不是长效的。2012年的IDISA(美国传染病协会)的推荐,可以使用一次性的青霉素G肌肉注射60万单位(小于60磅体重的)

来源: 御用文人 2016-01-01 17:05:12 [] [旧帖] [给我悄悄话] 本文已被阅读: 次 (33741 bytes)

大于60磅体重的一次性注射是 120 万单位。认为对于咽部的Strep感染有强效。。。

Treatment

Patients with acute group A streptococcal pharyngitis should be treated with an antibiotic that is likely to eradicate the organism, usually for 10 days. Penicillin or amoxicillin is commonly recommended because of its narrow spectrum of activity, few adverse effects, and modest cost. Alternative antibiotics for those with penicillin allergy include a first-generation cephalosporin, clindamycin, clarithromycin (Biaxin), or azithromycin (Zithromax). Table 2 summarizes antibiotic regimens for patients with and without penicillin allergy.

View/Print Table

Table 2.

Treatment Regimens for Group A Streptococcal Infection

DRUG DOSE/DOSAGE DURATION RECOMMENDATION STRENGTH, QUALITY OF EVIDENCE

Patients without penicillin allergy

Penicillin V, oral

Children: 250 mg two or three times daily

10 days

Strong, high

Adolescents and adults: 250 mg four times daily or 500 mg twice daily

 

Amoxicillin, oral

50 mg per kg once daily (maximum = 1,000 mg)

10 days

Strong, high

Alternative: 25 mg per kg twice daily (maximum= 500 mg)

Penicillin G benzathine, intramuscular

< 60 lb (27 kg): 600,000 U

Single dose

Strong, high

≥ 60 lb: 1,200,000 U

Patients with pencillin allergy

Cephalexin (Keflex), oral*

20 mg per kg per dose twice daily (maximum = 500 mg per dose)

10 days

Strong, high

Cefadroxil, oral*

30 mg per kg once daily (maximum = 1 g)

10 days

Strong, high

Clindamycin, oral

7 mg per kg per dose three times daily (maximum = 300 mg per dose)

10 days

Strong, moderate

Azithromycin (Zithromax), oral†

12 mg per kg once daily (maximum = 500 mg)

5 days

Strong, moderate

Clarithromycin (Biaxin), oral†

7.5 mg per kg per dose twice daily (maximum = 250 mg per dose)

10 days

Strong, moderate


*—Avoid in individuals with immediate hypersensitivity to penicillin.

†—Resistance of group A streptococcus to these agents is well-known and varies geographically and temporally.

Adapted with permission from Shulman ST, Bisno AL, Clegg HW, et al. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012;55(10):e89.

所有跟帖: 

不知依据是什么?别又弄个李冰冰事件出来。 -薛成- 给 薛成 发送悄悄话 薛成 的博客首页 (0 bytes) () 01/01/2016 postreply 17:20:58

估计是希望一次性把细菌杀光光。 -viewfinder- 给 viewfinder 发送悄悄话 viewfinder 的博客首页 (0 bytes) () 01/01/2016 postreply 18:00:41

我在国内的经验是,60万单位青霉素G的一次性注射不会有多大效果。 -御用文人- 给 御用文人 发送悄悄话 (0 bytes) () 01/01/2016 postreply 18:24:51

我印象中青霉素G的半衰期不长,血液浓度衰减很快。仅用一次,怎么保证细菌被有效杀灭?不知哪位有这方面的研究资料。 -薛成- 给 薛成 发送悄悄话 薛成 的博客首页 (0 bytes) () 01/01/2016 postreply 18:49:14

文献根据在这儿,发表在Jama上。但是发表日期太老。 -御用文人- 给 御用文人 发送悄悄话 (22234 bytes) () 01/01/2016 postreply 19:26:29

看你们这么说,这个一次性注射可能真是没起到彻底治疗strep的作用?那怎么办啊 -海水很咸- 给 海水很咸 发送悄悄话 (178 bytes) () 01/01/2016 postreply 22:50:36

谢谢老哥,新年快乐! -薛成- 给 薛成 发送悄悄话 薛成 的博客首页 (0 bytes) () 01/02/2016 postreply 01:37:34

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