179.2 📚 國考版

179.2.0.1 必背 — Anaerobe 共生䜍眮

  • Oral: Prevotella, Fusobacterium, Peptostreptococcus
  • Colon: B. fragilis + others
  • Skin: Cutibacterium

179.2.0.2 必背 — Lemierre’s Syndrome

  • Fusobacterium necrophorum → tonsillitis → IJV thrombophlebitis → 肺 septic emboli
  • Young adult, 高燒 post-sore throat
  • CT neck + CT chest
  • Pip-tazo / metro + ceftriaxone × 4-6 wk; anticoagulation controversial

179.2.0.3 必背 — Brain Abscess Empirical

  • Ceftriaxone + metronidazole + vanco

179.2.0.4 必背 — Lung Abscess

  • 倧倚 polymicrobial mouth flora
  • Pip-tazo or clindamycin × 4-6 wk + drainage if 倧

179.2.0.5 必背 — Anaerobe Antibiotic Map

藥 Anaerobe 掻
Metronidazole GN anaerobes (B. fragilis), Clostridium (NOT Actinomyces!)
β-lactam/inhibitor (pip-tazo, amox-clav) Yes
Carbapenem (mero, imi, ertapenem) Yes
Clindamycin Yes (rising R B. fragilis)
Moxifloxacin Yes (anaerobic activity)
Cephalosporins No (except cefoxitin/cefotetan)
Aminoglycosides No
Vancomycin No (oral PO works for C. diff only)
FQ (cipro, levo) No

179.2.0.6 必背 — B. fragilis 抗藥

  • β-lactamase universal → 侍甹 PCN/amox alone
  • Clindamycin R 30-50%
  • Metronidazole R rising
  • Carbapenem R emerging