{"id":1083,"date":"2024-01-10T19:28:53","date_gmt":"2024-01-10T11:28:53","guid":{"rendered":"https:\/\/taiwanfullarch.com.tw\/?p=1083"},"modified":"2025-10-13T10:38:25","modified_gmt":"2025-10-13T02:38:25","slug":"penicillin%e9%81%8e%e6%95%8f%e7%9a%84%e7%97%85%e4%ba%ba%e6%a4%8d%e7%89%99%e5%ae%b9%e6%98%93%e5%a4%b1%e6%95%97%ef%bc%9f","status":"publish","type":"post","link":"https:\/\/taiwanfullarch.com.tw\/?p=1083","title":{"rendered":"\u3164Penicillin\u904e\u654f\u7684\u75c5\u4eba\u690d\u7259\u5bb9\u6613\u5931\u6557\uff1f"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"1083\" class=\"elementor elementor-1083\" data-elementor-post-type=\"post\">\n\t\t\t\t<div class=\"elementor-element elementor-element-4ac34b4 e-flex e-con-boxed elementor-invisible e-con e-child\" data-id=\"4ac34b4\" data-element_type=\"container\" data-settings=\"{&quot;animation&quot;:&quot;fadeInUp&quot;,&quot;background_background&quot;:&quot;slideshow&quot;,&quot;background_slideshow_gallery&quot;:[{&quot;id&quot;:5744,&quot;url&quot;:&quot;https:\\\/\\\/taiwanfullarch.com.tw\\\/wp-content\\\/uploads\\\/2025\\\/08\\\/texture-1.jpg&quot;}],&quot;background_slideshow_loop&quot;:&quot;yes&quot;,&quot;background_slideshow_slide_duration&quot;:5000,&quot;background_slideshow_slide_transition&quot;:&quot;fade&quot;,&quot;background_slideshow_transition_duration&quot;:500}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-9f33c8f elementor-widget elementor-widget-heading\" data-id=\"9f33c8f\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Penicillin\u904e\u654f\u7684\u75c5\u4eba\u690d\u7259\u5bb9\u6613\u5931\u6557\uff1f<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7813755 elementor-widget__width-initial elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"7813755\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-160aea5f e-flex e-con-boxed e-con e-parent\" data-id=\"160aea5f\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-60d31f04 elementor-widget__width-initial elementor-widget elementor-widget-text-editor\" data-id=\"60d31f04\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t\t\t\t\t\t\n<p><img fetchpriority=\"high\" decoding=\"async\" width=\"1024\" height=\"1024\" class=\"wp-image-1084\" src=\"http:\/\/59.125.157.215\/wordpress\/wp-content\/uploads\/2024\/01\/1-5-1024x1024.png\" alt=\"\" srcset=\"https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/1-5-1024x1024.png 1024w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/1-5-300x300.png 300w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/1-5-150x150.png 150w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/1-5-768x768.png 768w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/1-5.png 1440w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/p>\n\n<p>\u00a0<\/p>\n\n<p>\u258b \u524d\u8a00<\/p>\n\n<p>\u6297\u751f\u7d20\u53ef\u4ee5\u5206\u6210\u6291\u83cc\u578b\u6297\u751f\u7d20(bacteriostatic)\uff0c\u53ca\u6bba\u83cc\u578b\u7684\u6297\u751f\u7d20(bactericidal\/ bacteriocidal)\u3002\u6291\u83cc\u578b\u6297\u751f\u7d20\u70ba\uff1a\u96d6\u7136\u7121\u6cd5\u76f4\u63a5\u6bba\u6b7b\u7d30\u83cc\uff0c\u4f46\u85c9\u7531\u63a7\u5236\u7d30\u83cc\u7684\u751f\u9577\uff0c\u80fd\u8b93\u514d\u75ab\u7cfb\u7d71\u6709\u6548\u7684\u6bba\u6b7b\u7d30\u83cc\uff0c\u800c\u9054\u5230\u611f\u67d3\u75c7\u72c0\u7684\u7de9\u89e3\u3002\u6bba\u83cc\u578b\u6297\u751f\u7d20\u80fd\u5920\u76f4\u63a5\u6bba\u6b7b\u7d30\u83cc\u3002<\/p>\n\n<p>\u258b \u7259\u79d1\u5e38\u4f7f\u7528\u7684\u53e3\u670d\u6297\u751f\u7d20<\/p>\n\n<p>\u2022 \u6bba\u83cc\u578b\u6297\u751f\u7d20<\/p>\n\n<p>1.Penicillins (\u9752\u9ef4\u7d20)\uff1aAmoxicillin\uff0cAugmentin\uff0c Unasyn\uff0cAmpicillin\u3002<\/p>\n\n<p>2. Cephalosporins(\u982d\u5b62\u83cc\u7d20)\uff1a\u4f9d\u7167\u6297\u83cc\u7bc4\u570d\u5206\u6210\u7b2c\u4e00\u5230 \u7b2c\u4e94\u4ee3\uff0c\u76ee\u524d\u53f0\u7063\u53e3\u670d\u5291\u578b\u50c5\u6709\u7b2c\u4e00\u5230\u7b2c\u4e09\u4ee3\uff1a\u7b2c\u4e00\u4ee3Cephalexin\uff0c\u7b2c\u4e8c\u4ee3Cefuroxime\uff0c\u7b2c\u4e09\u4ee3Cefixime\u3002<\/p>\n\n<p>\u2022 \u6291\u83cc\u578b\u6297\u751f\u7d20<\/p>\n\n<p>Tetracyclines (\u56db\u74b0\u9ef4\u7d20\u985e) : Tetracycline(\u56db\u74b0\u9ef4\u7d20)\uff0cDoxycycline\uff0cMinocycline \u3002<\/p>\n\n<p>Macrolides(\u5927\u74b0\u5167\u916f\u985e)\uff1aErythromycin(\u7d05\u9ef4\u7d20)\uff0cclarithromycin\uff0c azithromycin\u3002<\/p>\n\n<p>Lincosamides(\u6797\u53ef\u80fa\u985e)\uff1aClindamycin\u3002<\/p>\n\n<p>\u258b Penicillin\u904e\u654f\u7684\u60a3\u8005\u5bb9\u6613\u690d\u7259\u5931\u6557\uff1f<\/p>\n\n<p>\u7136\u800c\u6839\u64da\u7814\u7a76\u986f\u793aAmoxicillin\u70ba\u6700\u5bb9\u6613\u7522\u751f\u904e\u654f\u7684\u6297\u751f\u7d20\uff0c\u7d71\u8a08\u897f\u65b9\u793e\u6703\u8cc7\u6599\u7d04\u70ba7%~12%\uff0c\u91dd\u5c0d\u4e9e\u6d32\u4eba\u7a2e\u9999\u6e2f\u7684\u7814\u7a76\u7d04\u70ba2~5%\u3002\u9762\u5c0dpenicillin\u904e\u654f\u7684\u75c5\u4eba\uff0c\u8a31\u591a\u7684\u6cbb\u7642\u6307\u5f15\u5efa\u8b70\u7259\u91ab\u5e2b\u53ef\u4ee5\u9078\u64c7clindamycin\u70ba\u66ff\u4ee3\u6027\u6297\u751f\u7d20\u3002<\/p>\n\n<p>\u57282023\u5e74\u7684review article (Clin Oral Impl Res. 2023;34: 651-661)\u89c0\u5bdf\u6027\u7814\u7a76\u767c\u73fe\uff0c\u7576\u690d\u7259\u75c5\u4eba\u81ea\u8ff0\u6709penicillin\u904e\u654f\u800c\u4f7f\u7528clindamycin\u5f8c\uff0c\u6703\u67093\u500d\u4ee5\u4e0a\u7684\u6a5f\u6703\u5c0e\u81f4\u690d\u7259\u5931\u6557\uff0c(\u5982\u5716\u4e00)\u6709\u8f03\u9ad8\u7684\u6a5f\u6703\u7522\u751fearly implant failure\u3002<\/p>\n\n<p>\u57282021\u5e74\u7684\u7814\u7a76\u5831\u544a\uff0c\u4f7f\u7528clindamycin\u7684\u7d44\u5225\u6bd4\u8d77\u4f7f\u7528amoxicillin\uff0c\u6709\u9ad8\u90546.9\u500d\u7684\u6a5f\u6703\u5728ridge augmentation\u5f8c\u7522\u751f\u611f\u67d3\u5931\u6557\uff0c\u67094.5\u500d\u7684\u6a5f\u6703\u5728socket preservation\u5f8c\u7522\u751f\u611f\u67d3\u5931\u6557\uff0c\u7d71\u8a08Ridge augmentation+ socket preservation\u51712961 sites\uff0c\u4f7f\u7528clindamycin\u7684\u7d44\u5225\u67095.5\u500d\u7684\u6a5f\u6703\u7522\u751f\u611f\u67d3\u3002<\/p>\n\n<p>(Int J Oral Maxillofac Implants. 2021;36(1):122-25)<\/p>\n\n<p>\u7136\u800c\u7522\u751f\u6b64\u7d50\u679c\u7684\u8a73\u7d30\u539f\u56e0\u76ee\u524d\u4ecd\u7136\u672a\u660e\uff0c\u6709\u7814\u7a76\u8a8d\u70ba\u53ef\u80fd\u8ddfclindamycin\u6703\u5c0dosteoblast\u7522\u751f\u6bd2\u6027 (Arch Orthop Trauma Surg. 2008; 128(3):317-323 ); \u6216\u8005\u662f\u8207resistant clindamycin\u7684\u7d30\u83ccPrevotella\u6709\u95dc\uff0c\u9020\u6210\u690d\u7259\u5931\u6557\u3002<\/p>\n\n<p>\u258b \u6587\u737b\u53ca\u7b46\u8005\u7684\u5efa\u8b70<\/p>\n\n<p>\u4e00\u4f46\u5728\u9762\u5c0d\u6709\u81ea\u8ff0penicillin\u904e\u654f\u7684\u75c5\u4eba\u8981\u63a5\u53d7\u690d\u7259\u76f8\u95dc\u624b\u8853\u6642\uff0c\u6587\u737b\u53ca\u7b46\u8005\u7684\u5efa\u8b70\u662f\uff1a<\/p>\n\n<p>A.\u505a\u8a73\u7d30\u7684penicillin\u904e\u654f\u6aa2\u67e5\uff1a<\/p>\n\n<p>\u53ef\u4f9d\u7167\u75c5\u4eba\u81ea\u8ff0\u75c7\u72c0\u5206\u6210low risk\u53cahigh risk (Table 1)\uff0clow risk\u7684\u5b9a\u7fa9\u70ba\u8f15\u5fae\u62c9\u809a\u5b50\uff0c\u975e\u7acb\u5373\u6027\u7684\u7d05\u75b9\uff0c\u6216\u662f\u807d\u5bb6\u4eba\u8f49\u8ff0\u904e\u654f\u4f46\u662f\u4e0d\u78ba\u5b9a\u8a73\u7d30\u72c0\u6cc1\u2026\u7b49\u8f15\u5fae\u75c7\u72c0\u3002<\/p>\n\n<p>\u9019\u985e\u7684\u75c5\u4eba\u53ef\u4ee5\u53c3\u8003\uff08Fig 2\uff09\u505apenicillin allergy delabeling\u53bb\u6a19\u7c64\u5316\u6e2c\u8a66\u3002\u5c07\u75c5\u4eba\u8f49\u8a3a\u5230\u5167\u79d1\u6216\u514d\u75ab\u79d1\u505apenicillin skin test\u6216\u662f\u505aoral amoxicillin challenge\u3002<\/p>\n\n<p>\u7136\u800c\u7814\u7a76\u986f\u793a\u9019\u4e9b\u81ea\u8ff0\u6709penicillin\u904e\u654f\u7684\u4eba\u4e2d\uff0c\u6709\u8d85\u904e90%\u7684\u75c5\u4eba\u7d93\u904e\u6e2c\u8a66\u5f8c\u8b49\u5be6\u6c92\u6709\u904e\u654f\u554f\u984c\u3002<\/p>\n\n<p>B.\u4f7f\u7528\u66ff\u4ee3\u6027\u6297\u751f\u7d20\uff1a<\/p>\n\n<p>1.\u9996\u9078\u7528 Erythromycin(\u7d05\u9ef4\u7d20)<\/p>\n\n<p>2.\u6216\u8005\u7528 Cephalosporins(\u982d\u5b62\u83cc\u7d20)\u3002\u7136\u800c\u5728\u4f7f\u7528Cephalosporin\u985e\u7684\u85e5\u7269\u4ecd\u8981\u5c0f\u5fc3\u904e\u654f\u53cd\u61c9\uff08\u548cPenicillin\u90fd\u662f\u5c6c\u65bcBeta-lactam \u985e\u85e5\u7269)\uff0c\u96d6\u7136\u8fd1\u5e74\u7684\u7814\u7a76\u986f\u793a\uff0c\u6709\u4ea4\u53c9\u53cd\u61c9\u7684\u6a5f\u6703\u5c0f\u65bc1%\u3002<\/p>\n\n<p>\u7d50\u8ad6\uff1a\u5728\u7259\u79d1\u6cbb\u7642\u4e2dpenicillin\u985e\u6297\u751f\u7d20\u4ecd\u70ba\u9996\u9078\uff0c\u5982\u679c\u75c5\u4eba\u6709 \u300e\u81ea\u8ff0\u904e\u654f\u300f\u7684\u72c0\u6cc1\uff0c\u53ef\u8f49\u8a3a\u75c5\u4eba\u505a\u8a73\u7d30\u7684allergy test\uff0c\u5982\u679c\u300epenicillin\u904e\u654f\u300f\u75c5\u4eba\u8981\u505a\u690d\u7259\u88dc\u9aa8\u76f8\u95dc\u624b\u8853\uff0c\u5efa\u8b70\u4f7f\u7528Erythromycin\u4f5c\u70ba\u66ff\u4ee3\u6027\u6297\u751f\u7d20\u4f7f\u7528\u3002\u672c\u6587\u5c6c\u89c0\u5bdf\u6027\u7814\u7a76\u5f8c\u7684\u7d50\u8ad6\uff0c\u76ee\u524d\u5be6\u8b49\u7814\u7a76\u8b49\u64da\u5c1a\u5c6c\u4e0d\u8db3\uff0c\u8acb\u5404\u4f4d\u8b80\u8005\u53c3\u8003\u3002<\/p>\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"1024\" height=\"1024\" class=\"wp-image-1085\" src=\"http:\/\/59.125.157.215\/wordpress\/wp-content\/uploads\/2024\/01\/4-3-1024x1024.png\" alt=\"\" srcset=\"https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/4-3-1024x1024.png 1024w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/4-3-300x300.png 300w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/4-3-150x150.png 150w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/4-3-768x768.png 768w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/4-3.png 1440w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" width=\"1024\" height=\"1024\" class=\"wp-image-1086\" src=\"http:\/\/59.125.157.215\/wordpress\/wp-content\/uploads\/2024\/01\/5-4-1024x1024.png\" alt=\"\" srcset=\"https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/5-4-1024x1024.png 1024w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/5-4-300x300.png 300w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/5-4-150x150.png 150w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/5-4-768x768.png 768w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/5-4.png 1440w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1024\" class=\"wp-image-1087\" src=\"http:\/\/59.125.157.215\/wordpress\/wp-content\/uploads\/2024\/01\/6-3-1024x1024.png\" alt=\"\" srcset=\"https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/6-3-1024x1024.png 1024w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/6-3-300x300.png 300w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/6-3-150x150.png 150w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/6-3-768x768.png 768w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/6-3.png 1440w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1024\" class=\"wp-image-1088\" src=\"http:\/\/59.125.157.215\/wordpress\/wp-content\/uploads\/2024\/01\/7-3-1024x1024.png\" alt=\"\" srcset=\"https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/7-3-1024x1024.png 1024w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/7-3-300x300.png 300w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/7-3-150x150.png 150w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/7-3-768x768.png 768w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/7-3.png 1440w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1024\" class=\"wp-image-1089\" src=\"http:\/\/59.125.157.215\/wordpress\/wp-content\/uploads\/2024\/01\/8-5-1024x1024.png\" alt=\"\" srcset=\"https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/8-5-1024x1024.png 1024w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/8-5-300x300.png 300w, 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sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1024\" class=\"wp-image-1091\" src=\"http:\/\/59.125.157.215\/wordpress\/wp-content\/uploads\/2024\/01\/10-3-1024x1024.png\" alt=\"\" srcset=\"https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/10-3-1024x1024.png 1024w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/10-3-300x300.png 300w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/10-3-150x150.png 150w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/10-3-768x768.png 768w, https:\/\/taiwanfullarch.com.tw\/wp-content\/uploads\/2024\/01\/10-3.png 1440w\" sizes=\"(max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1024\" class=\"wp-image-1092\" 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