37.3 🩺 內科專科考前版

37.3.0.1 📌 䞀頁重點

  • 22Eantimicrobial stewardship for URI、COVID-19 / influenza testing routine
  • Lemierre’s syndrome 認可
  • Taiwan: 健保 antibiotic 限制

37.3.0.2 💊 進階治療

37.3.0.2.1 Antimicrobial Stewardship

  • 50% URI antibiotic 是 inappropriate

  • 即䜿 strep test +, 倚 self-limited
  • Delayed prescribing strategy (give script for 甹 only worsening)
37.3.0.2.2 Influenza
  • Oseltamivir within 48h reduces duration
  • Baloxavir single dose
37.3.0.2.3 COVID-19
  • Paxlovid for high-risk
  • Remdesivir for hospitalized
  • Vaccine

37.3.0.3 🌟 Pearls (8)

  1. 90% URI viral
  2. Centor low + don’t test
  3. Sinusitis bacterial > 10 d
  4. Lemierre’s = Fusobacterium → IJV
  5. Epiglottitis = airway protection ASAP
  6. Malignant OE in DM = ENT consult
  7. Influenza < 48h oseltamivir
  8. COVID Paxlovid high-risk early

37.3.0.4 📍 台灣 Context

  • 健保 antibiotic stewardship policy
  • 流感快篩 / COVID 快篩 普及
  • 䞭醫 + 西醫 sinus 治療

37.3.0.5 🎓 內專重點

  1. URI viral vs bacterial
  2. Centor + strep
  3. Acute急症epiglottitis, PTA, Lemierre, RPA
  4. Antimicrobial stewardship
37.3.0.5.1 跚章節
  • Ch 165 Strep
  • Ch 167 Pneumococcus
  • Ch 196 Influenza
  • Ch 197 COVID

⚠ AI 草皿。