--口腔牙科的抗生素应用(英文PPT)
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抗生素PPT课件(英文精品) Penicillin-resistant pneumococci - potentials for modeling(57p)
➢ > 40 serogroups (e.g. group 19) ➢ > 90 serotypes (e.g. types 19A, 19C, 19F)
• No immunologic cross-reactivity between serogroups • Some cross-reactivity within some serogroups and
➢ Midቤተ መጻሕፍቲ ባይዱle ear ➢ Sinuses ➢ Bronchi
Important for modelling: Pneumococcal serotypes
• Based on properties of capsular polysaccharides • Immunologically distinct and basis for classification
• Such types (6B, 9V, 14, 19F, 23F) more dominating among young children = child serotypes
➢ Account for the majority of carriage and disease in children ➢ Explains high incidences of carriage and disease in the
and macrophages • Elicits a T-cell–independent (not boostable)
immune response
Pathogenesis
• Colonisation of mucous membranes in respiratory tracts
• Adhesion (bacterial adhesins) • Invasion of tissues if not defeated
• No immunologic cross-reactivity between serogroups • Some cross-reactivity within some serogroups and
➢ Midቤተ መጻሕፍቲ ባይዱle ear ➢ Sinuses ➢ Bronchi
Important for modelling: Pneumococcal serotypes
• Based on properties of capsular polysaccharides • Immunologically distinct and basis for classification
• Such types (6B, 9V, 14, 19F, 23F) more dominating among young children = child serotypes
➢ Account for the majority of carriage and disease in children ➢ Explains high incidences of carriage and disease in the
and macrophages • Elicits a T-cell–independent (not boostable)
immune response
Pathogenesis
• Colonisation of mucous membranes in respiratory tracts
• Adhesion (bacterial adhesins) • Invasion of tissues if not defeated
口腔牙科的抗生素应用(英文PPT)
2020/6/29
COMMONLY USED A/B
• Mechanism of the antibiotics
2020/6/29
COMMONLY USED A/B
1. Groups of Penicillin • First choice for odontogenic infection • G(+) cocci and rod, spirochetes, anaerobes • 0.7~10% hypersensitivity => PST • Nature: penicillin G (IV), penicillin V (PO)
• Penicillinase-resistant: oxacillin, dicloxacillin • Extended spectrum: ampicillin, amoxicillin • Combine β-lactamase inhibitor: augmentin
2020/6/29
2. Cephalosporin • More resistance to penicillinase • G(+) cocci, many G(-) rods • Third generation: Pseudomonas aeruginosa • Second choice (less effect for anaerobes)
First generation
Second generation
Cefazolin Keflor
U-SAVE-A Ucefaxim
Tydine
2020/6/29
Third generation Forth generation
Claforan Cefepime
COMMONLY USED A/B
• Mechanism of the antibiotics
2020/6/29
COMMONLY USED A/B
1. Groups of Penicillin • First choice for odontogenic infection • G(+) cocci and rod, spirochetes, anaerobes • 0.7~10% hypersensitivity => PST • Nature: penicillin G (IV), penicillin V (PO)
• Penicillinase-resistant: oxacillin, dicloxacillin • Extended spectrum: ampicillin, amoxicillin • Combine β-lactamase inhibitor: augmentin
2020/6/29
2. Cephalosporin • More resistance to penicillinase • G(+) cocci, many G(-) rods • Third generation: Pseudomonas aeruginosa • Second choice (less effect for anaerobes)
First generation
Second generation
Cefazolin Keflor
U-SAVE-A Ucefaxim
Tydine
2020/6/29
Third generation Forth generation
Claforan Cefepime
抗生素PPT课件(英文精品) Antibiotics and Pain Control
– Fullen, et al.
• Both the timing and the choice are important.
– Thadepalli, et al.
What Bugs?
• Yom Kippur War
– Pseudomonas – 25.6% isolates – Gm Neg bacilli – 70% isolates overall
General Preventive Measures
• Adequate and Timely Resuscitation
• Early Wound Care • Antibiotics • Tetanus Immune Prophylaxis
Adequate and Timely Resuscitation
Why not?!
• Antibiotics not routinely given in the field by civilian pre-hospital personnel (EMT/paramedic model for
medic training).
• Combat medics don’t typically see wound infections during the time they care for them – may not appreciate their devastating effect.
• Debridement
– excise devitalized tissue
• Irrigation
– high pressure, solution
• Eliminate Dead Space
– fluid, blood
• Both the timing and the choice are important.
– Thadepalli, et al.
What Bugs?
• Yom Kippur War
– Pseudomonas – 25.6% isolates – Gm Neg bacilli – 70% isolates overall
General Preventive Measures
• Adequate and Timely Resuscitation
• Early Wound Care • Antibiotics • Tetanus Immune Prophylaxis
Adequate and Timely Resuscitation
Why not?!
• Antibiotics not routinely given in the field by civilian pre-hospital personnel (EMT/paramedic model for
medic training).
• Combat medics don’t typically see wound infections during the time they care for them – may not appreciate their devastating effect.
• Debridement
– excise devitalized tissue
• Irrigation
– high pressure, solution
• Eliminate Dead Space
– fluid, blood
抗生素PPT课件(英文精品) Proper Use of Antibiotics
Points to note when taking antibiotics (1)
➢ Follow your doctor’s instruction.
➢ Take the drugs on the right time at the right dose.
➢ If you miss one dose, take it as soon as you remember but never take a double dose.
Always consult your doctor for the use of antibiotics.
FAQ If I have fever, do I always need an antibiotic?
Fever is a common symptom for infections and not necessarily caused by bacterial infection.
抗生素PPT课件（英文精品） Proper Use of Antibiotics
Antibiotics
Antibiotics ≠ Anti-inflammatory drugs
Antibiotics ≠Panacea
Are there any risks for the use of antibiotics?
diarrhoea
Side effects of Antibiotics (2)
Allergic reaction - rash - itchiness - breathlessness
Antibiotic resistant bacteria
Predispose to the emergences of antibiotics resistant bacteria.
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VGH-TPE
TREATMENT of INFECTION
Remove the cause of infection is the most important of all, by either spontaneously or surgically drain the pus.
Antibiotics are merely an adjunctive therapy. Drainage
■ Assessment of the Patient ■ Diagnosis and Treatment of infection ■ Antibiotic Therapy ■ Indications for Prophylaxis ■ Antifungal Agent
VGH-TPE
ASSESSMENT
Requires a complete medical history and exam of the head and neck region with awareness to systemic factors as part of a comprehensive dental examination
Host defense
VGH-TPE
Antibiotics
INDICATION for ANTIBIOTICS
1. Severity of the infection
Acute onset Diffuse swelling involves fascial spaces
2. Adequacy of removing the source of infection
Loss of function < dysphagia, trismus, dyspnea >
VGH-TPE
ASSESSMENT (CON’T)
Systemic signs of infection < BP ↓ < WBC ↑ < CRP ↑ < urine output ↓
VGH-TPE
Penicillinase-resistant: oxacillin, dicloxacillin Extended spectrum: ampicillin, amoxicillin Combine β-lactamase inhibitor: augmentin
VGH-TPE
2. Cephalosporin More resistance to penicillinase G(+) cocci, many G(-) rods Third generation: Pseudomonas aeruginosa Second choice (less effect for anaerobes)
VGH-TPE
MICROBIOLOGY
Most oral infections are mixed in origin consisting of aerobic and anaerobic gram positive and gram negative organisms
Anaerobes predominant (75%)
First generation Second generation Third generation Forth generation
Cefazolin U-SAVE-A Tydine
Keflor Ucefaxim
Claforan
Cefepime
VGH-TPE
3. Clindamycin G(+) cocci Bacteriostatic -> bactericidal Second-line drug: should be held in reserve to
Identify local and/or systemic signs and symptoms to support the diagnosis of infection: < erythema, warmth, swelling, and pain > < malaise, fever ( >38 c), chills >
When drainage can’t be established immediately
3. The state of patients’ host defense
When the patient is febrile Compromised host defenses For prophylaxis
Antibiotic Use in Orofacial Dental Infection
台北榮民總醫院 牙科部 Speaker 陳雅薇 Moderator 羅文良 大夫
VGH-TPE
INTRODUCTION
This presentation will review the evaluation and management of orofacial infections with emphasis on:
DIAGNOSIS: Infection
Determine etiology > odontogenic > trauma wound, animal bite > TB, fungi, actinomycoses
VGH-TPE
DIAGNOSIS (CON’T)
Determine cellulitis versus abscess
VGH-TPE
COMMONLY USED A/B
Mechanism of the antibiotics
VGH-TPE
COMMONLY USED A/B
1. Groups of Penicillin First choice for odontogenic infection G(+) cocci and rod, spirochetes, anaerobes 0.7~10% hypersensitivity => PST Nature: penicillin G (IV), penicillin V (PO)
TREATMENT of INFECTION
Remove the cause of infection is the most important of all, by either spontaneously or surgically drain the pus.
Antibiotics are merely an adjunctive therapy. Drainage
■ Assessment of the Patient ■ Diagnosis and Treatment of infection ■ Antibiotic Therapy ■ Indications for Prophylaxis ■ Antifungal Agent
VGH-TPE
ASSESSMENT
Requires a complete medical history and exam of the head and neck region with awareness to systemic factors as part of a comprehensive dental examination
Host defense
VGH-TPE
Antibiotics
INDICATION for ANTIBIOTICS
1. Severity of the infection
Acute onset Diffuse swelling involves fascial spaces
2. Adequacy of removing the source of infection
Loss of function < dysphagia, trismus, dyspnea >
VGH-TPE
ASSESSMENT (CON’T)
Systemic signs of infection < BP ↓ < WBC ↑ < CRP ↑ < urine output ↓
VGH-TPE
Penicillinase-resistant: oxacillin, dicloxacillin Extended spectrum: ampicillin, amoxicillin Combine β-lactamase inhibitor: augmentin
VGH-TPE
2. Cephalosporin More resistance to penicillinase G(+) cocci, many G(-) rods Third generation: Pseudomonas aeruginosa Second choice (less effect for anaerobes)
VGH-TPE
MICROBIOLOGY
Most oral infections are mixed in origin consisting of aerobic and anaerobic gram positive and gram negative organisms
Anaerobes predominant (75%)
First generation Second generation Third generation Forth generation
Cefazolin U-SAVE-A Tydine
Keflor Ucefaxim
Claforan
Cefepime
VGH-TPE
3. Clindamycin G(+) cocci Bacteriostatic -> bactericidal Second-line drug: should be held in reserve to
Identify local and/or systemic signs and symptoms to support the diagnosis of infection: < erythema, warmth, swelling, and pain > < malaise, fever ( >38 c), chills >
When drainage can’t be established immediately
3. The state of patients’ host defense
When the patient is febrile Compromised host defenses For prophylaxis
Antibiotic Use in Orofacial Dental Infection
台北榮民總醫院 牙科部 Speaker 陳雅薇 Moderator 羅文良 大夫
VGH-TPE
INTRODUCTION
This presentation will review the evaluation and management of orofacial infections with emphasis on:
DIAGNOSIS: Infection
Determine etiology > odontogenic > trauma wound, animal bite > TB, fungi, actinomycoses
VGH-TPE
DIAGNOSIS (CON’T)
Determine cellulitis versus abscess
VGH-TPE
COMMONLY USED A/B
Mechanism of the antibiotics
VGH-TPE
COMMONLY USED A/B
1. Groups of Penicillin First choice for odontogenic infection G(+) cocci and rod, spirochetes, anaerobes 0.7~10% hypersensitivity => PST Nature: penicillin G (IV), penicillin V (PO)