门诊病人抗生素的使用(英文教学)Outpatient antibiotic use讲解说明.pptVIP

Outpatient antibiotic use;Case 1;Acute sinusitis;;Assess the probability of bacterial sinusitis and treat if high and symptoms severe. Otherwise, defer antibiotic Rx.;Red flags…consider early/immediate antibiotics;Sinusitis – AB duration;Case 2;Acute bronchitis;;Case 3;Community-acquired pneumonia;PCP vs. Bacterial;PCP vs. Bacterial;CAP;Site of care decisions;PSI Scoring;CURB – 65 Score;;;;Consider ruling out TB all patients that you treat for bacterial pneumonia with quinolone monotherapy;Case 4;Acute exacerbations of chronic bronchitis;Antibiotic options: Amoxicillin Doxycycline Bactrim Macrolides (azithromycin, clarithromycin) Levofloxacin ;;Case 5;Acute Pharyngitis;;Note: If you suspect GC from history, obtain swab for GC culture (ideally from urinary tract, rectum and tonsils) and consider NAAT. Rx is different, and it also has epidemiologic implications. ;What to do if rapid strep and cultures are not available? - ;;CASE 6A 42 yo HIV + man presents with fever, chills, and 2 lesions over the back of his neck. Gram stain of pus from 1 of the lesions is shown below. What is the likely pathogen and what are reasonable options to for empiric therapy?;Skin and soft-tissue infections;http://health.state.ga.us/pdfs/epi/notifiable/CA-MRSA%20rev.pdf;;;;;Case 7;Urinary tract infection;;1999 – IDSA Guidelines;Case 8;Pelvic inflammatory disease and STIs;;;;Conclusions;Conclusions;Conclusions;