179.4 📌 章末速蚘

  • Anaerobic infections — usually polymicrobial, breach of mucosal barrier
  • Gram + non-spore: Actinomyces, Propionibacterium, Peptostrep
  • Gram - main: B. fragilis (colon, intra-abd), Prevotella, Porphyromonas, Fusobacterium
  • Lemierre’s: F. necrophorum → IJV thrombophlebitis + septic emboli to lung — young adult, 4-6 wk abx
  • Brain abscess: ceftriaxone + metronidazole + vanco
  • Lung abscess: pip-tazo 4-6 wk + drainage
  • Anaerobe antibiotics: metro, β-lactam/inhib, carbapenem, clinda, moxi; NOT 1st-3rd ceph (except cefoxitin), AG, FQ, vanco
  • B. fragilis R: β-lactamase universal; clinda 30-50% R; metro/carbapenem rising
  • Source control + drainage essential