Broaderspectrum agents

a. If the initial response to antibiotics is unsatisfactory, beta-lactamase-producing bacteria are likely to be present, and broad-spectrum therapy is required.

b. Amoxicillin/clavulanate (Augmentin): adults, 250 mg tid or 875 mg bid; children, 40 mg/kg/d in 3 divided doses.

c. Cefuroxime axetil (Ceftin): adults, 250 mg bid; children, 125 mg bid.

d. Cefixime (Suprax): adults, 200 mg bid; children, 8 mg/kg/d bid.

e. Cefpodoxime (Vantin) 200 mg bid f. Loracarbef (Lorabid): 400 mg bid.

g. Azithromycin (Zithromax): 500 mg as a single dose on day 1, then 250 mg qd.

h. Clarithromycin (Biaxin): 500 mg bid.

4. Penicillin-resistant S. Pneumoniae result from bacterial alterations in penicillin-binding proteins. Highly resistant strains are resistant to penicillin, trimethoprim/sulfamethoxazole (TMP/SMX), and third-generation cephalosporins.The prevalence of multiple-drug resistant S. pneumoniae is 20-35%. High dose amoxicillin (80 mg/kg/d), or amoxicillin plus amoxicillin/clavulanate, or clindamycin are options.

B. Chronic sinusitis is commonly caused by anaerobic organisms. 3-4 weeks of therapy or longer is required.

Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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