抗生素PPT课件（英文精品）Update on use of antibiotics in GP（66p）.pptVIP

Update on use of antibiotics in GP Dr Lau Pui Lam Introduction empirical therapy and the choices of antibiotics may vary a great deal even for the same provisional diagnosis. On some occasions, inadequate dose and duration were prescribed antimicrobial guideline is an essential tool to promote rational use of antimicrobial agents with better application of existing knowledge and adherence to good practice IMPACT was developed in 1999 towards better control of the growing problem of antimicrobial resistance in Hong Kong a DH working group was formed in March 2001 to work out clinical guidelines on the use of antimicrobials for common infections in primary health care setting of the DH Today’s Menu CAP UTI ENT Gynaecological Respiratory tract infection URTI Acute inflammation of nasal or pharyngeal mucosa in the absence of other specifically defined respiratory infections such as sinusitis (ICPC) cough, sore throat, acute nasal congestion, rhinorrhea and sputum Particular attention to high-risk pt such as young children, frail elderly, immuno-compromised, and pt w/ chronic illness “Doc, I want antibiotics…” URTI most common etiology is viral in over 80-90% of patients includes rhinovirus, respiratory syncytial virus, influenza virus, parainfluenza virus and coronavirus. differentiating between bacterial and viral infections may not be possible on clinical grounds alone. Also might not be as helpful as some think primary goal to rule out serious illness URTI not enough evidence of significant benefits from the treatment of URTI with antimicrobials significant increase in adverse effects (The Cochrane Library, Issue 1, 2001). In view of the lack of efficacy and low complication rates, antimicrobials treatment of children with URTI is not supported by current evidence from randomised trials emphasizing positive aspects of non-antimicrobial treatment Community Acquired Pneumonia Management in children Aetiology and Epidemiology What is most common bacter