6 一住院懷孕 3 個月的女士因 methicillin 抗藥性金黃色葡萄球菌感染接受 vancomycin 注射治療，出院時，使用下列何種口服藥來完成療程最適當？
(A) minocycline
(B) linezolid
(C) vancomycin
(D) aztreonam

以下來自IDSA美國感染學會guide...

Linezolid 的抗菌範圍：

1. methicillin-resistant staphylococci

2. vancomycin-resistant enterococci

Ref：Basic&Clinical Pharmacology 12th

aztreonam抗菌範圍為革蘭氏陰性需氧菌(Gram-negative aerobic bacteria)，包括抗藥性菌種，亦即所有腸桿菌科細菌(Enterobacteriaceae), Pseudomonas aeruginosa, Haemophilus influenzae及Neisseria gonorrhoeae。其抗菌力超越第三代cephalosporins或與之相當

樓上好像寫錯了~

(A) minocycline G(+),G(-)

(B) linezolid G(+)

治療VRE

(C) vancomycin G(+)

但是口服吸收差，治療腸道內的困難梭狀桿菌腹瀉

(D) aztreonam G(-)

 linezolid跟vancomycin抗菌範圍最接近，而且可以治療VRE，比vancomycin更廣效一些些。

aztreonam的抗菌範圍為 G(-)好氧菌

Vancomycin口服不吸收，用來治腸胃道感染(Clostridium difficile-associated diarrhea)。Vancomycin is an antibiotic used to treat a severe intestinal condition known as Clostridium difficile-associated diarrhea. This condition usually occurs after the use of another antibiotic, which allows the growth of resistant bacteria in the intestines, leading to severe diarrhea. When vancomycin is given by mouth, it is not absorbed by the body but remains in the intestines, allowing it to stop the growth of the bacteria responsible for this form of colitis. This antibiotic treats only bacterial infections of the intestines. It will not work for other bacterial infections or viral infections (e.g., common cold, flu). Unnecessary use or overuse of any antibiotic can lead to its decreased effectiveness.

4.4.有關急性骨髓炎（acute osteomyelitis）的治療，下列建議何者最不適當？
(A)oxacillin注射2週，狀況改善後改口服dicloxacillin 2週
(B)vancomycin靜脈輸注2週
(C)vancomycin靜脈輸注2週，狀況改善後改口服linezolid 4週
(D)oxacillin靜脈輸注4週 .


編輯私有筆記及自訂標籤
專技 - 藥物治療學- 109 年 - 109 專技高考_藥師(二)：藥物治療學#82768
答案：B
難度：適中
統計： A(144),B(988),C(247),D(253),E(0) #2180208
個人： B(2) 答對率：100 %
書單：沒有書單，新增

【Linezolid口服劑量】

Community-acquired, nosocominal pneumonia; Complicated skin and soft tissue infections:PO 600 mg q12h for 10- 14 days.
Uncomplicated Skin and soft tissue infections: PO, 400 mg q12h for 10- 14 days.
Vancomycin-resistant Enterococcus faecium infections:PO, 600 mg q12h for 14- 28 days.
Max. 1200 mg/d.

D) Aztreonam  1–2 g IV every 8 h

Aztreonam 會穿過胎盤，並進入胎兒循環。目前對孕婦還沒有充分且具良好對照組的研究。由於動物生殖研究無法完全預測人類的反應，因此在懷孕期間，只有真正需要時，方可使用aztreonam。

資料來源：仿單

Linezolid（Zyvox）為抑制蛋...