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Viêm phổi ..

Xem chủ đề cũ hơn Xem chủ đề mới hơn Go down
Mon Oct 25, 2010 6:31 pm
không có việc gì khó, chỉ tại không biết làm
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hieu126
menber

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Danh vọng:
524%/1000%

Tài năng:%/100%

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» Tổng số bài gửi : 524
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Bài gửiTiêu đề: Viêm phổi ..


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STT

Tiêu chuẩn

1.

Nhịp thở ³ 30 lần/ phút

2.

Huyết áp tâm trương ≤ 60 mmHg

3.

Ure máu > 7 mmol/ lít

4.

Thay đổi ý thức
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Vi khuẩn (VK)

Kháng sinh ưu tiên

Kháng sinh thay thế

S pneumoniae

Amoxicilina 500mg- 1g/ lần x 3 lần/ ngày (uống), hoặc
Benzylpenicillin 1,2 g/ lần x 4 lần/ ngày (tiêm tĩnh mạch)
(a): Có thể dùng với liều cao hơn 3g/ ngày ở những trường hợp VK nhạy cảm trung gian.

Erythromycin 500mg/lần x 4 lần/ ngày (uống), hoặc
Clarithromycin 500mg/ lần x 2 lần/ ngày (uống), hoặc
Cefuroxime 0,75g-1,5 g/ lần x 3 lần/ ngày (tiêm tĩnh mạch), hoặc
Cefotaxime 1-2 g/ lần x 3 lần/ ngày (tĩnh mạch), hoặc
Ceftriaxone 2g/ ngày (tiêm tĩnh mạch 1 lần duy nhất)

M pneumoniae
C pneumoniae

Erythromycin 500mg/lần x 4 lần/ ngày (uống, tiêm TM), hoặc
Clarithromycin 500mg/ lần x 2 lần/ ngày (uống, tiêm tĩnh mạch)

Tetracycline 250-500mg/ lần x 4 lần ngày (uống), hoặc
Fluoroquinoloneb (uống, tiêm tĩnh mạch)
(b) Các quinolone thay thế khác: ciprofloxacin, ofloxacin, moxifloxacin, levofloxacin

C psittaci
C burnetii

Tetracycline 250-500mg/ lần x 4 lần ngày (uống), hoặc 500mg/ lần x 2 lần/ ngày (tiêm tĩnh mạch)

Erythromycin 500mg/lần x 4 lần/ ngày (uống) hoặc
Clarithromycin 500mg/ lần x 2 lần/ ngày (tiêm tĩnh mạch)

Legionella spp

Clarithromycin 500mg/ lần x 2 lần/ ngày (uống, tiêm tĩnh mạch)
Có thể kết hợp với RifampicineC 600mg/ lần x 1-2 lần/ ngày (uống hoặc tiêm TM)

Fluoroquinolone (uống, tiêm tĩnh mạch)

H influenza

VK không tiết b lactamase
Amoxicilin 500mg/ lần x 3 lần/ ngày (uống), hoặc
Ampicillin 0,5 g/lần x 4 lần/ ngày (tĩnh mạch)

Cefuroxime 1,5 g/ lần x 3 lần/ ngày (tiêm tĩnh mạch), hoặc
Cefotaxime 1-2 g/ lần x 3 lần/ ngày (tĩnh mạch), hoặc
Ceftriaxone 2g/ ngày (tiêm tĩnh mạch 1 lần duy nhất)

VK có tiết b lactamase
Amoxi- clavulanic 625 mg/ lần x 3 lần/ ngày (uống), hoặc 1,2 g/lần x 3 lần/ ngày (tiêm TM)


Fluoroquinoloneb (uống, tiêm tĩnh mạch)

Trực khuẩn gram âm đường ruột

Cefuroxime 1,5 g/ lần x 3 lần/ ngày (tiêm tĩnh mạch), hoặc
Cefotaxime 1-2 g/ lần x 3 lần/ ngày (tĩnh mạch), hoặc
Ceftriaxone 2g/ ngày (tiêm tĩnh mạch 1 lần duy nhất)

Fluoroquinoloneb (uống, tiêm tĩnh mạch), hoặc
Imipenem 500mg/ lần x 4 lần /ngày (tĩnh mạch), hoặc
Meropenem 0,5- 1g/ lần x 3 lần/ ngày (tĩnh mạch)

P aeruginosa

Ceftazidime 2g/ lần x 3 lần/ ngày (tiêm tĩnh mạh)
Kết hợp với gentamycin hoặc tobramycin

Ciprofloxacin 400mg/ lần x 2 lần ngày (tĩnh mạch), hoặc
Piperacillin 4g/ lần x 3 lần /ngày (tĩnh mạch)
Kết hợp với Gentamycin hoặc tobramycin

Staphylococcus aereus

Nhạy cảm Methicillin
Flucloxacin 1-2g/ lần x 4 lần/ ngày (tĩnh mạch). Có thể kết hợp với RifampicineC 600mg/ lần x 1-2 lần/ ngày (uống hoặc tiêm TM)

Teicoplanin 400mg/ lần x 2 lần/ ngày (tĩnh mạch). Có thể kết hợp với RifampicineC 600mg/ lần x 1-2 lần/ ngày (uống hoặc tiêm TM)

Kháng Methicillin
Vancomycin 1g/ lần x 2 lần/ ngày (tĩnh mạch)

Linezoid 600mg/ lần x 2 lần/ ngày (tĩnh mạch hoặc uống)


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