【Max】評論

SBP(Spontaneous Bacterial Peritonitis)原發性腹膜炎(一)診斷:透析液中的PMN250(二)常見菌種:G(+):S. pneumoniae and other Streptococcus species(20%)G(-):E. coli (most common)、K. pneumoniae、Enterococcus species(5%)(三)經驗性治療:首選:三代Cefa(Cefotaxime or Ceftriaxone) --較安全也比較有效次之:Ampicillin+Aminoglycoside類--若病患肝硬化，不可用Aminoglycoside類對β-lactam過敏:Levofloxacin or moxifloxacin--不建議使用CiprofloxacinContinuous Ambulatory Peritoneal Dialysis(CAPD)–Associated Peritonitis(一)診斷:透析液成混濁狀               WBC100               Neutrophili...

【GE】評論

(A) Bacterial peritonitis generally is accompanied by an elevated dialysate WBC count greater than 100/μL with greater than 50% neutrophils.(B) (C) (D) Empiric antibiotics(經驗性抗生素) must cover both gram-positive and gram-negative organisms. The increasing prevalence of vancomycin-resistant organisms has resulted in a shift in empiric therapy away from vancomycin, toward first-generation cephalosporins (cefazolin or cephalothin). Without a Gram stain, therapy should be initiated with a combination of cefazolin or cephalothin (to cover gram-positive organisms) and ceftazidime (to cov...