2003 ( ) If you have some questions, please mail to beholder96@citiz.net. 1
ß 1 2 60 33 ß 80 90 40 90 ß ESBLs ß- ß-, ß- 3 2
3 4 4 CSF cefuroxime ß cefotiam ß cefotaxime ceflzidime ceftriaxone 8h 12 40 cefoperazone ß 70 3
5 ceftizoxime cefpiramide (cefodizime) CD4+ 5 CSF ++~+++ CSF ß : cefepime, cefpirome ESBLs cefaclor 33 50 cefixlme ceftibuten ß 12 ß ß 5 cefmetazole cefoxitim cefotetan, ß ESBLs ESBLs 6 ceftuperazone2 6 4
ß 22.5mg/l 90.1mg/l 124.8mg/l 354.5mg/l CSF (moxalactam, latamoxef, ) flomoxef ß ß ß clavulanic acid sulbactamtazobactam ß 7 ++ ++ ++~+++ +++ ++~+++ - - ++~+++ +++ ++~+++ ++ - - ++ - ++ ++ ++ - +++ - - +++ - - + - - - + (imipenem), panipenem (meropenem), ß (cilastatin) 5
betamipron 8 (imipenem) (meropenem) panipenem G+. ESBL ß amikacin netilmicin etimicin isepamicin (sisomicin) 6
levofloxacin lomefloxacin fleroxacin (tosufloxacin) sparfloxacin >10 gatifloxacin moxifloxacin azithromycin clarithromycin (roxithromycin) 10mg/L ; teicoplanin, MRSA 7
fluconazole itraconazole 0.18mg/L 3-5mg/Kg.d (2),.. 8
) : ( ) 2/3~1/2,1/2~1/5,1/5~1/10 2 :, 10 ml/min90~120 >50-90 10-50 <10 u mol/l 88.4~132.5 132.6~176.8 176.8~442 >442 u mol/l 3.21~5.35 7.14~12.5 12.5~21.4 >21.4 140 kg 72 mg/dl 0.85 85 ().( ). 5-8mg/L 0.5~1.5mg/L; - / - /; / 5m/ 30~ g/l ~ mg/l, / / B 2mg/ TMP 115 /L3mg/L g/ 9
1l/in umol/l5 /L ß 2/3 / ß 10
. " " ß ß. 11
1 1 2 3Gilbert DN Moellering R C, Sande MA. The Sanford Guide to Antimicrobial Therapy, 28 th edition Antimicrobial Therapy Inc. USA. 1998.2 4Barrett J G Pocket Book of Infectious Disease Therapy, 9 th edition, Williams & Wilkins, USA 1998,1-142 5 12
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