters the blood stream or tissue. Studies have shown antibiotics have less effect if given after 3 hours from innoculation. Route Parenteral administration i