门诊病人抗生素应用(英文教学)Antibiotics in Outpatients总结概括.ppt

Antibiotics in Outpatient Practice  N. Buttar MD;Antibiotics in Outpatients;β-Lactam antibiotics;Resistance to β-lactam antibiotics;Natural Penicillin;Penicillinase Resistant Penicillin;Amino-Penicillin;Amino-Penicillin; Amino-Penicillin Amoxicillin is more completely absorbed than Ampicillin. Serum levels are twice as high. Small amount is left in GI tract, so less diarrhea. However, more complete absorption makes it less effective for Shigella enteritis. Both have same antibacterial spectrum. Bacampicillin is more expensive and no advantage.; Amino-Penicillin Primarily used for: Otitis media Sinusitis Bronchitis Urinary tract infection esp. Enterococcus Bacterial diarrhea Salmonella infection Shigella infection. H. Influenzae and E. Coli are increasingly becoming resistant. ;β-lactam, β-lactamase inhibitors; β-lactam, β-lactamase inhibitors Excellent drug for treating infection due to human and animal bites. May be first choice for β-lactamase producing organisms: - Otitis media - Sinusitis - Bronchitis - UTI - Skin and soft tissue infections ;β-lactam, β-lactamase inhibitors;Anti-Pseudomonal Penicillin;Cephalosporins;First Generation; First Generation Coverage Streptococcus Methicillin sensitive Staphylococcus aureus E. Coli Klebsiella Proteus mirabilis Effective in Tx of skin and soft tissue infection Preferred to anti-staph Penicillin (Cloxacillin) due to less GI side effects and better taste. 2nd line agents for UTI (after Sulfa and Quinolones) Not effective agent against Pseudomonas and Enterococcus. Safe in pregnancy. ; Not effective against H. Influenzae M. catarrhalis Other gram negative β-lactamase organisms Role of these agents for bronchitis, otitis media, sinusitis and pneumonia is not clear. ;Second Generation ; Second Generation They have improved activity against