tailieunhanh - Antimicrobial Therapy in Otolaryngology— Head and Neck Surgery

Of the historical events that have shaped the character of the specialty dealing with ear, nose, throat, head, and neck disorders, probably none has carried the impact as did the appearance of antimicrobial agents for clinical use. It is a story that continues to unfold even today with the appearance of new antibiotics every year and the continuing emergence of new strains of resistant bacteria. Such change gives our knowledge a short half-life, and perhaps in no other clinical discipline is reeducation as important as in the use of antimicrobials | Pocket Guide to Antimicrobial Therapy in Otolaryngology Head and Neck Surgery 13th Edition DAVID . FAIRBANKS . The American Academy of Otolaryngology Head and Neck Surgery Foundation EMPIRIC DRUG CHOICES FOR COMMON INFECTIONS OF THE EARS NOSE THROAT HEAD AND NECK see page 26 ff for microbiology rationale and more options OTOLOGY page 26 ff Acute otitis media See pages 26-27 46-48 Acute mastoiditis Chr suppurative otitis media Acute otitis externa ototopicals p. 55 alcohol acid Otomycosis ototopicals p. 55 Necrotizing otitis externa p. 30 Primary Choice high dose amoxicillin - clavulanate vancomycin ceftriaxone ciprofloxacin otic alcohol acid ciprofloxacin otic IV plus meropenem or ceftazidime Some Alternatives ceftriaxone resp quinolones cefpodoxime or cefdinir resp quinolones etc. p. 28 ofloxacin otic etc. p. 28 neo polymyx ciproflox etc. ketoconazole etc. p. 30 piperacillin tazobactam plus gentamicin etc. RHINOLOGY page 30 ff Acute rhinosinusitis Orbital CNS extended p. 32 Chr rhinosinusitis Pseudomonal Fungal levofloxacin moxifloxacin cefpodoxime etc. IV or vancomycin rifampin ceph metronidazole topicals ceftazidime gentamicin etc. p. 33 itraconazole pp. 22 33 high dose amoxicillin - clavulanate ceftriaxone IV or resp quinolone amox clav or clindamycin ciprofloxacin or levofloxacin voriconazole PHARYNX HEAD NECK p. 34 ff Tonsillo-adenoiditis Acute pharyngitis p. 36 Diphtheria p. 37 Necrotizing stomatitis p. 37 Aphthous stomatitis and herpangina Thrush fungal stomatitis p. 38 Tracheobronchitis subacute p. 39 Epiglottitis acute p. 39 Croup p. 40 Deep neck abscess p. 40 Necrotizing fasciitis p. 41 Sialadenitis p. 41 1st 2nd gen ceph - metronidazole clindamycin amox clav erythro-clarithromycin penicillin amox 1st 2nd gen cephs erythromycin or clindamycin or penicillin all plus antitoxin clindamycin or amox clav or ampi sulbac or penicillin metronidazole canker-sore mixture p. 38 topicals nystatin or clotrimazole or fluconazole erythromycins doxycycline resp .