tailieunhanh - Otolaryngolog Head and Neck Surgery - part 5

Thuốc lựa chọn cho vi khuẩn sialadenitis: tiểu học: Amoxicillin / clavulanate (Augmentin) uống Hoặc ampicillin / sulbactam (Unasyn) IV Hoặc nafcillin IV Hoặc dicloxacillin uống giải pháp thay thế: Clindamycin (Cleocin) uống hoặc IV 1 gen. ceph: cephalexin hoặc cefazolin có hoặc không có metronidazole 2 gen. ceph: | Drug choices for bacterial sialadenitis Primary Amoxicillin clavulanate Augmentin oral Or ampicillin sulbactam Unasyn IV Or nafcillin IV Or dicloxacillin oral Alternatives Clindamycin Cleocin oral or IV 1st gen. ceph. cephalexin or cefazolin with or without metronidazole 2nd gen. ceph. cefuroxime et al. with or without metronidazole Vancomycin IV plus metronidazole DACRYOCYSTITIS S. pneumoniae and Hemophilus influenzae predominate in children Staph. epidermidis Staph. aureus and Strep. pyogenes are more likely in adults. Anaerobes are occasional. Drug choices as dictated by gram stain Primary Levofloxacin moxifloxacin adult oral. ceftriaxone IM IV child Alternatives Cefpodoxime Vantin oral TMP SMX if MRSA SKIN IMPETIGO a superficial epidermal infection . Microbiology Strep. pyogenes Staph. aureus often co-isolated. Drug choices Mupirocin Bactroban ointment plus oral antistaphylococcals Primary Mupirocin ointment plus either 2nd generation cephalosporin or TMP SMX if MRSA Alternatives Mupirocin ointment plus either clindamycin or minocycline doxycycline FOLLICULITIS FURUNCULOSIS CARBUNCLES. Microbiology Staph aureus incl. MRSA Pseudomonas aeruginosa from hot tubs See pages 49-50. Drug choices Clindamycin TMP SMX 2nd gen. ceph. Linezolid levofloxacin if pseudomonas . ERYSIPELAS an epidermis and dermis infection . CELLULITIS a subcutaneous infection Microbiology Strep. pyogenes but occasionally other strep. Staph. aureus S. pneumoniae or Hemophilus influenzae. Treat for MRSA until proven otherwise Drug choices Primary Vancomycin IV plus ceftriaxone IV Alternatives Daptomycin or Linezolid plus ceftriaxone 42 ACUTE CATARRHAL CONJUNCTIVITIS is caused usually by Hemophilus influenzae occasionally S. pneumoniae Staph. aureus. Drug choices eye drops Primary Fluroquinolone eye drops cipro- gati- levo- moxi- floxacin Alternatives Polymyxin TMP ophth. drops This type of conjunctivitis may be the initial sign of a childhood purpural fever dusky reddish-purple .