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POCKET GUIDE FOR CUTANEOUS MEDICINE AND SURGERY - PART 6

Hệ thống đại lý kháng khuẩn. Trong: Wolverton SE. ed, ed. Điều trị bằng thuốc toàn diện Da. Philadelphia: W. B. Saunders Co 2001: p. 28. Ray WA, Murray KT, Meredith S et al. Erythromycin uống và nguy cơ đột tử do các nguyên nhân tim. | Therapeutics 111 Pregnancy cat. B Side effects antibiotic-associated colitis rarely Monitoring none Notes poor gram activity neuromuscular blocking properties may enhance other neuromuscular agents good anaerobic coverage Sadick NS. Systemic Antibacterial Agents. In Wolverton SE. ed. ed. Comprehensive Dermatologic Drug Therapy. Philadelphia W B. Saunders Co. 2001 p. 28. Ray WA Murray KT Meredith S et al. Oral erythromycin and the risk of sudden death from cardiac causes. N Engl J Med 2004 351 1089-1096. Yee CL Duffy C Gerbino PG et al. Tendon or joint disorders in children after treatment with fluoroquinolones or azithromycin. Pediatr Infect Dis J 2002 21 525-529. 112 Pocket Guide for Cutaneous Medicine and Surgery Topical Antimicrobials Bacitracin inhibits bacterial cell wall synthesis - inhibits peptidoglycan synthesis gram S. aureus S. pneumoniae Neisseria H. influenzae T pallidum gram - minimal coverage SE contact sensitization rare anaphylaxis Mupirocin Bactroban inhibits bacterial RNA and protein synthesis isoleucyl tDNA synthetase gram Staphylococci MRSA Streptococci gram some gram cocci SE local irritant does not cross-react with other topical antimicrobials renal toxicity when used on large denuded areas uncommon contact sensitization Neomycin inhibits protein synthesis binds 30S subunit gram good coverage vs. s. aureus weak for strep gram yes SE ototoxic and nephrotoxic contact sensitization virtually always used in combination Polymyxin B antibacterial via surface detergent-like mechanisms gram no activity gram Proteus Pseudomonas Serratia SE rare contact sensitization Spann CT et al. Topical antibacterial agents for wound care A primer. Dermatol Surg 2003 29 620-626. Therapeutics 113 Systemic Antifungals Terbinafine allylamine Mechanism inhibits squalene epoxidase h squalene and impairs ergosterol synthesis Metabolism hepatic 80 fecal 20 -15 metabolites Excretion renal Dosing 250 mg po qd 12 wks - toenails 6 wks -fingernails 125 mg po qd 20-40 kg 62.5 .