i***c 发帖数: 301 | 1 脑脓肿,培养出摩根摩根菌,不知用什么抗生素
现在用万古霉素,舒普深,甲硝锉 | l******k 发帖数: 27533 | 2 明天有空看看
morganii infection很少见吧,这还真一下子答不上
单纯从CNS penetration来说
Excellent with or without inflammation
–Chloramphenicol, TMP-SMX, metronidazole, rifampin, isoniazid
Good in the presence of inflammation
–Pcns, cefuroxime, 3rd gen cephs (except cefoperazone), vanco
你给的治疗方案,舒普深可能不妥,换成另外一种三代头孢才好。还有vanco并不能迅
速作用。
甲硝锉看来是个不错的选择,covers anaerobic gram negatives
为什么不用bactrium? 有头孢cover bactrium缺乏的strep.,gram positive就也差不
多cover完了,还不用vanco那么麻烦
随意说的,没有仔细查最佳治疗方案,抛砖引玉吧
【在 i***c 的大作中提到】 : 脑脓肿,培养出摩根摩根菌,不知用什么抗生素 : 现在用万古霉素,舒普深,甲硝锉
| i***c 发帖数: 301 | 3 谁给帮忙下篇文章:
http://mobile.journals.lww.com/amjmedsci/_layouts/oaks.jou
rnals.mobile/abstractviewer.aspx?year=2006&issue=01000&
article=00013 | l******k 发帖数: 27533 | 4 你这是搞research,还是兴趣呀?
我白天在医院忙死,你要就因为兴趣,等其他人有空帮你查吧
【在 i***c 的大作中提到】 : 谁给帮忙下篇文章: : http://mobile.journals.lww.com/amjmedsci/_layouts/oaks.jou : rnals.mobile/abstractviewer.aspx?year=2006&issue=01000& : article=00013
| a*****8 发帖数: 2115 | 5 M Morganii: gram negative rods anaerobic. No point using vancomycin treating
this bug if no other concern or risk factor for MRSA, or patient is not is
not in septic shock etc. Vancomycin does not
cover gram negative or anaerobic. Penicillin, 1st and 2nd gen cephalosporin
usually is resistant. You can use Unasyn, if high risk factor for
pseudomonas, can use zosyn, but if just M Morganii, Unasyn, or 3rd and 4th
gen of cephalosporin. You can also use carbapenems, like mero, dori or ime.
They both cover gram negatives. Also you will need to know whether it is a
beta-lactamase producing organism (ESBL), in that case, cephalosporin or
unasyn will not work. Carbapenem is the drug of choice.
不让我粘贴PDF,我有这篇文章,如果你要,把email地址给我。 | i***c 发帖数: 301 | 6 老教授给了个:环丙沙星和头孢他啶
正在用,不知会不会再改 | P*******D 发帖数: 523 | 7 我赞同 ann2008的回答。不知道lz是不是为国内的人问的,都用的中文的药名。国内的
情况有可能就和这边的不一样,但至少是要根据anaerobic gram negative rods来选择 |
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