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 A biofilm (form a slimy coat) : protective matrix consisting
of various polysaccharides and proteins. It covers surfaces
like a film and allows the bacteria to adhere firmly to various
structures (e.g., skin, heart valves, prosthetic joints, and
catheters).
 Exopolysaccharide matrix(glycocalyx) is an important
component of biofilms that excrete from bacteria cause
organisms multiply and persist in colonies within this
material.
diffusion barrier for some antimicrobials--> persistent and
difficult to treat , but other antimicrobials may bind to it
 Biofilms play an important role in the persistence
of Pseudomonas in the lungs of cystic fibrosis patients,
Staphylococcus epidermidis and viridans streptococci that
cause endocarditis, and also mediates adherence of certain
bacteria, such as Streptococcus mutans, to the surface of
teeth.in the formation of dental plaque, the precursor of
dental caries.
 Acute pyelonephritis
Symptoms
-Acute onset of fevers, chills
-back pain
-lower-tract symptoms such as dysuria, frequency,
and urgency
-Nausea and vomiting, and diarrhea are common
Signs
-costovertebral angle tenderness
-fever and tachycardia
 Acute cystitis
Symptoms
-Afebrile
-Dysuria,urinary frequency and urgency
-Suprapubic discomfort
-Women may experience gross hematuria
Signs
-Suprapubic tenderness
 Urethritis
Symptoms
-Dysuria (No frequency or urgency)
-Discharge from the urethra (predominantly
males)
-Vaginal discharge possible
Signs
-mucopurulent urethral discharge on physical
examination
Recurrent urinary tract infections
with urease-producing organisms
Proteus mirabilis,
Pseudomonas aeroginosa,
and, less
commonly, Klebsiella spp.,
Staphylococcus spp.,
and Mycoplasma spp. (but
not E coli)
Hydrolyze urea to ammonia
Urine alkalinization
Struvite stone
pH เป็นเบส เหมาะสมแก่การตกตะกอนของนิ่ว
Staghorn calculi
Nephrolithiasis
Urinary stasis
Bacteria overgrowth
Urinary tract infection
Such as Acute pyelonephritis
 ขนาดยาที่ใช้
แบบดั้งเดิม
-เด็ก 3-7.5 mg/kg/day q 8 hrs
-ผู้ใหญ่ 1-1.7 mg/kg q 8 hrs
ในภาวะไตทา งานบกพร่อง
Loading dose 1.5-2.0 mg/kg and
maintenance dose with 1.5-2.0 mg/kg
GFR (ml/min) >90 >50-90 10-50 <10
Dose interval q 8 h q 8-12 h q 12 h q 24-48 h
แบบ higher dose, extended interval
• ขนาดยาสาหรับผู้ที่ไตทางานปกติ =3 - 7 mg/kg/d (เฉลี่ย 5
mg/kg)
• ขนาดยาสาหรับผู้ที่ไตทางานบกพร่อง ให้ปรับระยะห่างการให้ยาตาม
creatinine clearance (Clcr) ของผู้ป่วย แต่ไม่แนะนา ให้ใช้ยา
เมื่อ Clcr < 20 มล./นาที/70 กก.
ขนาดยา
(mg./kg.)
Creatinine clearance
(ml./min/70kg)
> 60 40-59 20-39
5-7 ทุก 24 ชั่วโมง ทุก 36 ชั่วโมง ทุก 48 ชั่วโมง

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Case2homework

  • 1.
  • 2.  A biofilm (form a slimy coat) : protective matrix consisting of various polysaccharides and proteins. It covers surfaces like a film and allows the bacteria to adhere firmly to various structures (e.g., skin, heart valves, prosthetic joints, and catheters).  Exopolysaccharide matrix(glycocalyx) is an important component of biofilms that excrete from bacteria cause organisms multiply and persist in colonies within this material. diffusion barrier for some antimicrobials--> persistent and difficult to treat , but other antimicrobials may bind to it
  • 3.  Biofilms play an important role in the persistence of Pseudomonas in the lungs of cystic fibrosis patients, Staphylococcus epidermidis and viridans streptococci that cause endocarditis, and also mediates adherence of certain bacteria, such as Streptococcus mutans, to the surface of teeth.in the formation of dental plaque, the precursor of dental caries.
  • 4.
  • 5.  Acute pyelonephritis Symptoms -Acute onset of fevers, chills -back pain -lower-tract symptoms such as dysuria, frequency, and urgency -Nausea and vomiting, and diarrhea are common Signs -costovertebral angle tenderness -fever and tachycardia
  • 6.  Acute cystitis Symptoms -Afebrile -Dysuria,urinary frequency and urgency -Suprapubic discomfort -Women may experience gross hematuria Signs -Suprapubic tenderness
  • 7.  Urethritis Symptoms -Dysuria (No frequency or urgency) -Discharge from the urethra (predominantly males) -Vaginal discharge possible Signs -mucopurulent urethral discharge on physical examination
  • 8. Recurrent urinary tract infections with urease-producing organisms Proteus mirabilis, Pseudomonas aeroginosa, and, less commonly, Klebsiella spp., Staphylococcus spp., and Mycoplasma spp. (but not E coli) Hydrolyze urea to ammonia Urine alkalinization Struvite stone pH เป็นเบส เหมาะสมแก่การตกตะกอนของนิ่ว Staghorn calculi
  • 9. Nephrolithiasis Urinary stasis Bacteria overgrowth Urinary tract infection Such as Acute pyelonephritis
  • 10.  ขนาดยาที่ใช้ แบบดั้งเดิม -เด็ก 3-7.5 mg/kg/day q 8 hrs -ผู้ใหญ่ 1-1.7 mg/kg q 8 hrs ในภาวะไตทา งานบกพร่อง Loading dose 1.5-2.0 mg/kg and maintenance dose with 1.5-2.0 mg/kg GFR (ml/min) >90 >50-90 10-50 <10 Dose interval q 8 h q 8-12 h q 12 h q 24-48 h
  • 11. แบบ higher dose, extended interval • ขนาดยาสาหรับผู้ที่ไตทางานปกติ =3 - 7 mg/kg/d (เฉลี่ย 5 mg/kg) • ขนาดยาสาหรับผู้ที่ไตทางานบกพร่อง ให้ปรับระยะห่างการให้ยาตาม creatinine clearance (Clcr) ของผู้ป่วย แต่ไม่แนะนา ให้ใช้ยา เมื่อ Clcr < 20 มล./นาที/70 กก. ขนาดยา (mg./kg.) Creatinine clearance (ml./min/70kg) > 60 40-59 20-39 5-7 ทุก 24 ชั่วโมง ทุก 36 ชั่วโมง ทุก 48 ชั่วโมง