Slide 1

適當使用抗生素
抗微生物製劑使用指引

感控室

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

1. 肺炎: J Microbiol Immunol Infect. 2007;40:279-283.
2. 深層性黴菌症: J Microbiol Immunol Infect 2006;39:523525.

3. 發熱性嗜中性球減少症: J Microbiol Immunol Infect
2005;38:455-457.

4. 肺結核治療: J Microbiol Immunol Infect 2004;37:382-384.

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

5. 外科手術預防性抗生素使用指引: J Microbiol
Immunol Infect 2004;37:71-74.

6. 急性上呼吸道感染: J Microbiol Immunol Infect
2002;35:272-273.

7. 抗HIV治療: J Microbiol Immunol Infect 2001;34:224-226.
8. 泌尿道感染: J Microbiol Immunol Infect 2000;33:271-272.

肺炎
1. Guideline / IDST (IDSA) 1999
2. Taiwan Society of Pulmonary & Critical
Medicine 2001: HAP, VAP
3. IDST consensus 2005 / 2006
(1) CAP: OPD & IPD (mild / moderate &
severe / intensive)
(2) NP: early-onset & late-onset

Content
1. Target therapy: S. pneumoniae, H. influenzae, M.
catarrhalis, Legionella spp., M. pneumoniae, C.
pneumoniae

2. Empiric therapy:
(1) CAP: OPD vs IPD & mild-to-moderate vs
severe / ICU
(2) HAP: risk factor (MDRO, P. aeruginosa) &
early vs late-onset
(3) VAP: P. aeruginosa, Acinetobacter spp., MRSA
3. Recommendation of parenteral antibiotic
therapy of HAP in adults

深層性黴菌症 (IFI)
1. Essential for survival: aggressive dx
approach & institution of anti-fungal
therapy
2. Conventional amphotericin B & drugrelated adverse effects
3. Symposium 2006: limited to candidiasis,
aspergillosis, zygomycosis,
cryptococcosis
4. Principles: acadmic, local pathogen /
resistance patterns, marketed in Taiwan

Content
1. Candidiasis: candidemia, chronic invasive
candidiasis, intra-abdominal, urinary,
oropharyngeal, esophageal
2. Aspergillosis: pulmonary, ENT, disseminated,
cerebral
3. Zygomycosis: rhino-cerebral, disseminated,
pulmonary
4. Cryptococcosis: pulmonary, CNS /
disseminated
5. Mx of IICP: keep opening pressure
<200mmH2O) & repeat drainage / VP shunt

肺結核治療
1. Incidence / prevalence of MTb in Taiwan:
64.84 / 5.56 per 100,000 in 2001
2. Consensus meeting 2004:
(1) viewpoint of primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not
regulations of BNHI
3. excluded: HIV co-infected, drug-durg interaction,
treatment of pediatrics, lack of rifabutin,
cycloserine

Content
1. pulmonary TB:
(1) new case: standard regimen & fixeddose combinations
(2) re-treatemnt: relapse, default, faiIure
(3) drug resistance: 1 & >1
(4) intolerance
(5) sepcial situations: LC, ESRD,
pregnancy

Content
2. extra-pulmonary TB:
(1) pleurisy, lymphadenitis, peritonitis,
pericarditis, GU tract dz
(2) bone / joint dz, pleural empyema
(3) meningitis, CNS dz
3. Dosage of anti-TB agents (adults)

外科手術預防性抗生素使用
1. 目的: selection pressure, cost & quality
2. Indication: clean-contaminated wound
3. Antibiotic prophylaxis should be used in close
proximity to surgical procedure; exception: C/S
4. Single dose of antibiotic before OP is sufficient
prophylaxis for most procedures & re-used is
indicated for longer procedures (every t1/2)
5. Problem: inappropriate timing of administration
& prolonged use post-OP => consensus 2003

Content
1. site/procedure == likely pathogens ==
recommened antibiotics == duration
2. Included:
large skin; oto-naso-larynx procedures;
cardiovascular; thoracic; orthopedics;
neurosurgery; colorectal; GS; urology;
Gyn/Obs

急性上呼吸道感染
1. Widespread resistance to 1st line antibiotic
and made primary care physicians in
treating their pts appropriately
2. NHRI data: OPD 65.4% for RTI and 1/3 for
URI
3. 2002 symposium for URIs:
acute sinusitis, acute otitis media, acute
pharyngo-tonsilitis, acute epiglottis, acute
bronchitis, common cold, influenza

泌尿道感染
1. consensus:
1999 => 2000
2. including:
(1) for primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not NHRI
(4) local epidemiology (pathogen & resistance
patterns)
(5) prophylactic antibiotic usage

Content
1. Asymptomatic bacteriuria
2. Acute bacterial cystitis
3. Acute complicated / uncomplicated
pyelonephritis
4. Acute / chronic prostatitis
5. Others:
nosocomial / catheter-related UTI, UTI in
pregnancy, UTI in children, recurrent UTI


Slide 2

適當使用抗生素
抗微生物製劑使用指引

感控室

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

1. 肺炎: J Microbiol Immunol Infect. 2007;40:279-283.
2. 深層性黴菌症: J Microbiol Immunol Infect 2006;39:523525.

3. 發熱性嗜中性球減少症: J Microbiol Immunol Infect
2005;38:455-457.

4. 肺結核治療: J Microbiol Immunol Infect 2004;37:382-384.

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

5. 外科手術預防性抗生素使用指引: J Microbiol
Immunol Infect 2004;37:71-74.

6. 急性上呼吸道感染: J Microbiol Immunol Infect
2002;35:272-273.

7. 抗HIV治療: J Microbiol Immunol Infect 2001;34:224-226.
8. 泌尿道感染: J Microbiol Immunol Infect 2000;33:271-272.

肺炎
1. Guideline / IDST (IDSA) 1999
2. Taiwan Society of Pulmonary & Critical
Medicine 2001: HAP, VAP
3. IDST consensus 2005 / 2006
(1) CAP: OPD & IPD (mild / moderate &
severe / intensive)
(2) NP: early-onset & late-onset

Content
1. Target therapy: S. pneumoniae, H. influenzae, M.
catarrhalis, Legionella spp., M. pneumoniae, C.
pneumoniae

2. Empiric therapy:
(1) CAP: OPD vs IPD & mild-to-moderate vs
severe / ICU
(2) HAP: risk factor (MDRO, P. aeruginosa) &
early vs late-onset
(3) VAP: P. aeruginosa, Acinetobacter spp., MRSA
3. Recommendation of parenteral antibiotic
therapy of HAP in adults

深層性黴菌症 (IFI)
1. Essential for survival: aggressive dx
approach & institution of anti-fungal
therapy
2. Conventional amphotericin B & drugrelated adverse effects
3. Symposium 2006: limited to candidiasis,
aspergillosis, zygomycosis,
cryptococcosis
4. Principles: acadmic, local pathogen /
resistance patterns, marketed in Taiwan

Content
1. Candidiasis: candidemia, chronic invasive
candidiasis, intra-abdominal, urinary,
oropharyngeal, esophageal
2. Aspergillosis: pulmonary, ENT, disseminated,
cerebral
3. Zygomycosis: rhino-cerebral, disseminated,
pulmonary
4. Cryptococcosis: pulmonary, CNS /
disseminated
5. Mx of IICP: keep opening pressure
<200mmH2O) & repeat drainage / VP shunt

肺結核治療
1. Incidence / prevalence of MTb in Taiwan:
64.84 / 5.56 per 100,000 in 2001
2. Consensus meeting 2004:
(1) viewpoint of primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not
regulations of BNHI
3. excluded: HIV co-infected, drug-durg interaction,
treatment of pediatrics, lack of rifabutin,
cycloserine

Content
1. pulmonary TB:
(1) new case: standard regimen & fixeddose combinations
(2) re-treatemnt: relapse, default, faiIure
(3) drug resistance: 1 & >1
(4) intolerance
(5) sepcial situations: LC, ESRD,
pregnancy

Content
2. extra-pulmonary TB:
(1) pleurisy, lymphadenitis, peritonitis,
pericarditis, GU tract dz
(2) bone / joint dz, pleural empyema
(3) meningitis, CNS dz
3. Dosage of anti-TB agents (adults)

外科手術預防性抗生素使用
1. 目的: selection pressure, cost & quality
2. Indication: clean-contaminated wound
3. Antibiotic prophylaxis should be used in close
proximity to surgical procedure; exception: C/S
4. Single dose of antibiotic before OP is sufficient
prophylaxis for most procedures & re-used is
indicated for longer procedures (every t1/2)
5. Problem: inappropriate timing of administration
& prolonged use post-OP => consensus 2003

Content
1. site/procedure == likely pathogens ==
recommened antibiotics == duration
2. Included:
large skin; oto-naso-larynx procedures;
cardiovascular; thoracic; orthopedics;
neurosurgery; colorectal; GS; urology;
Gyn/Obs

急性上呼吸道感染
1. Widespread resistance to 1st line antibiotic
and made primary care physicians in
treating their pts appropriately
2. NHRI data: OPD 65.4% for RTI and 1/3 for
URI
3. 2002 symposium for URIs:
acute sinusitis, acute otitis media, acute
pharyngo-tonsilitis, acute epiglottis, acute
bronchitis, common cold, influenza

泌尿道感染
1. consensus:
1999 => 2000
2. including:
(1) for primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not NHRI
(4) local epidemiology (pathogen & resistance
patterns)
(5) prophylactic antibiotic usage

Content
1. Asymptomatic bacteriuria
2. Acute bacterial cystitis
3. Acute complicated / uncomplicated
pyelonephritis
4. Acute / chronic prostatitis
5. Others:
nosocomial / catheter-related UTI, UTI in
pregnancy, UTI in children, recurrent UTI


Slide 3

適當使用抗生素
抗微生物製劑使用指引

感控室

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

1. 肺炎: J Microbiol Immunol Infect. 2007;40:279-283.
2. 深層性黴菌症: J Microbiol Immunol Infect 2006;39:523525.

3. 發熱性嗜中性球減少症: J Microbiol Immunol Infect
2005;38:455-457.

4. 肺結核治療: J Microbiol Immunol Infect 2004;37:382-384.

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

5. 外科手術預防性抗生素使用指引: J Microbiol
Immunol Infect 2004;37:71-74.

6. 急性上呼吸道感染: J Microbiol Immunol Infect
2002;35:272-273.

7. 抗HIV治療: J Microbiol Immunol Infect 2001;34:224-226.
8. 泌尿道感染: J Microbiol Immunol Infect 2000;33:271-272.

肺炎
1. Guideline / IDST (IDSA) 1999
2. Taiwan Society of Pulmonary & Critical
Medicine 2001: HAP, VAP
3. IDST consensus 2005 / 2006
(1) CAP: OPD & IPD (mild / moderate &
severe / intensive)
(2) NP: early-onset & late-onset

Content
1. Target therapy: S. pneumoniae, H. influenzae, M.
catarrhalis, Legionella spp., M. pneumoniae, C.
pneumoniae

2. Empiric therapy:
(1) CAP: OPD vs IPD & mild-to-moderate vs
severe / ICU
(2) HAP: risk factor (MDRO, P. aeruginosa) &
early vs late-onset
(3) VAP: P. aeruginosa, Acinetobacter spp., MRSA
3. Recommendation of parenteral antibiotic
therapy of HAP in adults

深層性黴菌症 (IFI)
1. Essential for survival: aggressive dx
approach & institution of anti-fungal
therapy
2. Conventional amphotericin B & drugrelated adverse effects
3. Symposium 2006: limited to candidiasis,
aspergillosis, zygomycosis,
cryptococcosis
4. Principles: acadmic, local pathogen /
resistance patterns, marketed in Taiwan

Content
1. Candidiasis: candidemia, chronic invasive
candidiasis, intra-abdominal, urinary,
oropharyngeal, esophageal
2. Aspergillosis: pulmonary, ENT, disseminated,
cerebral
3. Zygomycosis: rhino-cerebral, disseminated,
pulmonary
4. Cryptococcosis: pulmonary, CNS /
disseminated
5. Mx of IICP: keep opening pressure
<200mmH2O) & repeat drainage / VP shunt

肺結核治療
1. Incidence / prevalence of MTb in Taiwan:
64.84 / 5.56 per 100,000 in 2001
2. Consensus meeting 2004:
(1) viewpoint of primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not
regulations of BNHI
3. excluded: HIV co-infected, drug-durg interaction,
treatment of pediatrics, lack of rifabutin,
cycloserine

Content
1. pulmonary TB:
(1) new case: standard regimen & fixeddose combinations
(2) re-treatemnt: relapse, default, faiIure
(3) drug resistance: 1 & >1
(4) intolerance
(5) sepcial situations: LC, ESRD,
pregnancy

Content
2. extra-pulmonary TB:
(1) pleurisy, lymphadenitis, peritonitis,
pericarditis, GU tract dz
(2) bone / joint dz, pleural empyema
(3) meningitis, CNS dz
3. Dosage of anti-TB agents (adults)

外科手術預防性抗生素使用
1. 目的: selection pressure, cost & quality
2. Indication: clean-contaminated wound
3. Antibiotic prophylaxis should be used in close
proximity to surgical procedure; exception: C/S
4. Single dose of antibiotic before OP is sufficient
prophylaxis for most procedures & re-used is
indicated for longer procedures (every t1/2)
5. Problem: inappropriate timing of administration
& prolonged use post-OP => consensus 2003

Content
1. site/procedure == likely pathogens ==
recommened antibiotics == duration
2. Included:
large skin; oto-naso-larynx procedures;
cardiovascular; thoracic; orthopedics;
neurosurgery; colorectal; GS; urology;
Gyn/Obs

急性上呼吸道感染
1. Widespread resistance to 1st line antibiotic
and made primary care physicians in
treating their pts appropriately
2. NHRI data: OPD 65.4% for RTI and 1/3 for
URI
3. 2002 symposium for URIs:
acute sinusitis, acute otitis media, acute
pharyngo-tonsilitis, acute epiglottis, acute
bronchitis, common cold, influenza

泌尿道感染
1. consensus:
1999 => 2000
2. including:
(1) for primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not NHRI
(4) local epidemiology (pathogen & resistance
patterns)
(5) prophylactic antibiotic usage

Content
1. Asymptomatic bacteriuria
2. Acute bacterial cystitis
3. Acute complicated / uncomplicated
pyelonephritis
4. Acute / chronic prostatitis
5. Others:
nosocomial / catheter-related UTI, UTI in
pregnancy, UTI in children, recurrent UTI


Slide 4

適當使用抗生素
抗微生物製劑使用指引

感控室

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

1. 肺炎: J Microbiol Immunol Infect. 2007;40:279-283.
2. 深層性黴菌症: J Microbiol Immunol Infect 2006;39:523525.

3. 發熱性嗜中性球減少症: J Microbiol Immunol Infect
2005;38:455-457.

4. 肺結核治療: J Microbiol Immunol Infect 2004;37:382-384.

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

5. 外科手術預防性抗生素使用指引: J Microbiol
Immunol Infect 2004;37:71-74.

6. 急性上呼吸道感染: J Microbiol Immunol Infect
2002;35:272-273.

7. 抗HIV治療: J Microbiol Immunol Infect 2001;34:224-226.
8. 泌尿道感染: J Microbiol Immunol Infect 2000;33:271-272.

肺炎
1. Guideline / IDST (IDSA) 1999
2. Taiwan Society of Pulmonary & Critical
Medicine 2001: HAP, VAP
3. IDST consensus 2005 / 2006
(1) CAP: OPD & IPD (mild / moderate &
severe / intensive)
(2) NP: early-onset & late-onset

Content
1. Target therapy: S. pneumoniae, H. influenzae, M.
catarrhalis, Legionella spp., M. pneumoniae, C.
pneumoniae

2. Empiric therapy:
(1) CAP: OPD vs IPD & mild-to-moderate vs
severe / ICU
(2) HAP: risk factor (MDRO, P. aeruginosa) &
early vs late-onset
(3) VAP: P. aeruginosa, Acinetobacter spp., MRSA
3. Recommendation of parenteral antibiotic
therapy of HAP in adults

深層性黴菌症 (IFI)
1. Essential for survival: aggressive dx
approach & institution of anti-fungal
therapy
2. Conventional amphotericin B & drugrelated adverse effects
3. Symposium 2006: limited to candidiasis,
aspergillosis, zygomycosis,
cryptococcosis
4. Principles: acadmic, local pathogen /
resistance patterns, marketed in Taiwan

Content
1. Candidiasis: candidemia, chronic invasive
candidiasis, intra-abdominal, urinary,
oropharyngeal, esophageal
2. Aspergillosis: pulmonary, ENT, disseminated,
cerebral
3. Zygomycosis: rhino-cerebral, disseminated,
pulmonary
4. Cryptococcosis: pulmonary, CNS /
disseminated
5. Mx of IICP: keep opening pressure
<200mmH2O) & repeat drainage / VP shunt

肺結核治療
1. Incidence / prevalence of MTb in Taiwan:
64.84 / 5.56 per 100,000 in 2001
2. Consensus meeting 2004:
(1) viewpoint of primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not
regulations of BNHI
3. excluded: HIV co-infected, drug-durg interaction,
treatment of pediatrics, lack of rifabutin,
cycloserine

Content
1. pulmonary TB:
(1) new case: standard regimen & fixeddose combinations
(2) re-treatemnt: relapse, default, faiIure
(3) drug resistance: 1 & >1
(4) intolerance
(5) sepcial situations: LC, ESRD,
pregnancy

Content
2. extra-pulmonary TB:
(1) pleurisy, lymphadenitis, peritonitis,
pericarditis, GU tract dz
(2) bone / joint dz, pleural empyema
(3) meningitis, CNS dz
3. Dosage of anti-TB agents (adults)

外科手術預防性抗生素使用
1. 目的: selection pressure, cost & quality
2. Indication: clean-contaminated wound
3. Antibiotic prophylaxis should be used in close
proximity to surgical procedure; exception: C/S
4. Single dose of antibiotic before OP is sufficient
prophylaxis for most procedures & re-used is
indicated for longer procedures (every t1/2)
5. Problem: inappropriate timing of administration
& prolonged use post-OP => consensus 2003

Content
1. site/procedure == likely pathogens ==
recommened antibiotics == duration
2. Included:
large skin; oto-naso-larynx procedures;
cardiovascular; thoracic; orthopedics;
neurosurgery; colorectal; GS; urology;
Gyn/Obs

急性上呼吸道感染
1. Widespread resistance to 1st line antibiotic
and made primary care physicians in
treating their pts appropriately
2. NHRI data: OPD 65.4% for RTI and 1/3 for
URI
3. 2002 symposium for URIs:
acute sinusitis, acute otitis media, acute
pharyngo-tonsilitis, acute epiglottis, acute
bronchitis, common cold, influenza

泌尿道感染
1. consensus:
1999 => 2000
2. including:
(1) for primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not NHRI
(4) local epidemiology (pathogen & resistance
patterns)
(5) prophylactic antibiotic usage

Content
1. Asymptomatic bacteriuria
2. Acute bacterial cystitis
3. Acute complicated / uncomplicated
pyelonephritis
4. Acute / chronic prostatitis
5. Others:
nosocomial / catheter-related UTI, UTI in
pregnancy, UTI in children, recurrent UTI


Slide 5

適當使用抗生素
抗微生物製劑使用指引

感控室

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

1. 肺炎: J Microbiol Immunol Infect. 2007;40:279-283.
2. 深層性黴菌症: J Microbiol Immunol Infect 2006;39:523525.

3. 發熱性嗜中性球減少症: J Microbiol Immunol Infect
2005;38:455-457.

4. 肺結核治療: J Microbiol Immunol Infect 2004;37:382-384.

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

5. 外科手術預防性抗生素使用指引: J Microbiol
Immunol Infect 2004;37:71-74.

6. 急性上呼吸道感染: J Microbiol Immunol Infect
2002;35:272-273.

7. 抗HIV治療: J Microbiol Immunol Infect 2001;34:224-226.
8. 泌尿道感染: J Microbiol Immunol Infect 2000;33:271-272.

肺炎
1. Guideline / IDST (IDSA) 1999
2. Taiwan Society of Pulmonary & Critical
Medicine 2001: HAP, VAP
3. IDST consensus 2005 / 2006
(1) CAP: OPD & IPD (mild / moderate &
severe / intensive)
(2) NP: early-onset & late-onset

Content
1. Target therapy: S. pneumoniae, H. influenzae, M.
catarrhalis, Legionella spp., M. pneumoniae, C.
pneumoniae

2. Empiric therapy:
(1) CAP: OPD vs IPD & mild-to-moderate vs
severe / ICU
(2) HAP: risk factor (MDRO, P. aeruginosa) &
early vs late-onset
(3) VAP: P. aeruginosa, Acinetobacter spp., MRSA
3. Recommendation of parenteral antibiotic
therapy of HAP in adults

深層性黴菌症 (IFI)
1. Essential for survival: aggressive dx
approach & institution of anti-fungal
therapy
2. Conventional amphotericin B & drugrelated adverse effects
3. Symposium 2006: limited to candidiasis,
aspergillosis, zygomycosis,
cryptococcosis
4. Principles: acadmic, local pathogen /
resistance patterns, marketed in Taiwan

Content
1. Candidiasis: candidemia, chronic invasive
candidiasis, intra-abdominal, urinary,
oropharyngeal, esophageal
2. Aspergillosis: pulmonary, ENT, disseminated,
cerebral
3. Zygomycosis: rhino-cerebral, disseminated,
pulmonary
4. Cryptococcosis: pulmonary, CNS /
disseminated
5. Mx of IICP: keep opening pressure
<200mmH2O) & repeat drainage / VP shunt

肺結核治療
1. Incidence / prevalence of MTb in Taiwan:
64.84 / 5.56 per 100,000 in 2001
2. Consensus meeting 2004:
(1) viewpoint of primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not
regulations of BNHI
3. excluded: HIV co-infected, drug-durg interaction,
treatment of pediatrics, lack of rifabutin,
cycloserine

Content
1. pulmonary TB:
(1) new case: standard regimen & fixeddose combinations
(2) re-treatemnt: relapse, default, faiIure
(3) drug resistance: 1 & >1
(4) intolerance
(5) sepcial situations: LC, ESRD,
pregnancy

Content
2. extra-pulmonary TB:
(1) pleurisy, lymphadenitis, peritonitis,
pericarditis, GU tract dz
(2) bone / joint dz, pleural empyema
(3) meningitis, CNS dz
3. Dosage of anti-TB agents (adults)

外科手術預防性抗生素使用
1. 目的: selection pressure, cost & quality
2. Indication: clean-contaminated wound
3. Antibiotic prophylaxis should be used in close
proximity to surgical procedure; exception: C/S
4. Single dose of antibiotic before OP is sufficient
prophylaxis for most procedures & re-used is
indicated for longer procedures (every t1/2)
5. Problem: inappropriate timing of administration
& prolonged use post-OP => consensus 2003

Content
1. site/procedure == likely pathogens ==
recommened antibiotics == duration
2. Included:
large skin; oto-naso-larynx procedures;
cardiovascular; thoracic; orthopedics;
neurosurgery; colorectal; GS; urology;
Gyn/Obs

急性上呼吸道感染
1. Widespread resistance to 1st line antibiotic
and made primary care physicians in
treating their pts appropriately
2. NHRI data: OPD 65.4% for RTI and 1/3 for
URI
3. 2002 symposium for URIs:
acute sinusitis, acute otitis media, acute
pharyngo-tonsilitis, acute epiglottis, acute
bronchitis, common cold, influenza

泌尿道感染
1. consensus:
1999 => 2000
2. including:
(1) for primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not NHRI
(4) local epidemiology (pathogen & resistance
patterns)
(5) prophylactic antibiotic usage

Content
1. Asymptomatic bacteriuria
2. Acute bacterial cystitis
3. Acute complicated / uncomplicated
pyelonephritis
4. Acute / chronic prostatitis
5. Others:
nosocomial / catheter-related UTI, UTI in
pregnancy, UTI in children, recurrent UTI


Slide 6

適當使用抗生素
抗微生物製劑使用指引

感控室

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

1. 肺炎: J Microbiol Immunol Infect. 2007;40:279-283.
2. 深層性黴菌症: J Microbiol Immunol Infect 2006;39:523525.

3. 發熱性嗜中性球減少症: J Microbiol Immunol Infect
2005;38:455-457.

4. 肺結核治療: J Microbiol Immunol Infect 2004;37:382-384.

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

5. 外科手術預防性抗生素使用指引: J Microbiol
Immunol Infect 2004;37:71-74.

6. 急性上呼吸道感染: J Microbiol Immunol Infect
2002;35:272-273.

7. 抗HIV治療: J Microbiol Immunol Infect 2001;34:224-226.
8. 泌尿道感染: J Microbiol Immunol Infect 2000;33:271-272.

肺炎
1. Guideline / IDST (IDSA) 1999
2. Taiwan Society of Pulmonary & Critical
Medicine 2001: HAP, VAP
3. IDST consensus 2005 / 2006
(1) CAP: OPD & IPD (mild / moderate &
severe / intensive)
(2) NP: early-onset & late-onset

Content
1. Target therapy: S. pneumoniae, H. influenzae, M.
catarrhalis, Legionella spp., M. pneumoniae, C.
pneumoniae

2. Empiric therapy:
(1) CAP: OPD vs IPD & mild-to-moderate vs
severe / ICU
(2) HAP: risk factor (MDRO, P. aeruginosa) &
early vs late-onset
(3) VAP: P. aeruginosa, Acinetobacter spp., MRSA
3. Recommendation of parenteral antibiotic
therapy of HAP in adults

深層性黴菌症 (IFI)
1. Essential for survival: aggressive dx
approach & institution of anti-fungal
therapy
2. Conventional amphotericin B & drugrelated adverse effects
3. Symposium 2006: limited to candidiasis,
aspergillosis, zygomycosis,
cryptococcosis
4. Principles: acadmic, local pathogen /
resistance patterns, marketed in Taiwan

Content
1. Candidiasis: candidemia, chronic invasive
candidiasis, intra-abdominal, urinary,
oropharyngeal, esophageal
2. Aspergillosis: pulmonary, ENT, disseminated,
cerebral
3. Zygomycosis: rhino-cerebral, disseminated,
pulmonary
4. Cryptococcosis: pulmonary, CNS /
disseminated
5. Mx of IICP: keep opening pressure
<200mmH2O) & repeat drainage / VP shunt

肺結核治療
1. Incidence / prevalence of MTb in Taiwan:
64.84 / 5.56 per 100,000 in 2001
2. Consensus meeting 2004:
(1) viewpoint of primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not
regulations of BNHI
3. excluded: HIV co-infected, drug-durg interaction,
treatment of pediatrics, lack of rifabutin,
cycloserine

Content
1. pulmonary TB:
(1) new case: standard regimen & fixeddose combinations
(2) re-treatemnt: relapse, default, faiIure
(3) drug resistance: 1 & >1
(4) intolerance
(5) sepcial situations: LC, ESRD,
pregnancy

Content
2. extra-pulmonary TB:
(1) pleurisy, lymphadenitis, peritonitis,
pericarditis, GU tract dz
(2) bone / joint dz, pleural empyema
(3) meningitis, CNS dz
3. Dosage of anti-TB agents (adults)

外科手術預防性抗生素使用
1. 目的: selection pressure, cost & quality
2. Indication: clean-contaminated wound
3. Antibiotic prophylaxis should be used in close
proximity to surgical procedure; exception: C/S
4. Single dose of antibiotic before OP is sufficient
prophylaxis for most procedures & re-used is
indicated for longer procedures (every t1/2)
5. Problem: inappropriate timing of administration
& prolonged use post-OP => consensus 2003

Content
1. site/procedure == likely pathogens ==
recommened antibiotics == duration
2. Included:
large skin; oto-naso-larynx procedures;
cardiovascular; thoracic; orthopedics;
neurosurgery; colorectal; GS; urology;
Gyn/Obs

急性上呼吸道感染
1. Widespread resistance to 1st line antibiotic
and made primary care physicians in
treating their pts appropriately
2. NHRI data: OPD 65.4% for RTI and 1/3 for
URI
3. 2002 symposium for URIs:
acute sinusitis, acute otitis media, acute
pharyngo-tonsilitis, acute epiglottis, acute
bronchitis, common cold, influenza

泌尿道感染
1. consensus:
1999 => 2000
2. including:
(1) for primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not NHRI
(4) local epidemiology (pathogen & resistance
patterns)
(5) prophylactic antibiotic usage

Content
1. Asymptomatic bacteriuria
2. Acute bacterial cystitis
3. Acute complicated / uncomplicated
pyelonephritis
4. Acute / chronic prostatitis
5. Others:
nosocomial / catheter-related UTI, UTI in
pregnancy, UTI in children, recurrent UTI


Slide 7

適當使用抗生素
抗微生物製劑使用指引

感控室

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

1. 肺炎: J Microbiol Immunol Infect. 2007;40:279-283.
2. 深層性黴菌症: J Microbiol Immunol Infect 2006;39:523525.

3. 發熱性嗜中性球減少症: J Microbiol Immunol Infect
2005;38:455-457.

4. 肺結核治療: J Microbiol Immunol Infect 2004;37:382-384.

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

5. 外科手術預防性抗生素使用指引: J Microbiol
Immunol Infect 2004;37:71-74.

6. 急性上呼吸道感染: J Microbiol Immunol Infect
2002;35:272-273.

7. 抗HIV治療: J Microbiol Immunol Infect 2001;34:224-226.
8. 泌尿道感染: J Microbiol Immunol Infect 2000;33:271-272.

肺炎
1. Guideline / IDST (IDSA) 1999
2. Taiwan Society of Pulmonary & Critical
Medicine 2001: HAP, VAP
3. IDST consensus 2005 / 2006
(1) CAP: OPD & IPD (mild / moderate &
severe / intensive)
(2) NP: early-onset & late-onset

Content
1. Target therapy: S. pneumoniae, H. influenzae, M.
catarrhalis, Legionella spp., M. pneumoniae, C.
pneumoniae

2. Empiric therapy:
(1) CAP: OPD vs IPD & mild-to-moderate vs
severe / ICU
(2) HAP: risk factor (MDRO, P. aeruginosa) &
early vs late-onset
(3) VAP: P. aeruginosa, Acinetobacter spp., MRSA
3. Recommendation of parenteral antibiotic
therapy of HAP in adults

深層性黴菌症 (IFI)
1. Essential for survival: aggressive dx
approach & institution of anti-fungal
therapy
2. Conventional amphotericin B & drugrelated adverse effects
3. Symposium 2006: limited to candidiasis,
aspergillosis, zygomycosis,
cryptococcosis
4. Principles: acadmic, local pathogen /
resistance patterns, marketed in Taiwan

Content
1. Candidiasis: candidemia, chronic invasive
candidiasis, intra-abdominal, urinary,
oropharyngeal, esophageal
2. Aspergillosis: pulmonary, ENT, disseminated,
cerebral
3. Zygomycosis: rhino-cerebral, disseminated,
pulmonary
4. Cryptococcosis: pulmonary, CNS /
disseminated
5. Mx of IICP: keep opening pressure
<200mmH2O) & repeat drainage / VP shunt

肺結核治療
1. Incidence / prevalence of MTb in Taiwan:
64.84 / 5.56 per 100,000 in 2001
2. Consensus meeting 2004:
(1) viewpoint of primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not
regulations of BNHI
3. excluded: HIV co-infected, drug-durg interaction,
treatment of pediatrics, lack of rifabutin,
cycloserine

Content
1. pulmonary TB:
(1) new case: standard regimen & fixeddose combinations
(2) re-treatemnt: relapse, default, faiIure
(3) drug resistance: 1 & >1
(4) intolerance
(5) sepcial situations: LC, ESRD,
pregnancy

Content
2. extra-pulmonary TB:
(1) pleurisy, lymphadenitis, peritonitis,
pericarditis, GU tract dz
(2) bone / joint dz, pleural empyema
(3) meningitis, CNS dz
3. Dosage of anti-TB agents (adults)

外科手術預防性抗生素使用
1. 目的: selection pressure, cost & quality
2. Indication: clean-contaminated wound
3. Antibiotic prophylaxis should be used in close
proximity to surgical procedure; exception: C/S
4. Single dose of antibiotic before OP is sufficient
prophylaxis for most procedures & re-used is
indicated for longer procedures (every t1/2)
5. Problem: inappropriate timing of administration
& prolonged use post-OP => consensus 2003

Content
1. site/procedure == likely pathogens ==
recommened antibiotics == duration
2. Included:
large skin; oto-naso-larynx procedures;
cardiovascular; thoracic; orthopedics;
neurosurgery; colorectal; GS; urology;
Gyn/Obs

急性上呼吸道感染
1. Widespread resistance to 1st line antibiotic
and made primary care physicians in
treating their pts appropriately
2. NHRI data: OPD 65.4% for RTI and 1/3 for
URI
3. 2002 symposium for URIs:
acute sinusitis, acute otitis media, acute
pharyngo-tonsilitis, acute epiglottis, acute
bronchitis, common cold, influenza

泌尿道感染
1. consensus:
1999 => 2000
2. including:
(1) for primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not NHRI
(4) local epidemiology (pathogen & resistance
patterns)
(5) prophylactic antibiotic usage

Content
1. Asymptomatic bacteriuria
2. Acute bacterial cystitis
3. Acute complicated / uncomplicated
pyelonephritis
4. Acute / chronic prostatitis
5. Others:
nosocomial / catheter-related UTI, UTI in
pregnancy, UTI in children, recurrent UTI


Slide 8

適當使用抗生素
抗微生物製劑使用指引

感控室

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

1. 肺炎: J Microbiol Immunol Infect. 2007;40:279-283.
2. 深層性黴菌症: J Microbiol Immunol Infect 2006;39:523525.

3. 發熱性嗜中性球減少症: J Microbiol Immunol Infect
2005;38:455-457.

4. 肺結核治療: J Microbiol Immunol Infect 2004;37:382-384.

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

5. 外科手術預防性抗生素使用指引: J Microbiol
Immunol Infect 2004;37:71-74.

6. 急性上呼吸道感染: J Microbiol Immunol Infect
2002;35:272-273.

7. 抗HIV治療: J Microbiol Immunol Infect 2001;34:224-226.
8. 泌尿道感染: J Microbiol Immunol Infect 2000;33:271-272.

肺炎
1. Guideline / IDST (IDSA) 1999
2. Taiwan Society of Pulmonary & Critical
Medicine 2001: HAP, VAP
3. IDST consensus 2005 / 2006
(1) CAP: OPD & IPD (mild / moderate &
severe / intensive)
(2) NP: early-onset & late-onset

Content
1. Target therapy: S. pneumoniae, H. influenzae, M.
catarrhalis, Legionella spp., M. pneumoniae, C.
pneumoniae

2. Empiric therapy:
(1) CAP: OPD vs IPD & mild-to-moderate vs
severe / ICU
(2) HAP: risk factor (MDRO, P. aeruginosa) &
early vs late-onset
(3) VAP: P. aeruginosa, Acinetobacter spp., MRSA
3. Recommendation of parenteral antibiotic
therapy of HAP in adults

深層性黴菌症 (IFI)
1. Essential for survival: aggressive dx
approach & institution of anti-fungal
therapy
2. Conventional amphotericin B & drugrelated adverse effects
3. Symposium 2006: limited to candidiasis,
aspergillosis, zygomycosis,
cryptococcosis
4. Principles: acadmic, local pathogen /
resistance patterns, marketed in Taiwan

Content
1. Candidiasis: candidemia, chronic invasive
candidiasis, intra-abdominal, urinary,
oropharyngeal, esophageal
2. Aspergillosis: pulmonary, ENT, disseminated,
cerebral
3. Zygomycosis: rhino-cerebral, disseminated,
pulmonary
4. Cryptococcosis: pulmonary, CNS /
disseminated
5. Mx of IICP: keep opening pressure
<200mmH2O) & repeat drainage / VP shunt

肺結核治療
1. Incidence / prevalence of MTb in Taiwan:
64.84 / 5.56 per 100,000 in 2001
2. Consensus meeting 2004:
(1) viewpoint of primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not
regulations of BNHI
3. excluded: HIV co-infected, drug-durg interaction,
treatment of pediatrics, lack of rifabutin,
cycloserine

Content
1. pulmonary TB:
(1) new case: standard regimen & fixeddose combinations
(2) re-treatemnt: relapse, default, faiIure
(3) drug resistance: 1 & >1
(4) intolerance
(5) sepcial situations: LC, ESRD,
pregnancy

Content
2. extra-pulmonary TB:
(1) pleurisy, lymphadenitis, peritonitis,
pericarditis, GU tract dz
(2) bone / joint dz, pleural empyema
(3) meningitis, CNS dz
3. Dosage of anti-TB agents (adults)

外科手術預防性抗生素使用
1. 目的: selection pressure, cost & quality
2. Indication: clean-contaminated wound
3. Antibiotic prophylaxis should be used in close
proximity to surgical procedure; exception: C/S
4. Single dose of antibiotic before OP is sufficient
prophylaxis for most procedures & re-used is
indicated for longer procedures (every t1/2)
5. Problem: inappropriate timing of administration
& prolonged use post-OP => consensus 2003

Content
1. site/procedure == likely pathogens ==
recommened antibiotics == duration
2. Included:
large skin; oto-naso-larynx procedures;
cardiovascular; thoracic; orthopedics;
neurosurgery; colorectal; GS; urology;
Gyn/Obs

急性上呼吸道感染
1. Widespread resistance to 1st line antibiotic
and made primary care physicians in
treating their pts appropriately
2. NHRI data: OPD 65.4% for RTI and 1/3 for
URI
3. 2002 symposium for URIs:
acute sinusitis, acute otitis media, acute
pharyngo-tonsilitis, acute epiglottis, acute
bronchitis, common cold, influenza

泌尿道感染
1. consensus:
1999 => 2000
2. including:
(1) for primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not NHRI
(4) local epidemiology (pathogen & resistance
patterns)
(5) prophylactic antibiotic usage

Content
1. Asymptomatic bacteriuria
2. Acute bacterial cystitis
3. Acute complicated / uncomplicated
pyelonephritis
4. Acute / chronic prostatitis
5. Others:
nosocomial / catheter-related UTI, UTI in
pregnancy, UTI in children, recurrent UTI


Slide 9

適當使用抗生素
抗微生物製劑使用指引

感控室

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

1. 肺炎: J Microbiol Immunol Infect. 2007;40:279-283.
2. 深層性黴菌症: J Microbiol Immunol Infect 2006;39:523525.

3. 發熱性嗜中性球減少症: J Microbiol Immunol Infect
2005;38:455-457.

4. 肺結核治療: J Microbiol Immunol Infect 2004;37:382-384.

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

5. 外科手術預防性抗生素使用指引: J Microbiol
Immunol Infect 2004;37:71-74.

6. 急性上呼吸道感染: J Microbiol Immunol Infect
2002;35:272-273.

7. 抗HIV治療: J Microbiol Immunol Infect 2001;34:224-226.
8. 泌尿道感染: J Microbiol Immunol Infect 2000;33:271-272.

肺炎
1. Guideline / IDST (IDSA) 1999
2. Taiwan Society of Pulmonary & Critical
Medicine 2001: HAP, VAP
3. IDST consensus 2005 / 2006
(1) CAP: OPD & IPD (mild / moderate &
severe / intensive)
(2) NP: early-onset & late-onset

Content
1. Target therapy: S. pneumoniae, H. influenzae, M.
catarrhalis, Legionella spp., M. pneumoniae, C.
pneumoniae

2. Empiric therapy:
(1) CAP: OPD vs IPD & mild-to-moderate vs
severe / ICU
(2) HAP: risk factor (MDRO, P. aeruginosa) &
early vs late-onset
(3) VAP: P. aeruginosa, Acinetobacter spp., MRSA
3. Recommendation of parenteral antibiotic
therapy of HAP in adults

深層性黴菌症 (IFI)
1. Essential for survival: aggressive dx
approach & institution of anti-fungal
therapy
2. Conventional amphotericin B & drugrelated adverse effects
3. Symposium 2006: limited to candidiasis,
aspergillosis, zygomycosis,
cryptococcosis
4. Principles: acadmic, local pathogen /
resistance patterns, marketed in Taiwan

Content
1. Candidiasis: candidemia, chronic invasive
candidiasis, intra-abdominal, urinary,
oropharyngeal, esophageal
2. Aspergillosis: pulmonary, ENT, disseminated,
cerebral
3. Zygomycosis: rhino-cerebral, disseminated,
pulmonary
4. Cryptococcosis: pulmonary, CNS /
disseminated
5. Mx of IICP: keep opening pressure
<200mmH2O) & repeat drainage / VP shunt

肺結核治療
1. Incidence / prevalence of MTb in Taiwan:
64.84 / 5.56 per 100,000 in 2001
2. Consensus meeting 2004:
(1) viewpoint of primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not
regulations of BNHI
3. excluded: HIV co-infected, drug-durg interaction,
treatment of pediatrics, lack of rifabutin,
cycloserine

Content
1. pulmonary TB:
(1) new case: standard regimen & fixeddose combinations
(2) re-treatemnt: relapse, default, faiIure
(3) drug resistance: 1 & >1
(4) intolerance
(5) sepcial situations: LC, ESRD,
pregnancy

Content
2. extra-pulmonary TB:
(1) pleurisy, lymphadenitis, peritonitis,
pericarditis, GU tract dz
(2) bone / joint dz, pleural empyema
(3) meningitis, CNS dz
3. Dosage of anti-TB agents (adults)

外科手術預防性抗生素使用
1. 目的: selection pressure, cost & quality
2. Indication: clean-contaminated wound
3. Antibiotic prophylaxis should be used in close
proximity to surgical procedure; exception: C/S
4. Single dose of antibiotic before OP is sufficient
prophylaxis for most procedures & re-used is
indicated for longer procedures (every t1/2)
5. Problem: inappropriate timing of administration
& prolonged use post-OP => consensus 2003

Content
1. site/procedure == likely pathogens ==
recommened antibiotics == duration
2. Included:
large skin; oto-naso-larynx procedures;
cardiovascular; thoracic; orthopedics;
neurosurgery; colorectal; GS; urology;
Gyn/Obs

急性上呼吸道感染
1. Widespread resistance to 1st line antibiotic
and made primary care physicians in
treating their pts appropriately
2. NHRI data: OPD 65.4% for RTI and 1/3 for
URI
3. 2002 symposium for URIs:
acute sinusitis, acute otitis media, acute
pharyngo-tonsilitis, acute epiglottis, acute
bronchitis, common cold, influenza

泌尿道感染
1. consensus:
1999 => 2000
2. including:
(1) for primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not NHRI
(4) local epidemiology (pathogen & resistance
patterns)
(5) prophylactic antibiotic usage

Content
1. Asymptomatic bacteriuria
2. Acute bacterial cystitis
3. Acute complicated / uncomplicated
pyelonephritis
4. Acute / chronic prostatitis
5. Others:
nosocomial / catheter-related UTI, UTI in
pregnancy, UTI in children, recurrent UTI


Slide 10

適當使用抗生素
抗微生物製劑使用指引

感控室

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

1. 肺炎: J Microbiol Immunol Infect. 2007;40:279-283.
2. 深層性黴菌症: J Microbiol Immunol Infect 2006;39:523525.

3. 發熱性嗜中性球減少症: J Microbiol Immunol Infect
2005;38:455-457.

4. 肺結核治療: J Microbiol Immunol Infect 2004;37:382-384.

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

5. 外科手術預防性抗生素使用指引: J Microbiol
Immunol Infect 2004;37:71-74.

6. 急性上呼吸道感染: J Microbiol Immunol Infect
2002;35:272-273.

7. 抗HIV治療: J Microbiol Immunol Infect 2001;34:224-226.
8. 泌尿道感染: J Microbiol Immunol Infect 2000;33:271-272.

肺炎
1. Guideline / IDST (IDSA) 1999
2. Taiwan Society of Pulmonary & Critical
Medicine 2001: HAP, VAP
3. IDST consensus 2005 / 2006
(1) CAP: OPD & IPD (mild / moderate &
severe / intensive)
(2) NP: early-onset & late-onset

Content
1. Target therapy: S. pneumoniae, H. influenzae, M.
catarrhalis, Legionella spp., M. pneumoniae, C.
pneumoniae

2. Empiric therapy:
(1) CAP: OPD vs IPD & mild-to-moderate vs
severe / ICU
(2) HAP: risk factor (MDRO, P. aeruginosa) &
early vs late-onset
(3) VAP: P. aeruginosa, Acinetobacter spp., MRSA
3. Recommendation of parenteral antibiotic
therapy of HAP in adults

深層性黴菌症 (IFI)
1. Essential for survival: aggressive dx
approach & institution of anti-fungal
therapy
2. Conventional amphotericin B & drugrelated adverse effects
3. Symposium 2006: limited to candidiasis,
aspergillosis, zygomycosis,
cryptococcosis
4. Principles: acadmic, local pathogen /
resistance patterns, marketed in Taiwan

Content
1. Candidiasis: candidemia, chronic invasive
candidiasis, intra-abdominal, urinary,
oropharyngeal, esophageal
2. Aspergillosis: pulmonary, ENT, disseminated,
cerebral
3. Zygomycosis: rhino-cerebral, disseminated,
pulmonary
4. Cryptococcosis: pulmonary, CNS /
disseminated
5. Mx of IICP: keep opening pressure
<200mmH2O) & repeat drainage / VP shunt

肺結核治療
1. Incidence / prevalence of MTb in Taiwan:
64.84 / 5.56 per 100,000 in 2001
2. Consensus meeting 2004:
(1) viewpoint of primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not
regulations of BNHI
3. excluded: HIV co-infected, drug-durg interaction,
treatment of pediatrics, lack of rifabutin,
cycloserine

Content
1. pulmonary TB:
(1) new case: standard regimen & fixeddose combinations
(2) re-treatemnt: relapse, default, faiIure
(3) drug resistance: 1 & >1
(4) intolerance
(5) sepcial situations: LC, ESRD,
pregnancy

Content
2. extra-pulmonary TB:
(1) pleurisy, lymphadenitis, peritonitis,
pericarditis, GU tract dz
(2) bone / joint dz, pleural empyema
(3) meningitis, CNS dz
3. Dosage of anti-TB agents (adults)

外科手術預防性抗生素使用
1. 目的: selection pressure, cost & quality
2. Indication: clean-contaminated wound
3. Antibiotic prophylaxis should be used in close
proximity to surgical procedure; exception: C/S
4. Single dose of antibiotic before OP is sufficient
prophylaxis for most procedures & re-used is
indicated for longer procedures (every t1/2)
5. Problem: inappropriate timing of administration
& prolonged use post-OP => consensus 2003

Content
1. site/procedure == likely pathogens ==
recommened antibiotics == duration
2. Included:
large skin; oto-naso-larynx procedures;
cardiovascular; thoracic; orthopedics;
neurosurgery; colorectal; GS; urology;
Gyn/Obs

急性上呼吸道感染
1. Widespread resistance to 1st line antibiotic
and made primary care physicians in
treating their pts appropriately
2. NHRI data: OPD 65.4% for RTI and 1/3 for
URI
3. 2002 symposium for URIs:
acute sinusitis, acute otitis media, acute
pharyngo-tonsilitis, acute epiglottis, acute
bronchitis, common cold, influenza

泌尿道感染
1. consensus:
1999 => 2000
2. including:
(1) for primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not NHRI
(4) local epidemiology (pathogen & resistance
patterns)
(5) prophylactic antibiotic usage

Content
1. Asymptomatic bacteriuria
2. Acute bacterial cystitis
3. Acute complicated / uncomplicated
pyelonephritis
4. Acute / chronic prostatitis
5. Others:
nosocomial / catheter-related UTI, UTI in
pregnancy, UTI in children, recurrent UTI


Slide 11

適當使用抗生素
抗微生物製劑使用指引

感控室

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

1. 肺炎: J Microbiol Immunol Infect. 2007;40:279-283.
2. 深層性黴菌症: J Microbiol Immunol Infect 2006;39:523525.

3. 發熱性嗜中性球減少症: J Microbiol Immunol Infect
2005;38:455-457.

4. 肺結核治療: J Microbiol Immunol Infect 2004;37:382-384.

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

5. 外科手術預防性抗生素使用指引: J Microbiol
Immunol Infect 2004;37:71-74.

6. 急性上呼吸道感染: J Microbiol Immunol Infect
2002;35:272-273.

7. 抗HIV治療: J Microbiol Immunol Infect 2001;34:224-226.
8. 泌尿道感染: J Microbiol Immunol Infect 2000;33:271-272.

肺炎
1. Guideline / IDST (IDSA) 1999
2. Taiwan Society of Pulmonary & Critical
Medicine 2001: HAP, VAP
3. IDST consensus 2005 / 2006
(1) CAP: OPD & IPD (mild / moderate &
severe / intensive)
(2) NP: early-onset & late-onset

Content
1. Target therapy: S. pneumoniae, H. influenzae, M.
catarrhalis, Legionella spp., M. pneumoniae, C.
pneumoniae

2. Empiric therapy:
(1) CAP: OPD vs IPD & mild-to-moderate vs
severe / ICU
(2) HAP: risk factor (MDRO, P. aeruginosa) &
early vs late-onset
(3) VAP: P. aeruginosa, Acinetobacter spp., MRSA
3. Recommendation of parenteral antibiotic
therapy of HAP in adults

深層性黴菌症 (IFI)
1. Essential for survival: aggressive dx
approach & institution of anti-fungal
therapy
2. Conventional amphotericin B & drugrelated adverse effects
3. Symposium 2006: limited to candidiasis,
aspergillosis, zygomycosis,
cryptococcosis
4. Principles: acadmic, local pathogen /
resistance patterns, marketed in Taiwan

Content
1. Candidiasis: candidemia, chronic invasive
candidiasis, intra-abdominal, urinary,
oropharyngeal, esophageal
2. Aspergillosis: pulmonary, ENT, disseminated,
cerebral
3. Zygomycosis: rhino-cerebral, disseminated,
pulmonary
4. Cryptococcosis: pulmonary, CNS /
disseminated
5. Mx of IICP: keep opening pressure
<200mmH2O) & repeat drainage / VP shunt

肺結核治療
1. Incidence / prevalence of MTb in Taiwan:
64.84 / 5.56 per 100,000 in 2001
2. Consensus meeting 2004:
(1) viewpoint of primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not
regulations of BNHI
3. excluded: HIV co-infected, drug-durg interaction,
treatment of pediatrics, lack of rifabutin,
cycloserine

Content
1. pulmonary TB:
(1) new case: standard regimen & fixeddose combinations
(2) re-treatemnt: relapse, default, faiIure
(3) drug resistance: 1 & >1
(4) intolerance
(5) sepcial situations: LC, ESRD,
pregnancy

Content
2. extra-pulmonary TB:
(1) pleurisy, lymphadenitis, peritonitis,
pericarditis, GU tract dz
(2) bone / joint dz, pleural empyema
(3) meningitis, CNS dz
3. Dosage of anti-TB agents (adults)

外科手術預防性抗生素使用
1. 目的: selection pressure, cost & quality
2. Indication: clean-contaminated wound
3. Antibiotic prophylaxis should be used in close
proximity to surgical procedure; exception: C/S
4. Single dose of antibiotic before OP is sufficient
prophylaxis for most procedures & re-used is
indicated for longer procedures (every t1/2)
5. Problem: inappropriate timing of administration
& prolonged use post-OP => consensus 2003

Content
1. site/procedure == likely pathogens ==
recommened antibiotics == duration
2. Included:
large skin; oto-naso-larynx procedures;
cardiovascular; thoracic; orthopedics;
neurosurgery; colorectal; GS; urology;
Gyn/Obs

急性上呼吸道感染
1. Widespread resistance to 1st line antibiotic
and made primary care physicians in
treating their pts appropriately
2. NHRI data: OPD 65.4% for RTI and 1/3 for
URI
3. 2002 symposium for URIs:
acute sinusitis, acute otitis media, acute
pharyngo-tonsilitis, acute epiglottis, acute
bronchitis, common cold, influenza

泌尿道感染
1. consensus:
1999 => 2000
2. including:
(1) for primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not NHRI
(4) local epidemiology (pathogen & resistance
patterns)
(5) prophylactic antibiotic usage

Content
1. Asymptomatic bacteriuria
2. Acute bacterial cystitis
3. Acute complicated / uncomplicated
pyelonephritis
4. Acute / chronic prostatitis
5. Others:
nosocomial / catheter-related UTI, UTI in
pregnancy, UTI in children, recurrent UTI


Slide 12

適當使用抗生素
抗微生物製劑使用指引

感控室

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

1. 肺炎: J Microbiol Immunol Infect. 2007;40:279-283.
2. 深層性黴菌症: J Microbiol Immunol Infect 2006;39:523525.

3. 發熱性嗜中性球減少症: J Microbiol Immunol Infect
2005;38:455-457.

4. 肺結核治療: J Microbiol Immunol Infect 2004;37:382-384.

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

5. 外科手術預防性抗生素使用指引: J Microbiol
Immunol Infect 2004;37:71-74.

6. 急性上呼吸道感染: J Microbiol Immunol Infect
2002;35:272-273.

7. 抗HIV治療: J Microbiol Immunol Infect 2001;34:224-226.
8. 泌尿道感染: J Microbiol Immunol Infect 2000;33:271-272.

肺炎
1. Guideline / IDST (IDSA) 1999
2. Taiwan Society of Pulmonary & Critical
Medicine 2001: HAP, VAP
3. IDST consensus 2005 / 2006
(1) CAP: OPD & IPD (mild / moderate &
severe / intensive)
(2) NP: early-onset & late-onset

Content
1. Target therapy: S. pneumoniae, H. influenzae, M.
catarrhalis, Legionella spp., M. pneumoniae, C.
pneumoniae

2. Empiric therapy:
(1) CAP: OPD vs IPD & mild-to-moderate vs
severe / ICU
(2) HAP: risk factor (MDRO, P. aeruginosa) &
early vs late-onset
(3) VAP: P. aeruginosa, Acinetobacter spp., MRSA
3. Recommendation of parenteral antibiotic
therapy of HAP in adults

深層性黴菌症 (IFI)
1. Essential for survival: aggressive dx
approach & institution of anti-fungal
therapy
2. Conventional amphotericin B & drugrelated adverse effects
3. Symposium 2006: limited to candidiasis,
aspergillosis, zygomycosis,
cryptococcosis
4. Principles: acadmic, local pathogen /
resistance patterns, marketed in Taiwan

Content
1. Candidiasis: candidemia, chronic invasive
candidiasis, intra-abdominal, urinary,
oropharyngeal, esophageal
2. Aspergillosis: pulmonary, ENT, disseminated,
cerebral
3. Zygomycosis: rhino-cerebral, disseminated,
pulmonary
4. Cryptococcosis: pulmonary, CNS /
disseminated
5. Mx of IICP: keep opening pressure
<200mmH2O) & repeat drainage / VP shunt

肺結核治療
1. Incidence / prevalence of MTb in Taiwan:
64.84 / 5.56 per 100,000 in 2001
2. Consensus meeting 2004:
(1) viewpoint of primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not
regulations of BNHI
3. excluded: HIV co-infected, drug-durg interaction,
treatment of pediatrics, lack of rifabutin,
cycloserine

Content
1. pulmonary TB:
(1) new case: standard regimen & fixeddose combinations
(2) re-treatemnt: relapse, default, faiIure
(3) drug resistance: 1 & >1
(4) intolerance
(5) sepcial situations: LC, ESRD,
pregnancy

Content
2. extra-pulmonary TB:
(1) pleurisy, lymphadenitis, peritonitis,
pericarditis, GU tract dz
(2) bone / joint dz, pleural empyema
(3) meningitis, CNS dz
3. Dosage of anti-TB agents (adults)

外科手術預防性抗生素使用
1. 目的: selection pressure, cost & quality
2. Indication: clean-contaminated wound
3. Antibiotic prophylaxis should be used in close
proximity to surgical procedure; exception: C/S
4. Single dose of antibiotic before OP is sufficient
prophylaxis for most procedures & re-used is
indicated for longer procedures (every t1/2)
5. Problem: inappropriate timing of administration
& prolonged use post-OP => consensus 2003

Content
1. site/procedure == likely pathogens ==
recommened antibiotics == duration
2. Included:
large skin; oto-naso-larynx procedures;
cardiovascular; thoracic; orthopedics;
neurosurgery; colorectal; GS; urology;
Gyn/Obs

急性上呼吸道感染
1. Widespread resistance to 1st line antibiotic
and made primary care physicians in
treating their pts appropriately
2. NHRI data: OPD 65.4% for RTI and 1/3 for
URI
3. 2002 symposium for URIs:
acute sinusitis, acute otitis media, acute
pharyngo-tonsilitis, acute epiglottis, acute
bronchitis, common cold, influenza

泌尿道感染
1. consensus:
1999 => 2000
2. including:
(1) for primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not NHRI
(4) local epidemiology (pathogen & resistance
patterns)
(5) prophylactic antibiotic usage

Content
1. Asymptomatic bacteriuria
2. Acute bacterial cystitis
3. Acute complicated / uncomplicated
pyelonephritis
4. Acute / chronic prostatitis
5. Others:
nosocomial / catheter-related UTI, UTI in
pregnancy, UTI in children, recurrent UTI


Slide 13

適當使用抗生素
抗微生物製劑使用指引

感控室

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

1. 肺炎: J Microbiol Immunol Infect. 2007;40:279-283.
2. 深層性黴菌症: J Microbiol Immunol Infect 2006;39:523525.

3. 發熱性嗜中性球減少症: J Microbiol Immunol Infect
2005;38:455-457.

4. 肺結核治療: J Microbiol Immunol Infect 2004;37:382-384.

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

5. 外科手術預防性抗生素使用指引: J Microbiol
Immunol Infect 2004;37:71-74.

6. 急性上呼吸道感染: J Microbiol Immunol Infect
2002;35:272-273.

7. 抗HIV治療: J Microbiol Immunol Infect 2001;34:224-226.
8. 泌尿道感染: J Microbiol Immunol Infect 2000;33:271-272.

肺炎
1. Guideline / IDST (IDSA) 1999
2. Taiwan Society of Pulmonary & Critical
Medicine 2001: HAP, VAP
3. IDST consensus 2005 / 2006
(1) CAP: OPD & IPD (mild / moderate &
severe / intensive)
(2) NP: early-onset & late-onset

Content
1. Target therapy: S. pneumoniae, H. influenzae, M.
catarrhalis, Legionella spp., M. pneumoniae, C.
pneumoniae

2. Empiric therapy:
(1) CAP: OPD vs IPD & mild-to-moderate vs
severe / ICU
(2) HAP: risk factor (MDRO, P. aeruginosa) &
early vs late-onset
(3) VAP: P. aeruginosa, Acinetobacter spp., MRSA
3. Recommendation of parenteral antibiotic
therapy of HAP in adults

深層性黴菌症 (IFI)
1. Essential for survival: aggressive dx
approach & institution of anti-fungal
therapy
2. Conventional amphotericin B & drugrelated adverse effects
3. Symposium 2006: limited to candidiasis,
aspergillosis, zygomycosis,
cryptococcosis
4. Principles: acadmic, local pathogen /
resistance patterns, marketed in Taiwan

Content
1. Candidiasis: candidemia, chronic invasive
candidiasis, intra-abdominal, urinary,
oropharyngeal, esophageal
2. Aspergillosis: pulmonary, ENT, disseminated,
cerebral
3. Zygomycosis: rhino-cerebral, disseminated,
pulmonary
4. Cryptococcosis: pulmonary, CNS /
disseminated
5. Mx of IICP: keep opening pressure
<200mmH2O) & repeat drainage / VP shunt

肺結核治療
1. Incidence / prevalence of MTb in Taiwan:
64.84 / 5.56 per 100,000 in 2001
2. Consensus meeting 2004:
(1) viewpoint of primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not
regulations of BNHI
3. excluded: HIV co-infected, drug-durg interaction,
treatment of pediatrics, lack of rifabutin,
cycloserine

Content
1. pulmonary TB:
(1) new case: standard regimen & fixeddose combinations
(2) re-treatemnt: relapse, default, faiIure
(3) drug resistance: 1 & >1
(4) intolerance
(5) sepcial situations: LC, ESRD,
pregnancy

Content
2. extra-pulmonary TB:
(1) pleurisy, lymphadenitis, peritonitis,
pericarditis, GU tract dz
(2) bone / joint dz, pleural empyema
(3) meningitis, CNS dz
3. Dosage of anti-TB agents (adults)

外科手術預防性抗生素使用
1. 目的: selection pressure, cost & quality
2. Indication: clean-contaminated wound
3. Antibiotic prophylaxis should be used in close
proximity to surgical procedure; exception: C/S
4. Single dose of antibiotic before OP is sufficient
prophylaxis for most procedures & re-used is
indicated for longer procedures (every t1/2)
5. Problem: inappropriate timing of administration
& prolonged use post-OP => consensus 2003

Content
1. site/procedure == likely pathogens ==
recommened antibiotics == duration
2. Included:
large skin; oto-naso-larynx procedures;
cardiovascular; thoracic; orthopedics;
neurosurgery; colorectal; GS; urology;
Gyn/Obs

急性上呼吸道感染
1. Widespread resistance to 1st line antibiotic
and made primary care physicians in
treating their pts appropriately
2. NHRI data: OPD 65.4% for RTI and 1/3 for
URI
3. 2002 symposium for URIs:
acute sinusitis, acute otitis media, acute
pharyngo-tonsilitis, acute epiglottis, acute
bronchitis, common cold, influenza

泌尿道感染
1. consensus:
1999 => 2000
2. including:
(1) for primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not NHRI
(4) local epidemiology (pathogen & resistance
patterns)
(5) prophylactic antibiotic usage

Content
1. Asymptomatic bacteriuria
2. Acute bacterial cystitis
3. Acute complicated / uncomplicated
pyelonephritis
4. Acute / chronic prostatitis
5. Others:
nosocomial / catheter-related UTI, UTI in
pregnancy, UTI in children, recurrent UTI


Slide 14

適當使用抗生素
抗微生物製劑使用指引

感控室

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

1. 肺炎: J Microbiol Immunol Infect. 2007;40:279-283.
2. 深層性黴菌症: J Microbiol Immunol Infect 2006;39:523525.

3. 發熱性嗜中性球減少症: J Microbiol Immunol Infect
2005;38:455-457.

4. 肺結核治療: J Microbiol Immunol Infect 2004;37:382-384.

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

5. 外科手術預防性抗生素使用指引: J Microbiol
Immunol Infect 2004;37:71-74.

6. 急性上呼吸道感染: J Microbiol Immunol Infect
2002;35:272-273.

7. 抗HIV治療: J Microbiol Immunol Infect 2001;34:224-226.
8. 泌尿道感染: J Microbiol Immunol Infect 2000;33:271-272.

肺炎
1. Guideline / IDST (IDSA) 1999
2. Taiwan Society of Pulmonary & Critical
Medicine 2001: HAP, VAP
3. IDST consensus 2005 / 2006
(1) CAP: OPD & IPD (mild / moderate &
severe / intensive)
(2) NP: early-onset & late-onset

Content
1. Target therapy: S. pneumoniae, H. influenzae, M.
catarrhalis, Legionella spp., M. pneumoniae, C.
pneumoniae

2. Empiric therapy:
(1) CAP: OPD vs IPD & mild-to-moderate vs
severe / ICU
(2) HAP: risk factor (MDRO, P. aeruginosa) &
early vs late-onset
(3) VAP: P. aeruginosa, Acinetobacter spp., MRSA
3. Recommendation of parenteral antibiotic
therapy of HAP in adults

深層性黴菌症 (IFI)
1. Essential for survival: aggressive dx
approach & institution of anti-fungal
therapy
2. Conventional amphotericin B & drugrelated adverse effects
3. Symposium 2006: limited to candidiasis,
aspergillosis, zygomycosis,
cryptococcosis
4. Principles: acadmic, local pathogen /
resistance patterns, marketed in Taiwan

Content
1. Candidiasis: candidemia, chronic invasive
candidiasis, intra-abdominal, urinary,
oropharyngeal, esophageal
2. Aspergillosis: pulmonary, ENT, disseminated,
cerebral
3. Zygomycosis: rhino-cerebral, disseminated,
pulmonary
4. Cryptococcosis: pulmonary, CNS /
disseminated
5. Mx of IICP: keep opening pressure
<200mmH2O) & repeat drainage / VP shunt

肺結核治療
1. Incidence / prevalence of MTb in Taiwan:
64.84 / 5.56 per 100,000 in 2001
2. Consensus meeting 2004:
(1) viewpoint of primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not
regulations of BNHI
3. excluded: HIV co-infected, drug-durg interaction,
treatment of pediatrics, lack of rifabutin,
cycloserine

Content
1. pulmonary TB:
(1) new case: standard regimen & fixeddose combinations
(2) re-treatemnt: relapse, default, faiIure
(3) drug resistance: 1 & >1
(4) intolerance
(5) sepcial situations: LC, ESRD,
pregnancy

Content
2. extra-pulmonary TB:
(1) pleurisy, lymphadenitis, peritonitis,
pericarditis, GU tract dz
(2) bone / joint dz, pleural empyema
(3) meningitis, CNS dz
3. Dosage of anti-TB agents (adults)

外科手術預防性抗生素使用
1. 目的: selection pressure, cost & quality
2. Indication: clean-contaminated wound
3. Antibiotic prophylaxis should be used in close
proximity to surgical procedure; exception: C/S
4. Single dose of antibiotic before OP is sufficient
prophylaxis for most procedures & re-used is
indicated for longer procedures (every t1/2)
5. Problem: inappropriate timing of administration
& prolonged use post-OP => consensus 2003

Content
1. site/procedure == likely pathogens ==
recommened antibiotics == duration
2. Included:
large skin; oto-naso-larynx procedures;
cardiovascular; thoracic; orthopedics;
neurosurgery; colorectal; GS; urology;
Gyn/Obs

急性上呼吸道感染
1. Widespread resistance to 1st line antibiotic
and made primary care physicians in
treating their pts appropriately
2. NHRI data: OPD 65.4% for RTI and 1/3 for
URI
3. 2002 symposium for URIs:
acute sinusitis, acute otitis media, acute
pharyngo-tonsilitis, acute epiglottis, acute
bronchitis, common cold, influenza

泌尿道感染
1. consensus:
1999 => 2000
2. including:
(1) for primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not NHRI
(4) local epidemiology (pathogen & resistance
patterns)
(5) prophylactic antibiotic usage

Content
1. Asymptomatic bacteriuria
2. Acute bacterial cystitis
3. Acute complicated / uncomplicated
pyelonephritis
4. Acute / chronic prostatitis
5. Others:
nosocomial / catheter-related UTI, UTI in
pregnancy, UTI in children, recurrent UTI


Slide 15

適當使用抗生素
抗微生物製劑使用指引

感控室

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

1. 肺炎: J Microbiol Immunol Infect. 2007;40:279-283.
2. 深層性黴菌症: J Microbiol Immunol Infect 2006;39:523525.

3. 發熱性嗜中性球減少症: J Microbiol Immunol Infect
2005;38:455-457.

4. 肺結核治療: J Microbiol Immunol Infect 2004;37:382-384.

八種感染症之抗微生物製劑使用指引
台灣感染症醫學會

5. 外科手術預防性抗生素使用指引: J Microbiol
Immunol Infect 2004;37:71-74.

6. 急性上呼吸道感染: J Microbiol Immunol Infect
2002;35:272-273.

7. 抗HIV治療: J Microbiol Immunol Infect 2001;34:224-226.
8. 泌尿道感染: J Microbiol Immunol Infect 2000;33:271-272.

肺炎
1. Guideline / IDST (IDSA) 1999
2. Taiwan Society of Pulmonary & Critical
Medicine 2001: HAP, VAP
3. IDST consensus 2005 / 2006
(1) CAP: OPD & IPD (mild / moderate &
severe / intensive)
(2) NP: early-onset & late-onset

Content
1. Target therapy: S. pneumoniae, H. influenzae, M.
catarrhalis, Legionella spp., M. pneumoniae, C.
pneumoniae

2. Empiric therapy:
(1) CAP: OPD vs IPD & mild-to-moderate vs
severe / ICU
(2) HAP: risk factor (MDRO, P. aeruginosa) &
early vs late-onset
(3) VAP: P. aeruginosa, Acinetobacter spp., MRSA
3. Recommendation of parenteral antibiotic
therapy of HAP in adults

深層性黴菌症 (IFI)
1. Essential for survival: aggressive dx
approach & institution of anti-fungal
therapy
2. Conventional amphotericin B & drugrelated adverse effects
3. Symposium 2006: limited to candidiasis,
aspergillosis, zygomycosis,
cryptococcosis
4. Principles: acadmic, local pathogen /
resistance patterns, marketed in Taiwan

Content
1. Candidiasis: candidemia, chronic invasive
candidiasis, intra-abdominal, urinary,
oropharyngeal, esophageal
2. Aspergillosis: pulmonary, ENT, disseminated,
cerebral
3. Zygomycosis: rhino-cerebral, disseminated,
pulmonary
4. Cryptococcosis: pulmonary, CNS /
disseminated
5. Mx of IICP: keep opening pressure
<200mmH2O) & repeat drainage / VP shunt

肺結核治療
1. Incidence / prevalence of MTb in Taiwan:
64.84 / 5.56 per 100,000 in 2001
2. Consensus meeting 2004:
(1) viewpoint of primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not
regulations of BNHI
3. excluded: HIV co-infected, drug-durg interaction,
treatment of pediatrics, lack of rifabutin,
cycloserine

Content
1. pulmonary TB:
(1) new case: standard regimen & fixeddose combinations
(2) re-treatemnt: relapse, default, faiIure
(3) drug resistance: 1 & >1
(4) intolerance
(5) sepcial situations: LC, ESRD,
pregnancy

Content
2. extra-pulmonary TB:
(1) pleurisy, lymphadenitis, peritonitis,
pericarditis, GU tract dz
(2) bone / joint dz, pleural empyema
(3) meningitis, CNS dz
3. Dosage of anti-TB agents (adults)

外科手術預防性抗生素使用
1. 目的: selection pressure, cost & quality
2. Indication: clean-contaminated wound
3. Antibiotic prophylaxis should be used in close
proximity to surgical procedure; exception: C/S
4. Single dose of antibiotic before OP is sufficient
prophylaxis for most procedures & re-used is
indicated for longer procedures (every t1/2)
5. Problem: inappropriate timing of administration
& prolonged use post-OP => consensus 2003

Content
1. site/procedure == likely pathogens ==
recommened antibiotics == duration
2. Included:
large skin; oto-naso-larynx procedures;
cardiovascular; thoracic; orthopedics;
neurosurgery; colorectal; GS; urology;
Gyn/Obs

急性上呼吸道感染
1. Widespread resistance to 1st line antibiotic
and made primary care physicians in
treating their pts appropriately
2. NHRI data: OPD 65.4% for RTI and 1/3 for
URI
3. 2002 symposium for URIs:
acute sinusitis, acute otitis media, acute
pharyngo-tonsilitis, acute epiglottis, acute
bronchitis, common cold, influenza

泌尿道感染
1. consensus:
1999 => 2000
2. including:
(1) for primary care physicians
(2) already marketed in Taiwan
(3) based on academic principles, but not NHRI
(4) local epidemiology (pathogen & resistance
patterns)
(5) prophylactic antibiotic usage

Content
1. Asymptomatic bacteriuria
2. Acute bacterial cystitis
3. Acute complicated / uncomplicated
pyelonephritis
4. Acute / chronic prostatitis
5. Others:
nosocomial / catheter-related UTI, UTI in
pregnancy, UTI in children, recurrent UTI