Elwa isizukulwana entsha ebanzi-spectrum

Phakathi amachiza uphethe indawo ebalulekileyo isizukulwana yokugqibela antibiotics esebenzayo kwiintsholongwane ezininzi. Zisetyenziswa ukuba unyango ezimbi ezasulelayo, leyo kunciphise kakhulu lokufa izigulane banal ukuya pneumonias umhla kunye pyelonephritis. Ngenxa yesifo lula ngesantya ukuchacha nephika, sinusitis, yaye kwenzeka ukwenza iinkqubo ezintsonkothileyo yotyando. izifo Nokuba nxeba babacukucezela antibiotics ngempumelelo.

Broad-spectrum antibiotics (ABSHS)

Olu didi lubandakanya arhente elwa asebenzayo ngokuchasene gram-HIV kunye gram-HIV eziphilayo. Eyokuqala zingabameli causative i zizifo isisu, ezimbi yokukrala enzala kunye neenkqubo zemiphunga. Gram-HIV izinto ngokuqhelekileyo bangenwe inxeba nokuzithethelela kukuvela iingxaki postoperative kutyando.

Uluhlu ABSHS ixesha release ezahlukeneyo

Abanye spectrum zintsholongwane ezibanzi isizukulwana zakutshanje asebenzayo ngokuchasene nezifo protozoal. Imizekelo iquka ahlobene nitroimidazole - tinidazole, metronidazole kunye ornidazole. Zezona lwimi zisetyenziswa metronidazole ngenxa nokufikeleleka. iklasi yakhe Togu - tinidazole - spectrum efanayo umsebenzi elwa, kodwa parenterally hayi isicelo. Ngokubanzi, onke amaqela antibiotics ebanzi-spectrum zithiwe thaca ngolu hlobo lulandelayo:

• penicillins zendalo;
• aminopenicillin ingibitorzaschischennye;
• penicillins pseudomonas, kuquka ingibitorzaschischennye;
• cephalosporins III isizukulwana cephalosporins ngezizukulwana IV ;
• iqela aminoglycosides;
• antibiotics tetracycline ;
• antibiotics macrolide;
• inani antibiotics carbapenem;
• chloramphenicol;
• fosfomycin;
• rifampin;
• dioxidine;
• sulfonamides;
• quinolones, fluoroquinolones;
• Iqela nitrofurans;
• nitroimidazole antibiotics series.

Olu luhlu ongayi kunikwa amagama amaqela antibiotics elimxinwa-omoya. Baya ethile inani elincinane eziphilayo kwaye ayasebenza kuzo. amachiza emxinwa-spectrum ayikwazi zingasetyenziswa ukunyanga superinfection kwaye isicelo empirically. Zisetyenziswa njenge antibiotics-umgca yokuqala lwegciwane emiselweyo.

Uluhlu kwizizukulwana ezidlulileyo ABSHS

Le ngasentla Amagosa elwa lilungu iintlobo ngeentlobo iziyobisi. Olu luluhlu olupheleleyo lwamaqela kwezinto umsebenzi nxamnye gram-HIV kunye gram-elibi iintsholongwane. Nangona kunjalo, uluhlu iqulethe zombini isizukulwana entsha antibiotics kunye nabameli zangaphambili qela. Abameli izizukulwana ezintsha zala ngasentla na amaqela iziyobisi zilandelayo:

• aminopenicillin ezingamelanga zidibane beta-lactamase ( "Sulbactam", "Ampicillin", "clavulanate" "Amoxicillin");
• cephalosporins zezizukulwana III kunye IV ( "Cefotaxime" "Cefoperazone" "Ceftazidime" "ceftriaxone" "cefpirome" "Cefepime");
• isizukulwana III antibiotics aminoglycoside ( "Amikacin" "Netilmicin");
• macrolides 14 no-15-membered semi-eyenziweyo ( "Roxithromycin" "Clarithromycin," "Azithromycin");
• Natural 16-membered antibiotics macrolide ( "midecamycin");
• fluoroquinolones III no IV kwizizukulwana ( "levofloxacin" "sparfloxacin" "Gatifloxacin" "Trovafloxacin" "moxifloxacin");
• carbapenems ( "meropenem" "Imipinem-cilastatin" "Ertapenem");
• nitrofurans ( "Nitrofurantoin" "Furazidin", "ersefuril").

Antibiotics abangekhoyo kuluhlu

Ezi penicillins ekhuselweyo ngaphambili antipseudomonal kufuneka spectrum ezibanzi msebenzi, nangona kunjalo, isicelo nxamnye kuphela P. aeruginosa ngenxa imfuneko ukunciphisa qha mhlawumbi kunye nomhla zakutshanje kunye olwa enamandla. Oku ke kuthintela le umngcipheko iintsholongwane-enganyangekiyo ngamachiza. Ukusebenza kakhulu kusulelo Pseudomonas ubonisa "tazobactam." Ngamanye amaxesha "Piperacillin" yaye "clavulanate" lisetyenziswa isizukulwana entsha ezifo pneumonia okubangelwa Ngeentlobo esibhedlele lwe gciwane.

Kwakhona kolu luhlu akukho qela antibiotics isizukulwana lokugqibela penicillins zendalo kunye anti-staphylococcal. I zangaphambili aziyi kusetyenziswa unyango nomonde ngenxa imfuneko wolawulo efakwa okanye intramuscular rhoqo. Forms eziya kubavumela ukuba ngomlomo, ayikho. A efanayo likhona cephalosporins. Ngenxa spectrum efanayo komsebenzi njengoko penicillins, abakwazi kwenziwa ngomlomo kuba intshabalalo esiswini.

Cephalosporins kunye penicillins ukusetyenziswa parenteral - ukuba isizukulwana entsha antibiotics olusebenzayo pneumonia. izazinzulu NASB baye baphumelela ekuphuhliseni ifom umthamo wolawulo enteral. Noko ke, uphando akakafiki kusebenzise, kunye nenani iziyobisi zingasetyenziswa kude kangaka kuphela kumaziko ononophelo lwempilo zokubhala.

antibiotics ezisebenzayo kakhulu ukuba abantwana

Ukuphonononga isizukulwana zakutshanje-ntsholongwane, uluhlu lwamachiza isincomo sazo ebantwaneni, imithambo kakhulu. Ebuntwaneni, zinokusetyenziswa kuphela ngabameli aminopenicillins ezininzi ( "Amoxicillin", "clavulanate"), cephalosporins ( "Ceftriaxone" "Cefepime"), macrolides ( "Azithromycin", "midecamycin" "Roxithromycin", "Clarithromycin"). antibiotics fluoroquinolone, carbapenems kunye nitrofurans ayikwazi ingasetyenziswa ngenxa yokubhuqwa ukukhula amathambo, wesibindi nezintso letyhefu.

nitrofurans System abalindelekanga isicelo ngenxa yokungabikho kobungqina yenzululwazi obuxhasa ukhuseleko unyango. Le ngaphandle kuphela yi "furatsillina", ifanele unyango yasekuhlaleni amanxeba. antibiotics Modern kwaye kakhulu nekhutheleyo kwisizukulwana yokugqibela abantwana ngolu hlobo lulandelayo: macrolides, penicillins, cephalosporins (amagama iziyobisi zinikwe apha ngentla). Iqela eziseleyo arhente elwa akukhuthazwa ngenxa isiphumo zinetyhefu, kunye nezigulo skeletal.

ABSHS ukuba abasetyhini abakhulelweyo

Ngokutsho FDA yokuhlela (US), nje ezimbalwa ntsholongwane isizukulwana yakutshanje ungasetyenziswa kunyango abafazi abakhulelweyo, nto leyo uluhlu encinane kakhulu. Basonta iindidi A and B, oko kukuthi ingozi kubo ayiqinisekiswanga okanye akukho iziphumo eteratogenic kwizifundo zezilwanyana.

Substances ngeziphumo bokuba ekukhuleni kosana olungekazalwa, kwakunye ne phambi kwesiphumo zinetyhefu zingasetyenziswa kuphela xa yokuxhaphaka ukusebenza zonyango phezu icala (udidi C no-D). Amalungiselelo X uhlobo kwahluka iziphumo eteratogenic kubonakele ekukhuleni kosana olungekazalwa, ukuba kuyimfuneko, ngenxa yokusebenzisa ngokuyimfuneko isisu.

Ngexa lokukhulelwa, le ntsholongwane zilandelayo isizukulwana yokugqibela iipilisi ebanzi-spectrum: aminopenicillin ekhuselweyo ( "Amoklav", "Amoxiclav"), cephalosporins ( "Cefazolin" "Ceftriaxone" "Cefepime"). Macrolides ( "Azithromycin", "Clarithromycin", "midecamycin" "Roxithromycin") zivumelekile ukusebenzisa kwi senyanga yesithathu yokumitha ngenxa yokuba ifuthe labo eteratogenic ayenziwanga kufundwe ngokupheleleyo, kunye nokungabikho lithe ayintsokothanga ukuthetha. Kwakhona, abasetyhini abakhulelweyo ngokukhuselekileyo ukusebenzisa antibiotics penicillin engekho komzimba.

Ukusetyenziswa antibiotics kwi unyango yomoya

Zonke antibiotics isizukulwana yokugqibela ebanzi-spectrum, ngethiyori, ingasetyenziselwa bronchitis kunye nenyumoniya ukuba iimpawu zazo pharmacodynamic kangangoko kulo. Nangona kunjalo, kukho izikimu ngokupheleleyo kunyango ubengo izifo ezinjalo. Ukuba acinge kwiiyantlukwano ingqalelo imidibaniso ngempumelelo antimicrobials kukuqinisekisa ukuba ngeentlobo Ngeentlobo abe nenkani.

Nitrofurans, ahlobene nitroimidazole kunye sulfonamides ukusetyenziswa ngqiqweni xa izifo yokukrala isixokelelwano sokuphefumla. Indibaniselwano iyimpumelelo nephika okanye inyumoniya, ukuhamba umphunga ekhuselwe macrolide ne aminopenicillin ( "Amoklav" + "Azithromycin"). bronchitis elide ifuna ukuqeshwa cephalosporin endaweni aminopenicillin ( "Ceftriaxone" + "Azithromycin"). Xa eli cebo, i macrolide ukuze kufakwe kunye nenye iklasi analog: ngokuba "midecamycin" "Clarithromycin" okanye "Roxithromycin".

Zonke ezi ntsholongwane zamva-sizukulwana nephika zibe nefuthe ngokukhawuleza, nangona imiqondiso kwezonyango sifo kuqhubeka khona. Le kwingongoma nganye ukusebenza unyango - imbonakalo ukhohlokhohlo kunye phlegm ngokuthe ukuwuhlamba isiqabu fever. Xa COPD yekeyeke dyspnea, inkanuko ephuculiweyo, kunciphise ukhohlokhohlo iminqweno rhoqo.

unyango olusebenzayo yinyumoniya

Inyumoniya nomoya baphathwa ngenxa yomoya, kodwa ukusetyenziswa cephalosporin kunye macrolide. Xa eliphakathi ukuya ezifunyenwe kuluntu-pneumonia kakhulu lwe imvelaphi elimisiweyo cephalosporin ( "Ceftriaxone" okanye "Cefepime") kunye nenani fluoroquinolones ( "ciprofloxacin" okanye "Levofloxacin"). Ezi antibiotics zezizukulwana yokugqibela ebanzi-spectrum microflora kakuhle Nyanzela yoluntu-ababeyiqwebile, kunye nefuthe ukusebenzisa kwabo buqapheleke ngosuku lwesibini lonyango.

Isizukulwana yanamhlanje entsha yeencwadi ezifo semiphunga (igama ezinikwe apha ngentla) kuchaphazela pathogen, imisebenzi yayo kubalulekile ngokuthi abathintela okanye ukumbulala. Izinto zokuqala kuthiwa bacteriostatic, bactericidal kunye neziyobisi yokugqibela. Cephalosporins, kunye fluoroquinolones aminopenicillin - bactericides, kunye macrolides - bacteriostats. Ngaphezu koko, ukuhlanganiswa antibiotics ekujongwe ukuba ukwandisa kuphela iindidi zemisebenzi, kodwa ukuba ukuthobela imithetho yokudibanisa iziyobisi enye omnye bacteriostatic bactericidal.

Unyango yinyumoniya yayinzima HITD

Xa labagula kakhulu, apho kusenokuba kukho izigulane kunye nenyumoniya kakhulu uyinkxwaleko syndrome kwisiqalo kunxilwe. Igalelo engundoqo ubungqongqo imeko izigulane esinjalo microflora yayintsholongwane eyosulela ukuba iyamelana antimicrobials ezininzi. Kwiimeko ezinjalo, isicelo carbapenems ( "Imipinem-cilastatin," "Tienam", "Meropenem"), alungile ukuze zisetyenziswe ezingalaliswayo sentlalo.

Unyango lwe sinusitis kunye sinusitis

Isizukulwana yanamhlanje entsha yeencwadi ezifo sinusitis okanye sinus esetyenziselwa ukubulala iintsholongwane. Kwiimeko ezinjalo, umntu unokusebenzisa olwa bactericidal. Noko ke, ukuba sinus nzima iphambili ufikelelo kwisiza ukudumba elwa. Ngoko ke, lo ezininzi eziqhele ukusetyenziswa cephalosporin iziyobisi. Umzekelo i "Ceftriaxone" okanye "Cefepime." Kusenokwenzeka kwakhona maliqhutywe fluoroquinolone III isizukulwana - "Levofloxacin".

Unyango antimicrobials angina mihla

isizukulwana entsha ezifo umqala obuhlungu ozimiselweyo injongo efanayo. Ngaphezu koko, yaye sinus, kwaye arhente ezifanayo anti-ngeentsholongwane singasetyenziswa tonsils. Umahluko kuphela kukuba kwimeko ukudumba tonsils nazo zinokusetyenziswa kunye kokuba, umzekelo, "furatsillina" - ukulungiswa eziliqela nitrofurans. Nangona aminopenicillins angina nazo zingasetyenziswa sulbactam ezikhuselweyo ngempumelelo okanye clavulanic acid ( "Amoklav" "Amoksiklav" "Ospamoks"). Kunye neziyobisi kufuneka ilawulwe iintsuku 10-14.

Unyango lwe pyelonephritis kunye nosulelo yenkqubo genitourinary

Ngenxa ukungcoliswa womchamo yi eziphilayo, isizukulwana entsha antibiotics e pyelonephritis ayimfuneko unyango lwabo. Ixabiso therapeutic kakhulu apha cephalosporins, fluoroquinolones kunye nitrofurans. Cephalosporins zisetyenziswa pyelonephritis kakhulu kakhulu kangako, kunye fluoroquinolones ( "ciprofloxacin", "Levofloxacin", "Ofloxacin", "moxifloxacin") - xa ukuvuthuluka kwisiqalo babe therapy.

Ichiza kakhulu yimpumelelo, ifanele zombini monotherapy kunye nodibaniso "Ceftriaxone" emele naliphi na inani nitrofurans - "FURAMAG"). Kwakhona quinolone zingasetyenziswa - "Nalidixic acid". Akutsha nje ukudala aphezulu lokuhlala umchamo kwaye asebenzayo ngokuchasene arhente causative le zizifo womchamo. Kwakhona, ngamanye amaxesha xa gardnelleze dysbacteriosis lobufazi kwaye isicelo "Metronidazole".

nemithi kunye nempembelelo yawo

Ngenxa utshintsho rhoqo kwi zofuzo ezincinane, ikakhulu iintsholongwane, ukusebenza ezininzi elwa yehliswe kakhulu. Ukufumana ukumelana iziyobisi, iintsholongwane walungisa ubuchule ukuze sisinde ngokuthi ekufumaneni ukuthotywa kwezifo ezosulelayo emzimbeni womntu. Oku inyanzela abaphandi ukuba bakhangele kwaye kusebenzise antibiotics kulemihla yokugqibela.

Ebudeni bexesha zempilo arhente elwa nawo aphuhliswe malunga 7000 izinto ngendlela ethile asetyenziswa ngayo amayeza. Inkoliso yabo yaphuma ukusetyenziswa ngenxa yeziphumo ebezingalindelekanga ngokwezonyango ebalulekileyo okanye ngenxa ekufunyanweni amagciwane kubo. Ngenxa yokuba namhlanje amayeza isicelo malunga 160 iziyobisi. Malunga 20 kuzo - sisizukulwana zakutshanje-ntsholongwane, abamagama zidla ngokuvela zikwixesha kwiincwadi zamayeza unyango elwa kwezifo ezosulelayo.