I-Cephalosporins ingenye yamakilasi amaningi kakhulu anikezelwe kakhulu emithi emhlabeni. Kungenzeka ukuthi uhlangabezane nalezi zinambuzane ngisho noma ungajwayele igama. Ngokwesibonelo, phakathi kwezinye izinto, i-Keflex (cefalexin) isetshenziselwa ukuphatha izifo zesikhumba. Ukwengeza, i-Rocephin (i-ceftriaxone) isetshenziselwa ukuphatha i- pneumonia .
Kunezizukulwane ezinhlanu ze-cephalosporins.
Yini I-Cephalosporin?
I-Cephalosporins yaqala ukutholakala emanzini okugeleza amanzi ogwini laseSardinia ngo-1945. Ngo-1964, i-cephalosporin yokuqala yayimiswe.
I-Cephalosporins ihlelekile ngokufanayo nezinye izilwa-antibiotics. Njengama-penicillin, i-cephalosporins inesandatho ye-beta-lactam enamathele kwindandatho ye-dihyrdothiazole. Ukulinda le ring dihyrdothiazole kunezinhlobonhlobo zamaketanga ahlukene, okwakhiwa kwawo okwenza i-cephalosporins ehlukene ngezokwelapha ezahlukene kanye nomsebenzi wokulwa namagciwane.
I-Cephalosporins inezinhlelo ezintathu ezahlukene zokwenza:
- Ukubophezela kumaprotheni athile okubopha i-penicillin.
- Ukuvinjelwa kwesakhi sezingqimba zeseli.
- Ukuvuselelwa kwe-enzyme yokuzimela (okuzilimazayo) ekudongeni kweseli yebhaktheriya
I-Cephalosporins ihlukaniswe ngezizukulwane ezinhlanu. Kodwa-ke, i-cephalosporins ehlukile esizukulwaneni esifanayo ngezinye izikhathi amakhemikhali ahlobene futhi abe nemisebenzi ehlukile yezinto (cabanga ngamacencycry).
I-generalization efundiswe abaningi abaqeqeshiwe bezempilo ukuthi yizizukulwane ezilandelayo ze-cephalosporins, ukufakwa kwegrime-positive kuyancipha ngenkathi ukwanda kwegriam-negative kunganda.
Amaphesenti angama-3 kubo bonke abantu aphikisana ne-cephalosporins. Nokho, empeleni, le nombolo cishe iphakeme ngoba abantu abane-penicillin imithi kaningi ayinqunywanga i-cephalosporins.
I-Generation Generation Cephalosporins
I-cephalosporin yesizukulwane sokuqala ifika ngamafomu omlomo nezangaphakathi. Basebenza ngokumelene ne-Viridans streptococci, i-group A hemolytic streptococci, i-Staphylococcus aureus, i- E. coli , i-Klebsiella nama-bacterium a-Proteus. Njengawo wonke amanye ama-cephalosporin, i-cephalosporins yokuqala yokuzalwa ayisebenzi ku-enterococci.
Izibonelo ze-cephalosporins zokuqala zokuzalwa zifaka okulandelayo:
- I-Cephalexin (i-Keflex)
- Cephradine
- Cefadroxil
- I-Cefazolin (i-intravenous and intramuscular)
Ngokuvamile, i-cephalosporins yesizukulwane sokuqala ingasetshenziswa ukulwa nesikhumba kanye nezinye izifo ezithintekayo, izifo zokuphefumula, kanye nokutheleleka kwamagciwane. I-cephalosporins yokuqala yokuzalwa engasetshenziswa ingasetshenziswa njengeprophylaxis ngemuva kokuhlinzwa okuhlanzekile. Ngokuyinhloko, ukusabalalisa kwe- MRSA kuye kwehlisa ukusebenza kwe-cephalosporin yokuqala njengezizukulwane njenge-prophylaxis kanye nokwelashwa.
I-Second-Generation Cephalosporins
Ngokuvamile, i-cephalosporins yesibili yesizukulwane isasebenza kakhulu ngokumelene nempilo yegram-negative, eyenza ibe usizo kakhulu ezimweni eziningi zemitholampilo.
Isibonelo, i-cephalosporins yesibili yesizukulwane iyasebenza ngokumelene nezinkinga ze-Proteus ne-Klebsiella. I-cephalosporins yesibili yesizukulwane nayo ilwa noH.
umkhuhlane-imbangela ye-pneumonia, i-sepsis, ne-meningitis. Noma kunjalo, i-cephalosporin yesizukulwane sokuqala ngokuvamile iscono kakhulu ekuphatheni izifo ezigulane.
Izibonelo ze-cephalosporins yesibili ezizukulwaneni zifaka lokhu okulandelayo:
- Cefoxitin (cephamycin)
- I-Cefotetan (cephamycin)
- I-Cefuroxime (ngomlomo nangenhliziyo)
- Cefprozil
I-cephalosporins yesibili yesizukulwane yenza lokhu okulandelayo:
- Sinusitis
- I-Otitis media (ukutheleleka kwezindlebe)
- Izifo ezinama-anaerobic ezixubile ezihlanganisa i-peritonitis ne-diverticulitis
- I-Prophylaxis ngemuva kokuhlinzwa okungaqondakali
I-cephalosporins yesibili yesizukulwane ayikho imisebenzi ephikisana no-Pseudomonas aeruginosa.
I-Generation Cephalosporins Yesibili
Inzuzo enkulu ye-antibiotics yesizukulwane sesithathu nesine yesine ihlanganiswa kakhulu ngokumelene namagciwane angama-gram-negative.
Ngaphezu kwalokho, i-cephalosporin ceftazidime yesizukulwane sesithathu isebenza ngokumelene ne-Pseudomonas aeruginosa, amabhaktheriya angabangela izifo zesikhumba kubantu abanezigciwane ezijwayelekile zokuzivikela (cabanga ngemuva kokuchayeka kwibhebhisi elishisayo noma echibini elishisayo) kanye ne-pneumonia, ukutheleleka kwegazi ngakho-ke ukuphuma kulabo abanamasosha omzimba obuthakathaka (cabanga ngeziguli zokugcina ngemuva kokuhlinzwa nezibhedlela).
Kunezinhlobo ezimbalwa ze-cephalosporins yesizukulwane sesithathu. Ukuxoxisana nabo bonke bekungekho ngaphandle kwalesi sihloko. Ake-ke sigxile ku-ceftriaxone (i-Rocephin) enokusetshenziswa okuningi okufaka:
- Izifo ezincane zokuphefumula
- Izifo zesikhumba nezithambile
- I-gonorrhea engaqondakali
- Izifo ezithinta u-Urinary
- I-Otitis media
- Isifo sokuvuvukala sama-pelvic
- I-prophylaxis yokuhlinza
- I-bacteria septicemia (ukutheleleka kwegazi)
- I-Meningitis
- Izifo ze-Bone
- Izifo ezihlangene
- Izifo zangaphakathi kwesisu
I-cephalosporin yesine yesine
I-Cefepime iyona kuphela etholakalayo (i-FDA-ivunyiwe) i-cephalosporin yesizukulwane sesine. Njengesizukulwane sesithathu isizukulwane cephalosporin ceftazidime, lefepime isebenza ngokumelene Pseudomonas aeruginosa. Ngaphezu kwalokho, ukuqhwala kusebenza kakhulu ngokumelene namagciwane e-enterobacter ne-citrobacter. Okokugcina, ukuqhwala okunempilo kunokufakwa kwegrime efana ne-ceftriaxone.
Nazi ezinye zokusetshenziswa komtholampilo zokuqapha:
- I-pneumonia enamandla kakhulu
- Ukutheleleka okukhulu kwe-urinary tract
- Izifo zesikhumba nezithambile
- Ukutheleleka kwe-intra-esiswini kwesisu
I-Fifth-Generation Cephalosporin
Ngonyaka ka-2010, i-FDA ivume iCeftaroline (Teflaro), i-cephalosporin yesihlanu kuphela noma isizukulwane esiphambili. Njenge-cefepime, i-ceftaroline iyi-antibiotic enamandla okufanele igcinwe ukutheleleka okukhulu. Ngokuqondile, isebenza ngokumelene nezifo ezingamelana nezifo ezifana ne-MRSA (i-methicillin-resistant S. aureus ) ne-VRSA (i-vancomycin-resistant S. aureus) . Lesi sidakamizwa siphinde sikhiqizwe futhi sinqunywe ukulwa ne-pneumonia esitholakale emphakathini kanye nokutheleleka okukhulu kwezicubu nezikhumba. Ngenhlanhla, i-ceftaroline iphephile futhi ayinamandla okwenza ukuphikiswa.
Njengoba ungakwazi manje ukuqonda, i-cephalosporins yilawa maqembu ahlukahlukene aphikisana nemithi elwa namagciwane. Kodwa-ke, njengama-antibiotics amaningi, ukumelana nemithi ye-antibiotic ukukhathazeka kwabahlengikazi abaningi, izifo ze-epidemiologists, izikhulu zezempilo zomphakathi, iziguli nokunye.
Ukuphikiswa kwamabhaktheriya kungenxa yokuthi odokotela baqedile ngokweqile; Nokho, thina, njengeziguli, singasiza ukulwa nokuthuthukiswa kokumelana. Isibonelo, akufanele ngaso sonke isikhathi ulindele noma ufune ukuthi umshini wakho we-prescriber uhlinzeke ngama-antibiotics ukuphatha isifo esingahle sibe yindlala emvelweni. (Ama-antibiotics awasebenzanga ngokumelene namagciwane.) Ngaphezu kwalokho, uma kutholakala ama-antibiotic anqunyiwe, kubalulekile ukuthi uqedele yonke inkambo noma ngabe uzizwa ungcono.
Imithombo:
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
Lesi sihloko esithi "Ukuxilongwa Nokuphathwa Kokuphendula Okusheshayo Kwe-Hypersensitivity to Cephalosporins" yi-MH Kim noJM Lee kusuka ku- Asthma, U-Allergy & Immunology Research eshicilelwe ngo-2014.
Isethulo esibizwa ngokuthi "Ukusetshenziswa Nokubaluleka Kwe-Cephalosporins kuMuthi Wezokwelapha" yi-JH Amandla ku-FDA.