I-fluoroquinolones yi-antibiotics ebanzi
Uma ufunda lesi sihloko, kungenzeka ukuthi u-ciprofloxacin (Cipro), i-levofloxacin (i-Levaquin) noma uhlobo oluthile lwe-fluoroquinolone yokuphathwa kwe-bacteria (cabanga ukutheleleka kokuphefumula noma ukuvuthwa kwamagciwane). Ngokuvamile, lezi zidakamizwa ziphephile futhi zisebenza ngokumelene nezinhlobo eziningi zegciwane lesigciwane-gram-negative kanye nama-gram-negative amagciwane abenza ukhetho oluhle ukwelashwa kwesistimu noma yomzimba wonke.
Emkhakheni wazo zonke izinhlobo ze-fluoroquinolones-kuhlanganise nezidakamizwa ezifana ne-ciprofloxacin ne-levofloxacin-ziyi-2 ilungu le-carbon almond rings elihlanganiswe ne-athomu ye-fluoride. Lezi zidakamizwa zisebenza ngokukhomba ama-enzyme amabili amabhaktheriya aphethwe ukukwazisa, ukubola, nokufaka uphawu lwe-DNA phakathi nokuphindaphinda: i-DNA gyrase ne-topoisomerase IV. Ngenxa yokuthi i-fluoroquinolones yamanje ibophezela ku-2 enzyme ehlukene, kunzima ukuthi amabhaktheriya aguqule futhi avimbele izenzo zalezi zidakamizwa.
Nasi uhlu lwamabhaktheriya ukuthi ama-fluoroquinolones asebenzayo ngokumelene:
- Staphylococci
- I-Streptococcus pneumoniae (i-levofloxacin ne-moxifloxacin iphumelela kakhulu)
- Staphylococci viridans
- I-Bacillus anthracis (i-ciprofloxacin ivunyelwe ukuphatha i-anthrax)
- I-Chlamydia (i-levofloxacin ne-moxifloxacin iphumelela kakhulu)
- I-enterococcus faecalis
- Listeria monocytogenes
- Izinhlobo ze-Nocardia
- I-Neisseria meningitides ne-gonorrhoeae
- I-Haemophilus influenzae
- Izinhlobo ze-Enterobacteriaceae
- I-Pseudomonas aeruginosa (i-ciprofloxacin iphumelela kakhulu)
- Izinhlobo ze-Vibrio.
Ngokuqondile, i-fluoroquinolones isebenzayo ngokumelene nama-aerobes kanye nama-anaerobes asebenzayo. Kodwa-ke, i-Anaerobes ngokuvamile ayimelana nale mithi.
Nasi uhlu lwamagciwane okugciwane ukuthi ama-fluoroquinolones afana ne-ciprofloxacin ne-levofloxacin aphathe:
- I-pneumonia
- I-brronchitis
- I-Anthrax
- I-gastroenteritis yebhaktheriya (isisu somkhuhlane)
- Izifo ezithinta u-Urinary
- Izifo ze-Urethral
- I-Septicemia
- Isifo sokuvuvukala sama-pelvic
- Ama-joint and bone infections
- Sinusitis
- Ama-joint and bone infections
- Izifo zangaphakathi kwesisu
Ngaphezu kokufakwa kwe-bacterial broad spectrum, i-fluoroquinolones nayo idlala ezinye izakhiwo ezibenza zibe ngama-antibiotic amakhulu. Okokuqala, bathathwa ngomlomo (hhayi ngomjovo). Okwesibili, basakaza kahle kuzo zonke izindawo ezihlukahlukene zomzimba. Okwesibili, i-fluoroquinolones inesigamu sempilo esivumelekile ukuthi ivumeleke ukuba ihanjiswe kanye noma kabili ngosuku. Okwesine, i-ciprofloxacin ne-levofloxacin ixoshwa kakhulu yizinso ezenza zikwazi ukulwa nokutheleleka kwamagciwane.
Ngokuyinhloko, i-fluoroquinolones imithi ephephile kakhulu. Noma kunjalo, zingabangela imiphumela eminye emibi ehlanganisa:
- Ukuphazamiseka kwamathumbu (ukucasuka kwesisu)
- Ukusabela kwe-allergenic (ukukhwabanisa isikhumba)
- Izinsizwa
- Ukuzizwa
- Ama-hallucinations
- Ukwandiswa kwe-QT (ukuphazamiseka kagesi kagesi okubonakalayo ku-ECG)
- I-Tendon rupture
- I-angioedema (ukuvuvukala kwesikhumba)
- Izithombeensitivity
Ngaphandle kwemiphumela emibi engenhla, okungavamile, i-fluoroquinolones ingabangela nokulimala kwesibindi nokwandisa ama-enzyme yesibindi. Ama-fluoroquinolones asekuqaleni ayeziwa kakhulu ngokubangela ukulimala kwesibindi (cabanga gatifloxacin kanye ne-trovafloxacin) futhi kamuva waxoshwa emakethe.
Namuhla, ithuba lokulimala kwesibindi ku-fluoroquinolone yi-1 kwabangu-100,000 abantu abaveziwe. Ngenxa yokuthi i-levofloxacin ne-ciprofloxacin yizona zinhlobo eziningi zokulwa namagciwane we-fluoroquinolone, yizona ezivame kakhulu ukulimala kwesibindi se-idiosyncratic. Ukulimala okunjalo kwesibindi ngokuvamile kwenzeka emasontweni angu-1 kuya kwangu-4 ngemva kokuphathwa kwe-fluoroquinolone.
Nakuba ukumelana ne-fluoroquinolones kungavamile kakhulu kunokumelana namanye ama-antibiotics, kusekhona ikakhulukazi phakathi kwe-staphylococci (MRSA), i-Pseudomonas aeruginosa, neSerratia marcescens. Futhi uma uhlobo lwebhaktheriya lungamelana nomuntu owodwa we-fluoroquinolone khona-ke kunamathele kubo bonke.
Uma wena noma othandekayo unqunywe i-fluoroquinolone-noma noma iyiphi imithi elwa namagciwane ngenxa yalolu daba-kubalulekile ukuba uqedele inkambo yakho yokwelapha. Ngokushiya ukwelashwa phakathi nendawo-emva kokuthi uzizwe "kangcono" -ukufaka isandla ekukhethweni, ekusindeni nasekusabalaleni kwama-antibiotic-resistant bacteria okuba khona ukukhathazeka kwezempilo emphakathini. Khumbula ukuthi sihlala silwa nempi elwa nama-antibiotics, futhi silahlekelwa yimpi uma sekuphikiswa.
Imithombo:
I-Deck DH, i-Winston LG. I-Sulfonamides, i-Trimethoprim, ne-Quinolones. Ku: Katzung BG, Trevor AJ. ama-eds. I-Basic & Clinical Pharmacology, 13e . ENew York, NY: McGraw-Hill; 2015. Kufinyelelwe ku-Mashi 29, 2015.
I-Guglielmo B. Amagciwane we-Anti-Infective Chemotherapeutic & Antibiotic. Ku: Papadakis MA, McPhee SJ, Rabow MW. ama-eds. Ukutholakala Kwezokwelapha Nokwelashwa Kwamanje 2015 . ENew York, NY: McGraw-Hill; 2014. Kufinyelelwe ngomhla ka-29 Mashi, 2015.
I-RYAN KJ, i-RAY C. I-Agent Antibacterial, kanye no-Resistance. Ku: RYAN KJ, RAY C. eds. I-Sherris Medical Microbiology, i-Sixth Edition . ENew York, NY: McGraw-Hill; 2014. Kufinyelelwe ngomhla ka-29 Mashi, 2015