2.有關蜂窩性組織炎（cellulitis）口服抗生素治療之敘述，下列何者正確？
(A) 對penicillin過敏的病人應使用ciprofloxacin
(B) 細菌培養還沒有結果時，應先以外用抗生素來治療
(C) 如果抗生素選用正確，一般2～3天就應該退燒，且臨床症狀應該有改善
(D) 一定要等到有細菌培養結果，才能選擇正確的抗生素開始治療

蜂窩性組織炎 (cellulitis) 是侵犯到表皮、真皮或皮下組織的感染症，通常以紅腫、發熱、壓痛表現。 非化膿性與化膿性蜂窩性組織炎的差異在於，後者通常與金黃色葡萄球菌 (S. aureus) 有關。 
非化膿性蜂窩性組織炎
輕中度：抗生素選擇為非後線的＂cephalosporins＂或＂penicillins＂為主，例如cephalexin或dicloxacillin等。
口服治療失敗，或符合兩項以上SIRS標準，靜脈注射抗生素選擇則是cefazolin或ceftriaxone或penicllin G。 嚴重：需判高抗藥性菌種 (MRSA) 感染的可能性，如果高度懷疑或確認，則必須使用可有效對抗MRSA的抗生素，如vancomycin、linezolid、daptomycin或tigecycline等。 
參考：http://jerryljw.blogspot.tw/2016/09/treatment-of-cellulitis.html

小弟想請問A錯在哪呢?

感謝各位高手

Cellulitis without draining or abscess

In cases of cellulitis without draining wounds or abscess, streptococci continue to be the likely etiology, and beta-lactam antibiotics are appropriate therapy, as noted in the following: ·      In mild cases of cellulitis treated on an outpatient basis, dicloxacillin, amoxicillin, and cephalexin are all reasonable choices.

 ·        Clindamycin or a macrolide (clarithromycin or azithromycin) are reasonable alternatives in patients who are allergic to penicillin.

 ·        Levofloxacin may also represent an alternative, but the prevalence of resistant strains has increased, and additional toxicity associated with fluoroquinolones has been recognized. Therefore, fluoroquinolones are best reserved for situations with limited alternatives, such as gram-negative organisms with sensitivity demonstrated by culture.

·        Some clinicians prefer an initial dose of parenteral antibiotic with a long half-life (eg, ceftriaxone followed by an oral agent).

回8F 只有看到黴菌感染時可以用外用的

1. If tinea pedis (足癬) is suspected to be the predisposing cause, treat with topical or systemic antifungals.
2. If tinea pedis is considered a possible cause of recurrent cellulitis episodes, treatment with a topical antifungal is recommended.

https://emedicine.medscape.com/article/214222-treatment