I-Vancomycin iyi-antibiotic yokusebenzisa okugcina
I-Vancomycin iyi-antibiotic yokugcina okujwayelekile isetshenziselwa ukuphatha izifo ezingamelana nezidakamizwa. I-Vancomycin yaqala ukuhlukaniswa amasampula omhlabathi waseBornean eminyakeni engaphezu kwengu-50 edlule. Ekuqaleni, odokotela abambalwa basebenzisa i-vancomycin kunalokho bakhetha amanye ama-antibiotic ayebhekwa njengempumelelo kakhulu (i-vancomycin ithatha isikhathi eside ukuba ithathe isenzo kunama-penicillin) futhi ibe ne-toxic.
Kodwa-ke, kusukela ekuqaleni kwawo-1980, odokotela kanye nabanye ochwepheshe bezempilo baqala ukuveza isithakazelo esivuselelwe kulo muthi. Le nzalo evuselelwe kwakungenxa yokuthi ikhono lika-vancomycin lokulwa ne- Staphylococcus aureus (MRSA) ye-methicillin kanye nekhono lokuphatha i-colitis. I-colitis ye-pseudomembranous isifo esibi kakhulu se-colon (isifo sohudo) esithatha ngemuva kokulashwa namanye ama-antibiotic abulala isitshalo esijwayelekile samathumbu.
Indlela ye-Vancomycin yesenzo
I-Vancomycin yi-glycopeptide ye-tricyclic. Ibophezela ezindongeni zamangqamuzana ezincithakathaka futhi iguqule i-membrane cell memmane. Iphazamisa futhi ama-bacterium RNA synthesis.
Lapho silwa nezinhlobo eziningi zegrime-positive njenge-staphylococci ne-streptococci, izenzo zika-vancomycin ziyi-bacteriocidal. Ngamanye amazwi, i-vancomycin isebenza ngokuqondile ukubulala amagciwane anesigamu. Kodwa-ke, lapho elwa ne-enterococci, olunye uhlobo lwezinto eziphilayo, uhlelo lwe-vancomycin luyi-bacteriostatic, futhi lusebenza ukuvimbela ukukhiqizwa kwebhaktheriya.
Ukutholakala kwe-Vancomycin
I-Vancomycin isetshenziselwa ukulwa nezinhlobo eziningana zama-bacterial pathogens, eziningi zazo ezingamelana nezinye izinhlobo zama-antibiotic kuhlanganise:
- ukutheleleka okukhulu kwe-staphylococcal kubantu abahlukumeza i-penicillin
- i- Staphylococcus aureus engamelana ne-methicillin (MRSA)
- Staphylococcus epidermidis engamelana ne-methicillin
- Streptococcus pneumoniae emelana nezidakamizwa
- ukutheleleka okukhulu kwe-enterococcal kubantu abaphikisana ne-penicillin
- ukutheleleka okukhulu kwe-enterococcal okumelene ne-penicillin
- I-Viridans streptococci
- i-multi-drug resistant Corynebacterium jeikeium
- I-Clostridium difficile
Izifo eziphathwe i-vancomycin
I-Vancomycin isetshenziselwa ukuphatha izinhlobo eziningana zokutheleleka okujulile kuhlanganisa:
- Izifo zokuphefumula;
- amathambo, isikhumba kanye nezifo ezithintekayo;
- i-peritonitis;
- endocarditis (ukutheleleka kwenhliziyo);
- i-enterocolitis kanye ne-colitis epseudomembranous (izifo zamathumbu);
- i-prophylaxis lapho ihlolwa amazinyo, ama-biliary, i-GI, izifo zokuphefumulela nokuphefumula;
- ubumpofu bobuchopho (ukusetshenziswa okungekho kwelebuli);
- izifo ezithathelwanayo ngezikhathi (ukusetshenziswa okungekho kwelebuli);
- i-meningitis (ukusetshenziswa kwe-off off).
Ukuphathwa kwe-vancomycin nomthamo
Ngenxa yokuthi i-vancomycin ayitholakali kahle ngamathambo omzimba, ngokuvamile iqhutshwa njengomjovo. Kodwa-ke, uma isetshenziselwa ukwelapha i-enterocolitis kanye ne-pseudomembranous colitis, kokubili izifo zesisu, iziguli zithatha i-vancomycin yomlomo.
I-Vancomycin ivame ukuhlinzekwa kwisilonda esibhedlela. Ngenxa yokuthi ukulingana kunzima futhi kuxhomeke ekugxilweni kwezinga eliphezulu nokudla, izidakamizwa zezokwelapha zivame ukubizwa ukuba zibale izilinganiso.
Ngaphezu kwalokho, ngoba i-vancomycin idonswa yizinso, ukulandwa kwalesi sidakamizwa kunzima kakhulu kubantu abanokuhluleka kwenqunu.
Imiphumela ye-Vancomycin emibi
Imiphumela emibi kakhulu eyingozi eyenziwa yi-vancomycin ayivamile, futhi umphumela omubi kakhulu we-vancomycin yi-hypersensitivity elinganiselwe noma impendulo yokuhlunga. Kodwa-ke, i-vancomycin ingaba nephrotoxic futhi iwonakele izinso ikakhulukazi uma iphathwa nge-aminoglycosides, enye uhlobo lwe-antibiotic. Ngaphezu kwalokho, uma kusetshenziswa i-aminoglycosides noma i-high-dose e-erythromycin enomzimba, futhi futhi uhlobo oluthile lwe-antibiotic, i-vancomycin ingalimaza ukuzwa (i-ototoxicity).
Okokugcina, i-vancomycin ingabangela i-hyperemia noma i-red-man syndrome, uhlobo lokuqhuma; Ukuhlwitha okunjalo kunganciphisa uma isiguli sithola kuqala ama-antihistamine.
Ukuvimbela iVancomycin kubangela ukukhathazeka okukhulayo phakathi kwabahlengikazi, abacwaningi kanye ne-epidemiologists ngokufanayo. Ngenxa yokuthi i-vancomycin ingenye yezindlela zethu zokugcina ezibhekene nezifo ezivimbela izidakamizwa nezidakamizwa, ithemba lokuthi ngeke lisasebenza ukulwa nokutheleleka liyesabeka futhi lingasishiyi ezinye izinketho (cabanga ngoZosyn no-ceftaroline). Ngokuqondile, izinhlanzi ze-vanocycin ezingamelana ne-entococci ziye zanyuka ezibhedlela emhlabeni wonke. Ngenxa yokuthi i-vancomycin ivame ukuphathwa ezibhedlela, izindawo zokuhlengikaza (SKFs), amakhaya asebehlengikazi nokunye, kubalulekile ukuthi ochwepheshe bezempilo bathathe izinyathelo zokunciphisa ukuvimbela i-vancomycin njengokuvimbela ukucindezeleka nokunciphisa ukusakazwa kwe-vancomycin ukumelana neziguli ngokusebenzisa isiguli esifanele ukuzihlukanisa nokuhlanzeka.
Imithombo ekhethiwe
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 ngo-Ephreli 07, 2015.
I-Mosby's Drug Reference for Professions yezeMpilo, Edition lwesibili eyanyatheliswa nguMosby / Elsevier ngo-2010.