Profilaxis Antibiotica
Transcript of Profilaxis Antibiotica
![Page 1: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/1.jpg)
INDICACIONES ADICIONALES PARA LA PROFILAXIS ANTIBIOTICA
Regla General:La profilaxis antibiótica está indicada para: Pacientes con alteraciones en el sistema de defensa . Cualquier cirugía con alto índice de complicaciones infecciosas asociadas.Pacientes con transplantes de órganos Medicación inmunosupresora con por ejemplo ciclosporina y/o
glucocorticoesteroide para suprimir las funciones de las células T. El médico del paciente sugiere la profilaxis antibiótica. En los procedimientos que se espera una bacteremia se indica: Profilaxis a largo plazo con 1500mg/día de amoxicilina , por tres días . ( un día antes y dos días después. ) Pacientes con alergia a la penicilina : 200 mg de doxiciclina, un día antes de la intervención ,después 100mg /día
![Page 2: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/2.jpg)
Radiación de cabeza y cuello
El daño vascula con hipovascularidad, degeneración de la médula ósea, y destrucción casi completa de osteoblastos y osteoclastos provpcan riesgo de osteonecrosis
Parta una extracción dental es obligatoria profilaxis antibiótica 1500 mg/día de amoxicilina o 600 mg/día de clindamicina, el día del procedimiendto hasta dos días después.
![Page 3: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/3.jpg)
La s operaciones mayores deben ser realizadas en el hospital.
Los tratamientos periodontales deben realizarse antes de la radiación
![Page 4: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/4.jpg)
Profilaxis Antibiótica de Acuerdo a las Instrucciones del Médico
Pacientes con diálisis
Pacientes con discrasias Sanguíneas
Hemorragia subcojuntival Púrpura Hemorrágica
![Page 5: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/5.jpg)
Pacientes con enfermedad Reumática, que toman corticosteroides y consultar al médico acerca de la profilaxis antibiótica
Pacientes con prótesis articulares ,la profilaxis antibiótica puede ser 2 g de cefalexina 1 H antes del procedimiento . 1 g cada 4h después de eritromicina o clindamicina.
![Page 6: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/6.jpg)
TRANTORNOS DE LA COAGULACION TRATAMIENTO ANTICOAGULANTE
El tratamiento periodontal de pacientes con alteraciones vasculares y plaquetarias como:
-Hemofilia congénita .
- Tratamiento con anticoagulantes ( derivados de la cumarina,
o heparina después de un infarto al miocardio , profilaxis para la trombosis)
Solo puede ser realizado después de consultar con el m´ñedico epecialista
![Page 7: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/7.jpg)
Después de cualquier procedimiento quirúrgico en la boca puede suceder una hemorragia que pueda ser mortal :
o Extracción dentalo Procedimiento por colgajo o Gingevectomía o Eliminación de calculo dental
![Page 8: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/8.jpg)
Paciente con INR ( international normalized ratio) (coficiente internacional normalizado), basada en el tiempo de protrombina:
De 3 .0 a 3.4 se puede realizar procedimientos quirúrgicos menores en boca .
El INR es igual o mayor a 3.5 , solo es recomendable realizar procedimientos quirúrgicos menores de emergencia
Lo ideal es llevar a cabo un tratamiento integral en pocas citas.
![Page 9: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/9.jpg)
Interacciones Farmacológicas con Medicamentos Anticoagulantes
![Page 10: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/10.jpg)
![Page 11: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/11.jpg)
![Page 12: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/12.jpg)
El médico del pacientedebe ser consultado y verificar de manaera cuidadosa todos los medicamentos prescritos
No debe realizar tratamientos dentales durante los primeros seis meses después de un infarto del miocardio.
De ser necesario , premedicación con diazepam; debe haber nitroglicerina disponible.
No existe una contraindicación general con rspecto a los anestésicos locales con un contenido de adrenalina de hasta
1 : 100 000 Se deben planear sesiones cortas
![Page 13: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/13.jpg)
En pacientes con marcapasos , está contraindicado el uso de ultrasonidos dispositivos electroquirúrgicos , y pruebas eléctricas de vitalidad pulpar.
La medicación antihipertensiva debe continuar en el tratamiento dental
![Page 14: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/14.jpg)
ASOCIACIONES ENTRE PERIODONTITIS Y ENFERMEDADD CARDIOVASCULAR
Se han reportado asociaciones entre las enfermedades vasculares, en especial enfermedad coronaria y evento vascular cerebral y ciertas infecciones crónicas .
Chlamydia pnmeumoniae: infecciones respiratorias
Helicobacter pylori: úlcera péptica, gastritis
Citomegalovirus: herpesvirus 5
Infecciones dentales especialmente periodontitis crónica
![Page 15: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/15.jpg)
crónicatromboembó
trigliceridos; una dieta alta en grasas conduce al aumento en la secreción de citoninas catabólicas y proinflamatorias
Estrés
![Page 16: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/16.jpg)
![Page 17: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/17.jpg)
![Page 18: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/18.jpg)
![Page 19: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/19.jpg)
![Page 20: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/20.jpg)
![Page 21: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/21.jpg)
![Page 22: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/22.jpg)
![Page 23: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/23.jpg)
![Page 24: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/24.jpg)
![Page 25: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/25.jpg)
![Page 26: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/26.jpg)
![Page 27: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/27.jpg)
![Page 28: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/28.jpg)
![Page 29: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/29.jpg)
![Page 30: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/30.jpg)
![Page 31: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/31.jpg)
![Page 32: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/32.jpg)
![Page 33: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/33.jpg)
![Page 34: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/34.jpg)
![Page 35: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/35.jpg)
![Page 36: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/36.jpg)
![Page 37: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/37.jpg)
![Page 38: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/38.jpg)
![Page 39: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/39.jpg)
![Page 40: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/40.jpg)
![Page 41: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/41.jpg)
![Page 42: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/42.jpg)
![Page 43: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/43.jpg)
![Page 44: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/44.jpg)
![Page 45: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/45.jpg)
![Page 46: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/46.jpg)
![Page 47: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/47.jpg)
![Page 48: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/48.jpg)
![Page 49: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/49.jpg)
![Page 50: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/50.jpg)
![Page 51: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/51.jpg)
![Page 52: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/52.jpg)
![Page 53: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/53.jpg)
![Page 54: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/54.jpg)
![Page 55: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/55.jpg)
![Page 56: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/56.jpg)
![Page 57: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/57.jpg)
![Page 58: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/58.jpg)
![Page 59: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/59.jpg)
![Page 60: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/60.jpg)
![Page 61: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/61.jpg)
![Page 62: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/62.jpg)
![Page 63: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/63.jpg)
![Page 64: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/64.jpg)
![Page 65: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/65.jpg)
![Page 66: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/66.jpg)
![Page 67: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/67.jpg)
![Page 68: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/68.jpg)
![Page 69: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/69.jpg)
![Page 70: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/70.jpg)
![Page 71: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/71.jpg)
![Page 72: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/72.jpg)
![Page 73: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/73.jpg)
![Page 74: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/74.jpg)
![Page 75: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/75.jpg)
![Page 76: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/76.jpg)
![Page 77: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/77.jpg)
![Page 78: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/78.jpg)
![Page 79: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/79.jpg)
![Page 80: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/80.jpg)
![Page 81: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/81.jpg)
![Page 82: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/82.jpg)
![Page 83: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/83.jpg)
![Page 84: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/84.jpg)
![Page 85: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/85.jpg)
![Page 86: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/86.jpg)
![Page 87: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/87.jpg)
![Page 88: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/88.jpg)
![Page 89: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/89.jpg)
![Page 90: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/90.jpg)
![Page 91: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/91.jpg)
![Page 92: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/92.jpg)
![Page 93: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/93.jpg)
![Page 94: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/94.jpg)
![Page 95: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/95.jpg)
![Page 96: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/96.jpg)
![Page 97: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/97.jpg)
![Page 98: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/98.jpg)
![Page 99: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/99.jpg)
![Page 100: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/100.jpg)
![Page 101: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/101.jpg)
![Page 102: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/102.jpg)
![Page 103: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/103.jpg)
![Page 104: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/104.jpg)
![Page 105: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/105.jpg)
![Page 106: Profilaxis Antibiotica](https://reader036.fdocuments.net/reader036/viewer/2022081419/556b5a8cd8b42a280c8b45a5/html5/thumbnails/106.jpg)