Ngenyanga ka-Mashi 2013, i-US Food and Drug Administration yanikeza isixwayiso mayelana nezinkinga ezingase zenzeke ngokwenhliziyo nge-antibiotic azithromycin. Isixwayiso sibonise ukuthi abanye abantu bangase babe nengozi yokufa ngokungazelelwe lapho bethatha lesi sidakamizwa, ikakhulu abantu abanezinhlobo ezithile zesifo senhliziyo.
Isixwayiso se-FDA senze ukuba kube khona ukusabalalisa kwezindaba ezandakazekayo, futhi kunikezwe ukuthandwa kwe-Z-Pack (okubekiwe ukuthi kulinganiselwa izikhathi ezingu-60 ngonyaka), futhi kwaholela ekwesabeni nokwesaba okukhulu phakathi kweziguli nodokotela ngokufanayo.
Kanjani I-Azithromycin Eyingozi Kangakanani?
U-Azithromycin uyilungu lomndeni we-macrolide, kanye ne-erythromycin ne-clarithromycin. Sekuyisikhathi eside saziwa ukuthi cishe wonke ama-antibiotic e-macrolide adala ukunwetshwa kwekhasi le- QT , isilinganiso esenziwe ku- electrocardiogram . Futhi kwabanye abantu - labo abazalwa abanesimo esihlukile se- QT syndrome eside , okuyisimo sezakhi zofuzo ezingabangela ama- arrhythmias enhliziyo - noma yini eyandisa isikhathi se-QT ingandisa ingozi ye-arrhythmia eyingozi okuthiwa i- tricycardia ye-ventricular .
Izikhathi eziningana ze-QT zingase zibe yingozi nakakhulu kubantu abanezinhlobo ezithile zezifo zenhliziyo, ikakhulukazi izifo ze-coronary isifo nokuhluleka kwenhliziyo .
Ngenhlanhla, ingozi enkulu yokwakha i-arrhythmia eyingozi nge-azithromycin incane kakhulu - into enjengeyodwa ezinkulungwaneni ezimbili.
Ngakho-ke i-Azithromycin ijoyina uhlu olude lwezidakamizwa ezingalula isikhathi se-QT, futhi ngaleyo ndlela kungandisa ukwanda kokufa okungazelelwe kubantu abanokukhubazeka abanesifo se-QT syndrome noma isifo senhliziyo.
Lezi zidakamizwa, ngaphezu kwemithi elwa namagciwane, zihlanganisa imishanguzo eminingana yama- antiarrhythmic (izidakamizwa, okungavamile, kufanele zivimbele ama-arrhythmias), izidakamizwa eziningana zokucindezeleka, kanye nezidakamizwa eziningana ezisetshenziselwa izimpawu zamathumbu.
Nasi uhlu lwezidakamizwa ezandisa isikhala se-QT, esilondolozwe yi-CredibleMeds, isikhungo se-University of Education and Research on therapeutics esekelwe eyunivesithi nesezimali.
Asikho isizathu sokucabanga ukuthi i-azithromycin iyingozi nakakhulu kunezinye izidakamizwa kulolu hlu olude: okungukuthi, kubantu abanezinhlobo ezihlukahlukene ze-QT syndrome noma izinhlobo ezihlukahlukene zesifo senhliziyo, noma iyiphi yalezi zidakamizwa kungenzeka kuyingozi. Kukhona omunye umuntu, lezi zidakamizwa zingathathwa ngaphandle kokukhathazeka mayelana nama-arrhythmias ahambisana nesikhathi eside se-QT.
Indlela Abantu Abasengozini Ngayo Engaziwa
Kunezibalo eziningi zezakhi zofuzo eziye zaqaphela ukuthi zikhomba abaningi balaba bantu abakhubazekile, kanti amanye amanqaku atholakele ngaso sonke isikhathi. Noma ubani onomunye walezi zimpawu zofuzo kufanele agweme i-azithromycin nanoma yisiphi esinye isidakamizwa kulolu hlu. Ngeshwa, ukuhlolwa kofuzo okwamanje akuyona inqubo evamile, kanti abantu abaningi abanokushintshashintsha kwe-QT eside abazi ukuthi basengozini.
Iningi odokotela namuhla baligweme ukusebenzisa noma yiliphi lezidakamizwa ze-QT-interval-prolonging kubantu abaye bazi i-long-QT syndrome, emalungwini omndeni wabantu abane-long-QT syndrome, noma kubantu abaye babe neziqephu ezingabonakali zokuboshwa komzimba noma i- syncope . Uma kukhona ukusola kokuhluka okude kwe-QT, ukuhlolwa kokucindezeleka kokuvivinya umzimba kungasetshenziswa njengesivivinyo sokuhlola. (Isikhathi se-QT singase sikhulise ngesikhathi sokuzivocavoca kubantu abakhubazekile.)
Kodwa uma kunikezwe isimo samanje sobuciko, iningi labo odokotela lizobeka izidakamizwa ezifana ne-azithromycin, uma kudingeka, kunoma ubani ongenaso isifo senhliziyo esingenalo umlando womuntu siqu noma womndeni ohambisana ne-long-QT syndrome, futhi umshini wakhe wokuqala we-electrocardiogram ujwayelekile - ikakhulukazi uma (njengoba kunjalo kuwe) lesi sidakamizwa sesivele sisetshenziswe izikhathi eziningana ngaphandle kwesibonakaliso senkinga.
Ngokusobala, noma kunjalo, into engcono kakhulu okufanele uyenze ukukhuluma nodokotela wakho mayelana nokuthi ungaqhubeka yini nokusebenzisa i-azithromycin ngezikhathi ezithile ngokuphepha.
> Imithombo:
> Ray WA, Murray KT, Hall K, et al. I-Azithromycin kanye Nengozi Yokufa Kwegazi. N Engl J Med 2012; 366: 1881.
> Ukuphathwa Kwezokudla Nezidakamizwa zase-US. I-Azithromycin (i-Zithromax noma i-Zmax): Ukuxhumana koKhuseleko Lwezidakamizwa - Ingozi Yezingcingo Zengqondo Ezibulalayo. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm343350.htm?source=govdelivery