抗菌药物临床应用的基本原则5（The basic principle of clinical application of antibacterials 5）.doc

抗菌药物临床应用的基本原则5（The basic principle of clinical application of antibacterials 5） [pathogeny treatment] See table 4.18. Table 4.18 pathogenic treatment of bone and joint infection Pathogeny Suitable drugs Optional drugs Remarks Staphylococcus aureus Methicillin sensitive Oxacillin Cefazolin, cefuroxime, clindamycin Cephalosporins should not be used in the history of penicillin anaphylactic shock Methicillin resistance Vancomycin or vancomycin combined with fosfomycin or rifampin Compound sulfamethoxazole and aminoglycosides Compound sulfamethoxazole and aminoglycosides should not be used alone, and can be used as one of the combined drugs Hemolytic streptococcus Penicillin The first generation cephalosporins were erythromycin, lincomycin, and so on Enterococcus Ampicillin or penicillin plus aminoglycosides Vancomycin or vancomycin Enterobacteriaceae Fluoroquinolones, ampicillin / sulbactam, amoxicillin / clavulanic acid Third generation cephalosporins, piperacillin and aminoglycosides According to the result of drug sensitivity test, the medicine was selected. Escherichia coli is more resistant to fluoroquinolones Pseudomonas aeruginosa Fluoroquinolones or piperacillin or Pseudomonas aeruginosa, cephalosporin + aminoglycosides Pseudomonas aeruginosa beta lactamase / beta lactamase inhibitors or carbapenems + aminoglycosides According to the result of drug sensitivity test, the medicine is usually used in combination Bacteroides and other anaerobic bacteria Metronidazole Clindamycin, beta lactam / beta lactamase inhibitors Skin and soft tissue infections Skin and soft tissue infections include folliculitis, furuncle, carbuncle, lymphangitis, acute cellulitis, burn wound infection, postoperative incision infection and bedsore infection etc.. The most common pathogens of folliculitis, furuncle, carbuncle and wound infection of Staphylococcus aureus; lymphatic inflammation and acute cellulitis mainly by Streptococcus pyogenes cause; bedsore infection often mixed infection