细菌耐药与合理用药儿科主要内容•细菌耐药•各类抗菌药物的作用特点•特殊用药•抗菌药物的PK/PD原理及其临床应用1stPenicillinPatientTreated第一例青霉素耐药报导肺炎链球菌耐药时间线YearCiproFDAApproved(Bayer)FirstLevoUSResistantisolateReport4yrs红霉素发现第一例红霉素耐药报导---------15yrs-------------------------------24yrs-----------------AntibioticResistance–AGlobalProblemMRSAMBLVISAVRSAPRPESBLVRE1961196719831986198819962002All-lactamsPenicillin3rdgencephalosporinCarbapenemVancomycinVancomycinandteicoplaninVancomycinandteicoplaninEmergence→Spread革兰阴性杆菌革兰阴性杆菌•肠杆菌科•非发酵菌群•弧菌科•其他埃希菌属:大肠埃希氏菌克雷伯菌属:肺炎克...