Mankhwalawa ndi mbadwo atsopano a yotakata-sipekitiramu

Mwa mankhwala zatenga malo ofunika m'badwo wotsiriza mankhwala yogwira ndi majeremusi ambiri. Iwo ntchito zochizira pathologies matenda, zomwe kwambiri yafupika ndi imfa odwala ku banal kuti tsiku pneumonias ndi pyelonephritis. Chifukwa mankhwala kwa ntchito ndi inapita patsogolo kuchira ku matenda, sinusitis, ndipo anakhala zotheka kuchita zovuta popanga munthu opaleshoni. matenda ngakhale chilonda bwinobwino ankachitira ndi mankhwala.

Yotakata-sipekitiramu mankhwala (ABSHS)

gulu Izi zikuphatikizapo wothandizila antimicrobial yogwira ndi galamu alibe ndi galamu HIV zamoyo. Woyamba ndi wothandizila causative matenda matumbo, pathologies yotupa wa urogenital ndi machitidwe kupuma. Galamu HIV zamoyo ambiri chifukwa matenda chilonda ayimire pakutchulidwa matendawo postoperative opaleshoni.

List ABSHS osiyana kumasulidwa nthawi

Ena yotakata sipekitiramu mankhwala a mbadwo atsopano mwakhama ndi matenda protozoal. Zitsanzo ndi ena ofanana nitroimidazole - tinidazole, mankhwala a metronidazole ndi ornidazole. Ambiri ntchito mankhwala a metronidazole chifukwa chodya. kalasi lake analogue - tinidazole - ofanana sipekitiramu wa ntchito antimicrobial, koma osati ntchito parenterally. Ambiri, magulu onse a mankhwala yotakata-sipekitiramu amene timapemphera motere:

• penicillin achilengedwe
• ingibitorzaschischennye aminopenicillin;
• pseudomonas penicillin kuphatikizapo ingibitorzaschischennye;
• cephalosporins III m'badwo cephalosporins IV mbadwo ;
• aminoglycosides gulu;
• angamwe tetracycline mankhwala ;
• macrolide mankhwala;
• Chiwerengero cha mankhwala carbapenem;
• ndi chloramphenicol;
• fosfomycin;
• rifampicin;
• dioxidine;
• sulfonamides;
• quinolones, fluoroquinolones;
• nitrofurans gulu;
• nitroimidazole mankhwala angapo.

Mafunso amenewa sanapatsidwe mayina a magulu a mankhwala yopapatiza-sipekitiramu. Iwo yeniyeni ochepa tizilomboto ndipo polimbana iwo. yopapatiza-sipekitiramu mankhwala sangathe ntchito zochizira superinfection ndipo sizinaikidwe empirically. Iwo ntchito monga mankhwala oyamba-mzere pa tizilomboto zinalembedwa.

Mndandanda za mibadwomibadwo ya m'mbuyomu ABSHS

Pamwamba wothandizila antimicrobial a zosiyanasiyana mankhwala. Izi ndi mndandanda wa magulu a zinthu ndi ntchito ndi galamu HIV ndi galamu alibe mabakiteriya. Komabe, mndandanda uli ndi mbadwo atsopano a mankhwala ndi owayimilira kale m'gululo. Wa akuluakulu a mibadwo atsopano a pamwamba ndi magulu a mankhwala zotsatirazi:

• aminopenicillin kuti ndi kugonjetsedwa beta-lactamase ( "Sulbactam", "Ampicillin", "clavulanate" "Amoxicillin");
• cephalosporins mibadwo III ndi IV ( "Cefotaxime" "Cefoperazone" "Ceftazidime" "ceftriaxone" "cefpirome" "Cefepime");
• m'badwo III aminoglycoside mankhwala ( "Amikacin" "Netilmicin");
• 14- 15-ziwalo theka-kupanga macrolides ( "Roxithromycin" "Clarithromycin," "Azithromycin");
• Natural 16-ziwalo macrolide mankhwala ( "midecamycin");
• fluoroquinolones III ndi IV mibadwo ( "levofloxacin" "sparfloxacin" "Gatifloxacin" "Trovafloxacin" "Moxifloxacin");
• carbapenems ( "meropenem" "Imipinem-cilastatin" "Ertapenem");
• nitrofurans ( "Nitrofurantoin" "Furazidin", "ersefuril").

Maantibayotiki kuti amachotsedwa mndandanda

Izi kale kutetezedwa penicillin antipseudomonal ndi sipekitiramu yotakata ntchito Koma okhawo ndi P. aeruginosa polingalira za kufunika kuchepetsa kukhudzana Nkosatheka ndi tsiku atsopano ndi amphamvu mankhwala. Zimenezi zimathandiza kuti kufala kwa tizilombo mankhwala. The efficacy kwambiri ndi Pseudomonas matenda kuwawonetsera "tazobactam." Nthawi zina "Piperacillin" ndi "clavulanate" ntchito ngati m'badwo atsopano a mankhwala a chibayo chifukwa cha tizilombo ta kuchipatala cha tizilomboto lapansi.

Komanso pa mndandanda palibe gulu mankhwala m'badwo wotsiriza wa penicillin zachilengedwe ndi odana staphylococcal. Zoyambazo sangathe ntchito mankhwala wodwala chifukwa chosowa cha pafupipafupi mtsempha kapena mu mnofu utsogoleli. Mafomu kuti kuwalola kutenga pakamwa, kulibe. Ndi mmene zililinso ndi cephalosporins. Ndi sipekitiramu womwewo wa ntchito monga penicillin, iwo sangakhoze kutumikiridwa pakamwa chifukwa chiwonongeko mmimba.

Cephalosporins ndi penicillin ntchito parenteral - ndi mbadwo atsopano a mankhwala ochiza chibayo. Sizichokera asayansi anakwanitsa kukhala mlingo mawonekedwe makonzedwe enteral. Komabe, kafukufuku sanabadwe muyika mumachitidwe, ndipo ambiri mankhwala angagwiritsidwe ntchito mpaka okha n'kupuma mabungwe zaumoyo.

mankhwala kwambiri zothandiza ana

Kuyendera m'badwo atsopano a maantibayotiki mndandanda wa mankhwala osavomerezeka chifukwa ana, mwapang'ono kwambiri. Mu ubwana, zitha kugwiritsidwa ntchito ndi oimira aminopenicillins angapo ( "Amoxicillin", "clavulanate"), cephalosporins ( "Ceftriaxone" "Cefepime"), macrolides ( "Azithromycin", "midecamycin" "Roxithromycin", "Clarithromycin"). mankhwala Fluoroquinolone, carbapenems ndi nitrofurans sangathe ntchito chifukwa cha chinyengo cha kukula kwa mafupa, chiwindi ndi impso kawopsedwe.

System nitrofurans si ntchito chifukwa cha kusowa umboni wasayansi kuchirikiza chitetezo cha mankhwala. Yekha ndi "furatsillina", oyenera chithandizo m'dera mabala. Lamakono kwambiri kothandiza mankhwala m'badwo wotsiriza wa ana motere: macrolides, penicillin, cephalosporins (mayina a mankhwala amapatsidwa pamwamba). Gulu otsala wothandizila antimicrobial ali osavomerezeka chifukwa cha poizoni, ndipo matenda chigoba.

ABSHS kwa amayi apakati

Malinga FDA gulu (US), ochepa maantibayotiki m'badwo atsopano angagwiritsidwe ntchito pa matenda a amayi apakati amene ali mndandanda ochepa. Iwo ali siyana A ndi B, kuti ngozi iwo anatsimikizira kapena ayi zotsatira teratogenic mu maphunziro nyama.

Zinthu ndi zotsatira unproven pa mwana wosabadwayo, komanso pamaso pa zotsatira poizoni zitha kugwiritsidwa ntchito ngati kuchuluka kwa zotsatira achire pa mbali (gulu C ndi D). Kukonzekera X gulu amasiyana kutsimikiziridwa zotsatira teratogenic pa mwana wosabadwayo, ngati n'koyenera, chifukwa cha ntchito yawo kwenikweni mimba.

Woyembekezera, maantibayotiki zotsatirazi m'badwo wotsiriza mapiritsi yotakata-sipekitiramu: kutetezedwa aminopenicillin ( "Amoklav", "Amoxiclav"), cephalosporins ( "Cefazolin" "Ceftriaxone" "Cefepime"). Macrolides ( "Azithromycin", "Clarithromycin", "midecamycin" "Roxithromycin") saloledwa ntchito mu trimester wachitatu wa gestation chifukwa chakuti mmene teratogenic sichinayambe anaphunzira mokwanira, ndipo wopanda sangathe unambiguously kulankhula. Komanso, amayi apakati bwinobwino ntchito ya penicillin mankhwala, pakalibe chifuwa.

Kugwiritsa ntchito mankhwala mankhwalawa matenda

mankhwala onse m'badwo wotsiriza yotakata-sipekitiramu, chiphunzitso, angagwiritsidwe ntchito matenda ndi chibayo ngati makhalidwe awo pharmacodynamic mulingo woyenera izi. Komabe, pali akadakwanitsira ziwembu za chithandizo zomveka za matenda. Iwo amatenga mu yofanana chifukwa osakaniza bwino antimicrobials kuonetsetsa Kuphunzira lonse tizilombo ta tizilombo tating'onoting'ono.

Nitrofurans, opangidwa kuchokera nitroimidazole ndi sulfonamides zopanda nzeru ntchito matenda yotupa a dongosolo kupuma. Kuphatikiza bwino kwambiri chifuwa kapena chibayo, m'mapapo otaya kutetezedwa macrolide ndi aminopenicillin ( "Amoklav" + "Azithromycin"). Yaitali matenda amafuna kusankhidwa cephalosporin m'malo aminopenicillin ( "Ceftriaxone" + "Azithromycin"). Mu chiwembu izi, macrolide mwina amasinthidwa ndi gulu lina analogi: chifukwa "midecamycin" "Clarithromycin" kapena "Roxithromycin".

Onsewa mankhwala atsopano-m'badwo kwa matenda ndi zotsatira kutchulidwa, ngakhale zizindikiro matenda a matenda apitirize kukhala. Muyezo wa mphamvu ya mankhwala - maonekedwe a chifuwa ndi phlegm pang'onopang'ono kuchapidwa ndi chithandizo cha malungo. Mu COPD komanso imafoola dyspnea, kudya bwino, yafupika chifuwa pafupipafupi zilakolako.

mankhwala a chibayo

Chibayo wa wofatsa ankachitira pamaziko a matenda, koma ntchito cephalosporin ndi macrolide. Pamene zolimbitsa kuti chaukali chibayo chiyambi yoikidwiratu cephalosporin ( "Ceftriaxone" kapena "Cefepime") angapo fluoroquinolones ( "Ciprofloxacin" kapena "Levofloxacin") dera zinazake. Izi mankhwala a m'badwo wotsiriza yotakata-sipekitiramu bwino kubisa microflora dera yotengedwa, ndi zotsatira za ntchito yawo ndi noticeable pa tsiku lachiwiri la mankhwala.

Masiku ano atsopano m'badwo wa mankhwala a chibayo (dzina pamwamba) zimakhudza tizilomboto, ntchito zake zofunika ndi kupondereza kapena kumupha. Zinthu woyamba amatchedwa bacteriostatic, bactericidal ndi mankhwala masika. Cephalosporins, ndi fluoroquinolones aminopenicillin - bactericides, ndi macrolides - bacteriostats. Komanso, kuphatikiza kwa mankhwala anafuna osati kukuza osiyanasiyana zochita, komanso kutsatira malamulo a kaphatikizidwe mankhwala limodzi ndi bactericidal bacteriostatic wina.

Chithandizo cha chibayo kwambiri HITD

Mu odwala kwambiri pamene pangakhale odwala ndi chibayo kwambiri ndi matenda mavuto pa maziko a kuledzera. Chopereka waukulu kukula kwa chikhalidwe cha odwala bwino, microflora tizilombo kuti kugonjetsedwa antimicrobials kwambiri. Zikatero, ntchito carbapenems ( "Imipinem-cilastatin," "Tienam", "Meropenem"), si zomveka ntchito pokhazikitsa ndi outpatient.

Chithandizo cha sinusitis ndi sinusitis

Masiku ano atsopano m'badwo wa mankhwala kwa sinusitis kapena nkusani ntchito aphe majeremusi. Zikatero, munthu akhoza kugwiritsa ntchito mankhwala bactericidal. Komabe, ngati nkusani vuto lalikulu ndi kupeza malo a kutupa antimicrobial. Choncho, ambiri amangoti ntchito mankhwala cephalosporin. Chitsanzo ndi "Ceftriaxone" kapena "Cefepime." Lusoli kuperekedwa fluoroquinolone III m'badwo - "Levofloxacin".

Chithandizo cha antimicrobials angina zamakono

m'badwo atsopano a mankhwala pa zilonda zapakhosi amaikidwa kwa cholinga chomwecho. Komanso, ndi nkusani, ndi chimodzimodzi wothandizila odana ndi tizilombo tating'onoting'ono akhoza kugwiritsidwa ntchito pa zilonda zapakhosi. Kusiyana kokha kuti mu nkhani ya kutupa tonsils akhoza kugwiritsidwa ntchito ndi antiseptics, mwachitsanzo, "furatsillina" - yokonza angapo nitrofurans. Ngakhale aminopenicillins angina komanso zikhoza kugwiritsidwa ntchito kutetezedwa sulbactam kapena asidi clavulanic ( "Amoklav" "Amoksiklav" "Ospamoks"). Ndipo mankhwala ayenera kuperekedwa kwa masiku 10-14.

Chithandizo cha pyelonephritis ndi matenda a dongosolo genitourinary

Chifukwa kuipitsidwa wa kapepalako mkodzo ndi tizilombo ting'onoting'ono, m'badwo atsopano a mankhwala mu pyelonephritis zofunika mankhwala. Wamkulu achire phindu apa ndi cephalosporins, fluoroquinolones ndi nitrofurans. Cephalosporins ntchito pyelonephritis ndi zochepa kwambiri, ndipo fluoroquinolones ( "Ciprofloxacin", "Levofloxacin", "Ofloxacin", "Moxifloxacin") - pa kuwonongeka chapansipansi ndi chithandizocho.

Mankhwala bwino kwambiri, oyenera onse monotherapy ndi osakaniza "Ceftriaxone" ndi nthumwi za chiwerengero cha nitrofurans - "FURAMAG"). Komanso quinolone angagwiritsidwe ntchito - "asidi Nalidixic". Recent kulenga woipa mkulu mu mkodzo ndi zikugwira ntchito yolimbana ndi wothandizila causative matenda a njira ya mkodzo. Komanso, nthawi zina pamene gardnelleze dysbacteriosis nyini ndi ntchito "Metronidazole".

azikana mankhwala ndi zotsatira zake

Chifukwa cha kusintha nthawi zonse zakuthupi chibadwa cha tizilombo, makamaka mabakiteriya, ambiri antimicrobial mogwira ali kwambiri yafupika. Kupeza kukana mankhwala, mabakiteriya anakonza luso kupulumuka mu thupi mwa mediating kudzitsitsa matenda opatsirana. Zimenezi zimachititsa ofufuza kuyang'ana ndi muyika mumachitidwe mankhwala atsopano m'badwo wotsiriza.

M'nthawi ya kukhalapo kwa wothandizila antimicrobial zithandize za 7000 zinthu mwa njira inayake ntchito mankhwala. Ambiri a iwo anatuluka ntchito chifukwa zotsatira ndi kukomoka zofunika mbali kapena chifukwa cha kupeza kukana tating'onoting'ono kwa iwo. Chifukwa lero mankhwala ntchito cha m'ma 160 mankhwala. Pafupifupi 20 - ndiwo m'badwo atsopano a mankhwala amene maina kaŵirikaŵiri amawonekera mu mabuku zachipatala mankhwala antimicrobial matenda opatsirana.