Ebook The washington manual of medical therapeutics (35th edition): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook The washington manual of medical therapeutics (35th edition): Part 2
Ebook The washington manual of medical therapeutics (35th edition): Part 2
15 AntimicrobialsDavid J. RitchieMatthew p. CrottyNigar KirmaniEmpiric antimicrobial therapy should be initiated based on expected pathogens for a giv Ebook The washington manual of medical therapeutics (35th edition): Part 2ven infection. As microbial resistance is increasing among many pathogens, a review of institutional as well as local, regional, national, and global susceptibility trends can assist in the development of empiric therapy regimens. Antimicrobial therapy should be modified, if possible, based on resul Ebook The washington manual of medical therapeutics (35th edition): Part 2ts of culture and sensitivity testing to agent(s) that have the narrowest spectrum possible. In some cases, shorter durations of therapy have been shoEbook The washington manual of medical therapeutics (35th edition): Part 2
wn to be as effective as traditionally longer courses. Attention should be paid to the possibility of switching from parenteral to oral therapy where 15 AntimicrobialsDavid J. RitchieMatthew p. CrottyNigar KirmaniEmpiric antimicrobial therapy should be initiated based on expected pathogens for a giv Ebook The washington manual of medical therapeutics (35th edition): Part 2 hepatic insufficiency, or both. For antiretroviral, antiparasitic, and antihepatitis agents, see Chapter 16, Sexually Transmitted Infections, Human Immunodeficiency Virus, and Acquired Immunodeficiency Syndrome; Chapter 14. Treatment of Infectious Diseases; and Chapter 19. Liver Diseases, respectiv Ebook The washington manual of medical therapeutics (35th edition): Part 2ely.ANTIBACTERIAL AGENTSPenicillinsGENERAL PRINCIPLES•Penicillins (PCNs) irreversibly bind PCN-binding proteins in the bacterial cell wall, causing osEbook The washington manual of medical therapeutics (35th edition): Part 2
motic rupture and death. These agents have a diminished role today because of acquired resistance in many bacterial species through alterations in PCN15 AntimicrobialsDavid J. RitchieMatthew p. CrottyNigar KirmaniEmpiric antimicrobial therapy should be initiated based on expected pathogens for a giv Ebook The washington manual of medical therapeutics (35th edition): Part 2tococci, methicillin-sensitive Staphylococcus aureus (MSSA), Listeria monocytogenes. Pasteurella multocida. and Actinomyces.TREATMENT•Aqueous PCN G (2-5 million units IV q4h or 12-30 million units daily by continuous infusion) is the IV preparation of PCN G and the drug of choice for most PCN-suscep Ebook The washington manual of medical therapeutics (35th edition): Part 2tible streptococcal infections and neurosyphilis.•Procaine PCN G is an IM repository form of PCN G that can be used as an alternative ưeatment for neuEbook The washington manual of medical therapeutics (35th edition): Part 2
rosyphilis at a dose of 2.4 million units IM daily in combination with probenecid 500 mg PO qid for IQ-14 days.•Benzathine PCN is a long-acting IM rep15 AntimicrobialsDavid J. RitchieMatthew p. CrottyNigar KirmaniEmpiric antimicrobial therapy should be initiated based on expected pathogens for a giv Ebook The washington manual of medical therapeutics (35th edition): Part 2hilis (unknown duration or >1 year [2.4 million units IM weekly for three doses]). It is occasionally given for group A streptococcal pharyngitis and prophylaxis after acute rheumatic fever.•PCN V (250-500 mg PO q6h) is an oral formulation of PCN that is typically used to treat group A streptococcal Ebook The washington manual of medical therapeutics (35th edition): Part 2 pharyngitis.•Ampicillin (1-3 g IV q4-6h) is the drug of choice for treatment of infections causeu uy ausuepuuie Enterococcus species or L monocytogenEbook The washington manual of medical therapeutics (35th edition): Part 2
es. Oral ampicillin (250-500 mg PO q6h)P.479 may be used for uncomplicated sinusitis, pharyngitis, otitis media, and urinary tract infections (UTIs). 15 AntimicrobialsDavid J. RitchieMatthew p. CrottyNigar KirmaniEmpiric antimicrobial therapy should be initiated based on expected pathogens for a giv Ebook The washington manual of medical therapeutics (35th edition): Part 2extending the spectrum to include MSSA, anaerobes, and many Enterobacteriaceae. The sulbactam component also has unique activity against some strains of Acinetobacter. The agent is effective for upper and lower respiratory tract infections; genitourinary tract infections; and abdominal, pelvic, and Ebook The washington manual of medical therapeutics (35th edition): Part 2polymicrobial soft tissue infections, including those due to human or animal bites.•Amoxicillin (250-1000 mg PO q8h, 875 mg PO q12h, or 775 mg extendeEbook The washington manual of medical therapeutics (35th edition): Part 2
d-release q24h) is an oral antibiotic similar to ampicillin that is commonly used for uncomplicated sinusitis, pharyngitis, otitis media, community-ac15 AntimicrobialsDavid J. RitchieMatthew p. CrottyNigar KirmaniEmpiric antimicrobial therapy should be initiated based on expected pathogens for a giv Ebook The washington manual of medical therapeutics (35th edition): Part 2 mg PO q12h [Augmentin XR]) is an oral antibiotic similar to ampicillin/sulbactam that combines amoxicillin with the 0-lactamase inhibitor clavulanate. It is useful for treating complicated sinusitis and otitis media and for prophylaxis of human or animal bites after appropriate local treatment.•Naf Ebook The washington manual of medical therapeutics (35th edition): Part 2cillin and oxacillin (1-2 g IV q4-6h) are penicillinase-resistant synthetic PCNs that are drugs of choice for treating MSSA infections. Dose reductionEbook The washington manual of medical therapeutics (35th edition): Part 2
should be considered in decompensated liver disease.•Dicloxacillin (250-500 mg PO q6h) is an oral antibiotic with a spectrum of activity similar to t15 AntimicrobialsDavid J. RitchieMatthew p. CrottyNigar KirmaniEmpiric antimicrobial therapy should be initiated based on expected pathogens for a giv Ebook The washington manual of medical therapeutics (35th edition): Part 2 of 4.5 g IV q6h for Pseudomonas) combines piperacillin with the p-lactamase inhibitor tazobactam. This combination is active against most Enterobacteriaceae. Pseudomonas. MSSA, ampicillin-sensitive enterococci, and anaerobes, making it useful for intra-abdominal and complicated polymicrobial soft t Ebook The washington manual of medical therapeutics (35th edition): Part 2issue infections. The addition of an aminoglycoside should be considered for treatment of serious infections caused by Pseudomonas aeruginosa or for nEbook The washington manual of medical therapeutics (35th edition): Part 2
osocomial pneumonia.SPECIAL CONSIDERATIONSAdverse events: All PCN derivatives have been rarely associated with anaphylaxis, interstitial nephritis, an15 AntimicrobialsDavid J. RitchieMatthew p. CrottyNigar KirmaniEmpiric antimicrobial therapy should be initiated based on expected pathogens for a giv Ebook The washington manual of medical therapeutics (35th edition): Part 2 function tests (LFTs) are also monitored with oxacillin/nafcillin, as these agents can cause hepatitis. All patients should be asked about PCN, cephalosporin, or carbapenem allergies. These agents should not be used in patients with a reported serious PCN allergy without prior skin testing or desen Ebook The washington manual of medical therapeutics (35th edition): Part 2sitization, or both.CephalosporinsGENERAL PRINCIPLESCephalosporins exert their bactericidal effect by interfering with cell wall synthesis by the sameEbook The washington manual of medical therapeutics (35th edition): Part 2
mechanism as PCNs.These agents are clinically useful because of their broad spectrum of activity anu IUW lUAiuuy piume. /511 cephalosporins are devoi15 AntimicrobialsDavid J. RitchieMatthew p. CrottyNigar KirmaniEmpiric antimicrobial therapy should be initiated based on expected pathogens for a giv Ebook The washington manual of medical therapeutics (35th edition): Part 2s. aureus (MRSA).P.480TREATMENT•First-generation cephalosporins have activity against staphylococci, streptococci. Escherichia coll. and many Klebsiella and Proteus species. These agents have limited activity against other enteric gramnegative bacilli and anaerobes. Cefazolin (1-2 g IV/IM q8h) is th Ebook The washington manual of medical therapeutics (35th edition): Part 2e most commonly used parenteral preparation, and cephalexin (250-500 mg PO q6h) and cefadroxil (500 mg to 1 g PO q12h) are oral preparations. These agEbook The washington manual of medical therapeutics (35th edition): Part 2
ents are commonly used for treating skin/soft tissue infections, UTIs, and minor MSSA infections and for surgical prophylaxis (cefazolin).•Second-gene15 AntimicrobialsDavid J. RitchieMatthew p. CrottyNigar KirmaniEmpiric antimicrobial therapy should be initiated based on expected pathogens for a giv Ebook The washington manual of medical therapeutics (35th edition): Part 2ents.o Cefuroxime (1.5 g IV/IM q8h) is useful for treatment of infections above the diaphragm. This agent has reasonable antistaphylococcal and antistreptococcal activity in addition to an extended spectrum against gram-negative aerobes and can be used for skin/soft tissue infections, complicated UT Ebook The washington manual of medical therapeutics (35th edition): Part 2Is. and some community-acquired respiratory tract infections. It does not reliably cover Bacteroides fragilis.o Cefuroxime axetil (250-500 mg PO q12h)Ebook The washington manual of medical therapeutics (35th edition): Part 2
. cefprozil (250-500 mg PO q12h), and cefaclor (250-500 mg PO q12h) are oral second-generation cephalosporins typically used for bronchitis, sinusitis15 AntimicrobialsDavid J. RitchieMatthew p. CrottyNigar KirmaniEmpiric antimicrobial therapy should be initiated based on expected pathogens for a giv Ebook The washington manual of medical therapeutics (35th edition): Part 2efoxitin (1-2 g IV q4-8h) and cefotetan (1-2 g IV q12h) are useful for treatment of infections below the diaphragm. These agents have reasonable activity against gram negatives and anaerobes. Ebook The washington manual of medical therapeutics (35th edition): Part 215 AntimicrobialsDavid J. RitchieMatthew p. CrottyNigar KirmaniEmpiric antimicrobial therapy should be initiated based on expected pathogens for a givGọi ngay
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