Beta-lactam imithi elwa namagciwane: mshini wezenzo kanye ngezigaba

Imithi elwa namagciwane - iqembu zezidakamizwa Etiotropic mshini wezenzo. Ngamanye amazwi, lezi izidakamizwa isinyathelo ngqo imbangela isifo (kuleli cala, lesi silwanyana iyona ejenti causative) wenze njalo ngezindlela ezimbili: ukubhubhisa amagciwane (microbicides - penicillins, cephalosporins) noma zivimbele ukwanda kwabo (bacteriostatic - tetracyclines, sulfonamides).

Kukhona omningi izidakamizwa elwa namagciwane, kodwa iqembu yakhula kakhulu wabo - lena beta-lactams. Kuyinto ngazo futhi uzobe okuxoxwe ngazo kulesi sihloko.

Ukwahlukanisa kwamaphilisi

On lo mshini wezenzo le mithi zihlukaniswe amaqembu ayisithupha main:

1. Imithi elwa namagciwane ukuthi zivimbela zamagama izingxenye cell ulwelwesi: penicillins, cephalosporins, nabanye.
2. Imithi ukuvimbela ukusebenza evamile odongeni cell: polyenes polymyxins.
3. Izidakamizwa ukuthi zivimbela amaprotheni zamagama: macrolides, tetracyclines, aminoglycosides, nabanye.
4. Inhibitory RNA zamagama ngesikhathi isinyathelo isinyathelo-RNA polymerase: rifamycins, sulphonamides.
5. Inhibitory RNA zamagama ngesikhathi isinyathelo isinyathelo of polymerase DNA: actinomycins et al.
6. DNA zamagama blocker: anthracyclines, nitrofurans nabanye.

Nokho, lokhu ngezigaba zingavumi kakhulu. Ngo umkhuba emtholampilo, wenza division elandelayo antimicrobial:

1. Penicillins.
2. Cephalosporins.
3. Macrolides.
4. Aminoglycosides.
5. Polymyxin futhi polyenes.
6. Tetracyclines.
7. Sulfonamides.
8. Aminohinolonov nemikhiqizo.
9. Nitrofurans.
10. Fluoroquinolones.

Beta-lactam antibiotic. Sakhiwo mshini wezenzo

Leli qembu zezidakamizwa umphumela amagciwane futhi uhlu ngokwanele ebanzi izinkomba ukusetshenziswa. Beta-lactam imithi elwa namagciwane zihlanganisa penicillins, cephalosporins, carbapenems, monobactams. Bonke 'zinezikhathi ukusebenza kahle eliphezulu futhi ubuthi iphansana, abenze kwezidakamizwa ezivame engabelwe ukwelapha izifo eziningi.

Lo mshini wezenzo we-beta-lactam imithi elwa namagciwane ngenxa isakhiwo sabo. Omningi imininingwane lapha yini, kuwufanele kokukhuluma kuphela mayelana ebaluleke kakhulu, okuyinto wanika igama lonke iqembu izidakamizwa. Afakwe molecule iringi beta-lactam futhi ihlinzeka umphumela evelele amagciwane, okuyinto livezwa ekuvimbeni zamagama weseli odongeni izingxenye pathogen. Nokho, ama-bacterium amaningi ziyakwazi ukukhiqiza enzyme akhethekile, okuyinto ephula isakhiwo esiyingini, kanjalo wayencisha-antibiotic kuyinto isikhali zako ezisemqoka. Yingakho ukusetshenziswa kwezidakamizwa ekwelapheni ayengawazi isivikelo beta-lactamases, nesigqi.

Manje beba kwande imithi elwa namagciwane beta-lactam iqembu, bavikelekile isenzo enzyme virus. Ukwakheka yabo ihlanganisa izinto ukuvimba zamagama we-beta-lactamase, ezifana clavulanic acid. avikelwe beta-lactam ngezilapha magciwane (njenge "Amoxiclav") wadala ngaleyo ndlela. Okunye inhibitor of enzyme webhaktheriya zihlanganisa "Sulbactam" futhi "tazobactam."

Imithi kusukela iqembu penicillins: Umlando

Amalungiselelo kulolu chungechunge babe antibiotic lokuqala, nomphumela oqabulayo zazo wayaziwa abantu. Kwaphela isikhathi eside ziye kabanzi for ekwelapheni izifo ezihlukahlukene futhi eminyakeni yokuqala isicelo cishe panacea. Nokho, ngokushesha yaba sobala ukuthi ukusebenza kwabo kancane kancane ewa, njengoba ukuziphendukela izwe lama-bacterium awusizo akemi namanje. Amagciwane bayakwazi ukuzivumelanisa ngokushesha ukuze ezihlukahlukene izimo eziyinkimbinkimbi khona, futhi isishiya isizukulwane ukukhanya-bacterium-antibiotic nemithi.

Ukwanda penicillin akuzange kusize kwaholela ekwandeni okusheshayo zamagciwane non-singangena kwamagciwane kubo, ngakho njengoba injalo emsulwa manje izidakamizwa kuleli qembu ayizwakali futhi azisetshenziswa. Basuke engcono sisetshenziswa ndawonye izinto okuyinto ukuthuthukisa ukusebenza yabo amagciwane, futhi kuvimbela izindlela webhaktheriya zokuzivikela.

Amalungiselelo penicillin akuzange kusize

Lena beta-lactam antibiotic, Ukwahlukaniswa okuyinto ngempela ebanzi:

1. I penicillins zemvelo (isib "penicillin").
2. Anti-staphylococcal ( "Oxacillin").
3. Penicillins, enwetshiwe-spectrum ( "Ampicillin" "Amoxicillin").
4. Pseudomonas ( "azlocillin").
5. penicillins Okuvikelwe (kuhlanganiswe clavulanic acid "sulbactam", "tazobactam").
6. Izidakamizwa, kufaka phakathi isibalo samalungu alo ambalwa imithi elwa namagciwane penicillin akuzange kusize.

Ekuhlaziyeni izidakamizwa bohlanga penicillin akuzange kusize

I penicillins zemvelo ongaphumelela ukucindezela umsebenzi kokubili igremu-HIV futhi igremu-negative nezilwanyana ezincane. Wale mithandazo, sizwele kuleli qembu we-beta-lactam imithi elwa namagciwane Streptococcus kanye izimbangela meningitis. I-bacterium esisele usuku atholwe izindlela ukuzivikela. penicillins Yemvelo aphumelela ngokumelene anaerobes :. Clostridial peptokokki, peptostreptokokkov njll Le mithi mancane ezinobuthi futhi abe Inani elincane nemiphumela engemihle, uhlu okuyinto kuyehla ngokuyinhloko komzimba, nakuba ukweqisa izidakamizwa kungenzeka kanye nokuthuthukiswa sokuwa futhi ukubonakala izimpawu ubuthi by kwezitho wokugaya ukudla.

Kusukela penicillins anti-staphylococcal Inani enkulu kunazo lo muthi beta-lactam ngokuthi "Oxacillin". Lokhu belungiselela isicelo ewumngcingo, ngoba kuhloswe ikakhulu ukuze silwe S. aureus. Kungenxa yalesi lwegciwane (kuhlanganise penitsillinrezistentnyh zamagciwane) "Oxacillin" ndlela iphumelela kakhulu. ukungaphathwa kahle imithi kuba ezifanayo nalezo namanye amalungu aleli qembu elithi izidakamizwa.

Penicillins, enwetshiwe-spectrum ngaphandle nje igremu-HIV, amalutshwana-negative futhi anaerobic flora nazo asebenzayo ngokumelene causative ejenti izifo emathunjini. Imiphumela engemihle akazange zehluke ngenhla, nakuba lezi izidakamizwa zinezikhathi okungenzeka lisetudlwana kuphazamiseka wokugaya ukudla.

Beta-lactam antibiotic "azlocillin" (kummeleli iqembu wesine penicillins) yakhelwe ukubhekana Pseudomonas aeruginosa. Nokho, okwamanje we lwegciwane wembula ukumelana izidakamizwa kulolu chungechunge, okwenza ukusetshenziswa kwabo akuyona yaphumelela kangaka.

penicillins Mayelana Okuvikelwe eshiwo ngenhla. Ngenxa yokuthi le mithi afaka ngezithako zawo izinto zivimbela beta-lactamase esikhiqiza amagciwane, zingabantu aphumelela kakhudlwana ukwelapha izifo eziningi.

Iqembu lokugcina - kuba inhlanganisela abameleli eziningana penicillin, eziqinisanayo isinyathelo nomunye.

Izizukulwane ezine amagciwane fighters

Beta-lactam antibiotic cephalosporins ukuphi. Le mithi, efana penicillin akuzange kusize, banakekele bohlu lwabo ebanzi isinyathelo futhi ayinayo imiphumela eminingi engemihle.

Kunamaqembu (isizukulwane) cephalosporins ezine:

1. Laba bameleli be-esivelele kunazo zonke isizukulwane sokuqala - "Cefazolin" futhi "Cephalexin". Basuke ngokuyinhloko yakhelwe ulwe staphylococci, streptococci, meningococci futhi gonococci, kanye ezinye izinto eziphilayo igremu-HIV.
2. Isizukulwane sesibili - kuyinto "Cefuroxime" beta-lactam antibiotic. endaweni wakhe wemfanelo kuhlanganisa nezilwanyana ezincane ikakhulu igremu-HIV.
3. "Cefotaxime", "Ceftazidime" - abamele iqembu lesithathu ngezigaba. Ziyakwazi ngempumelelo kakhulu ngokumelene enterobacteria futhi singayibhubhisa izitshalo nosocomial (esibhedlela zakulezi nezilwanyana ezincane).
4. kwesizukulwane sesine umkhiqizo main - ". Cefepime" It has zonke izinzuzo izidakamizwa ngenhla, ngaphezu kwalokho, uqinile kakhulu beta-lactamases bacterium ine umsebenzi ngokumelene Pseudomonas aeruginosa.

Cephalosporins ne-beta-lactam imithi elwa namagciwane sisonke elinesimo umphumela evelele amagciwane.

Ngenxa ukusabela ezingezinhle nokuphathwa izidakamizwa ukunakwa kakhulu bafanelwe idatha ahlukahlukene komzimba (awahlabi kusukela ezincane ezisongela ukuphila, ezifana ukushaqeka anaphylactic), kwezinye izimo iziyaluyalu ngokweqile, izitho zokugaya.

inqolobane izimali

"Imipenem" - a-antibiotic beta-lactam bohlanga carbapenem. Yena, kanye engengaphansi adumile "Meropenem" ukusebenza umthelela ukumelana nezinye izidakamizwa e-microflora anganika kangakanani izingqinamba ngisho yesithathu neyesine cephalosporins isizukulwane.

Beta-lactam amagciwane iqembu carbapenems - umuthi esetshenziswa ezimweni ezinzima kakhulu, lapho Amagciwane akuzona amenable ekwelashweni ngamanye izidakamizwa.

Yenza kusho inombolo ezimbili

"Aztreonam" - ummeleli ovelele monobactams, it libhekene spectrum kuqhathaniswa emincane senzo. Lokhu-antibiotic beta-lactam ndlela iphumelela kakhulu ngokumelene aerobic igremu-HIV. Nokho, kufanele kuphawulwe ukuthi njengoba "Imipenem" "Aztreonam" kakhulu kungayinaki beta-lactamases, okwenza kube izidakamizwa oluthandwa yamafomu ezinzima izifo esibangelwa lezi Amagciwane, ikakhulukazi uma ukwehluleka ukwelashwa nezinye elwa namagciwane.

Nomkhakha we isinyathelo we-beta-lactam imithi elwa namagciwane

Kafushane nje, kufanele kuphawulwe ukuthi amalungiselelo ala maqembu sinomthelela isibalo esikhulu sezithunjwa zinhlobo kwamagciwane. Lo mshini wezenzo we-beta-lactam imithi elwa namagciwane yokuthi engashiyi ithuba kwamagciwane lokusinda: iseli odongeni zamagama ukuvinjelwa - isigwebo sentambo ngokuba amagciwane.

Gram-HIV futhi Gram-negative eziphilayo, aerobic kanye anaerobic ... Zonke lezi abameleli flora pathogenic kukhona izidakamizwa ngempumelelo kakhulu. Yiqiniso, kukhona phakathi alama-antibiotic kanye namathuluzi ezikhethekile kakhulu, kodwa iningi labo ilungela ukulwa nama ejenti ethu eziningana ezithathelwanayo. Beta-lactam imithi elwa namagciwane bayakwazi ukumelana ngisho nalabo abamele flora nosocomial, kukhona ukumelana kakhulu nokwelashwa.

Kuyini nesigqi esibhedlela?

Sikhuluma ezincane-eziphilayo ezikhona ezikhungweni zezempilo. Imithombo ngokubukeka kwabo ukukhonza iziguli kanye nabasebenzi bezempilo. Ikakhulukazi iyingozi ezifihliwe, amafomu indolent izifo. Isibhedlela - indawo ephelele ukuze abuthele kuzo zonke inkampani kungenzeka yezifo ezithathelwanayo. A ukwephulwa imithetho yenhlanzeko kanye nezinkambiso kukhona evundile okungamila lokhu flora ithole niche sokuba khona, lapho ayengase baphile, zohlobo futhi zithole amandla okumelana nemithi.

Ukumelana High esibhedlela zamagciwane ngokuyinhloko ngenxa yokuthi lokho, nasezibhedlela kwendawo bacterium ayakwazi ukuxhumana ezihlukahlukene izidakamizwa. Ngokwemvelo, lokhu kusho imiphumela izidakamizwa ku eziphilayo kwenzeka ngengozi, ngaphandle kokuba ukubhubhisa ilitshe, futhi ngemithamo emincane, futhi lokhu kusenza sibe yokuthi abameleli microflora esibhedlela ingakha isivikelo izindlela elimazayo bakufunde ngayo ukuba simelane nawo. Nasezinhluphekweni zakulezi avele silwe ukuthi kunzima kakhulu, futhi ngezinye izikhathi kubonakala sengathi akunakwenzeka.

Beta-lactam kwamaphilisi eziningi ngandlela-thile ozama ukuxazulula le nkinga eziyinkimbinkimbi. Phakathi kwabo kukhona abamele ukuthi ungakwazi ukubhekana ngempela ngokuphumelelayo ngisho izinhliziyo ezilukhuni kakhulu izidakamizwa amagciwane. Lesi sidakamizwa Reserve. ukusetshenziswa alinganiselwe, njengoba amiswa kuphela uma sidingeka ngempela. Uma lezi imithi ngokweqile zifana nokuthela esetshenziswa ngokuvamile ngokungadingekile ke, cishe, siyophela ekwindla ka ukusebenza kwabo, ngoba ngaleso sikhathi ama-bacterium nethuba basebenzisane kwafakwa isilinganiso esincane semithi lezi izidakamizwa, ukufunda kubo nokuthuthukisa izindlela yokuvikela.

Lapho iqondiswa beta-lactam elwa namagciwane?

Izinkomba ukusetshenziswa kwaleli qembu izidakamizwa ngenxa ngokuyinhloko spectrum izenzo zabo. Kungaba kuhle kakhulu ukuba aqoke-antibiotic beta-lactam e ukutheleleka, okuyinto lwegciwane ozwelayo isenzo izidakamizwa.

Penicillins zaziwa kahle kakhulu ekwelapheni pharyngitis, namathansela, inyumoniya, scarlet fever, meningitis endocarditis webhaktheriya, actinomycosis, anaerobic izifo, leptospirosis, salmonellosis, shigellosis, izifo ezithathelwanayo of isikhumba nezicubu esithambile. Ungakhohlwa mayelana izidakamizwa ezingaba ukulwa ne Pseudomonas aeruginosa.

Cephalosporins babe spectrum efanayo yomsebenzi, ngakho izinkomba ngabo cishe iyafana ukuthi penicillins. Nokho, kufanele kusho ukuthi ukusebenza kwe-cephalosporins, ikakhulukazi zokugcina izizukulwane ezimbili, hhayi isibonelo ngenhla.

Monobactams futhi carbapenems zenzelwe zokunqanda izifo ezimbi kakhulu futhi kahle esilaphekayo, kuhlanganise nalezo okubangelwa amagciwane e esibhedlela. Futhi aphumelele sepsis futhi ukushaqeka ukonakala.

imiphumela engathandeki

Njengoba kakade kushiwo, antibiotic beta-lactam (izidakamizwa fanele kuze lo xuku ahlelwe ngenhla) zihlukaniswa linani lelincane yokuba nemiphumela elimazayo emzimbeni. Ukudlikizela ezingavamile futhi izimpawu kuphazamiseka wokugaya ukudla esongela ukuphila cha. I esiyingozi ngempela kungaba ezinzima ukusabela iguliswa imithi phakathi beta-lactam antibiotic.

Ukuqubuka, pruritus, rhinitis futhi conjunctivitis akuyona kuphila kwetfu engotini, nakuba kubuhlungu ngempela. Yini ngempela kumelwe esatshwe, ngoba enjalo ukusabela kabi komzimba njengoba angioedema (ikakhulukazi endaweni amalaka, okuyinto kuhambisana dyspnea ezinzima kuze ukungakwazi ukuphefumula) futhi ukushaqeka anaphylactic. Ngakho-ke, lo muthi Ungaqala kuphela ngemva kokwenza ukuhlolwa yokungezwani komzimba.

Okungenzeka cross-ukusabela. Beta-lactam antibiotic, ngezigaba okusho khona inani elikhulu amaqembu izidakamizwa, ikhipha kakhulu efana nomunye, okusho ukuthi uma ukungabekezelelani ukuba omunye wabo, wonke umuntu uzobe ziqondakala umzimba njengenhlangano allergen.

A amazwi ambalwa mayelana nezici ezikhulisa ukumelana amagciwane

Ukuncipha kancane ukusebenza izidakamizwa elwa namagciwane (kuhlanganise beta-lactam antibiotic) ngenxa ngokungenangqondo njalo futhi ngokuvamile asilungile isicelo. Kuvele Yiqiniso akuphelele ukwelashwa, ukusetshenziswa ngemithamo emincane zokwelapha akuzona kunikela yokutakula, kodwa ukuvimbela nezilwanyana ezincane ithuba "isitimela", baziqambela nokuthuthukisa izindlela isivikelo izidakamizwa. Ngakho ingabe kuyamangalisa ukuthi yokugcina ibe ayizwakali ngokuhamba kwesikhathi?

Nakuba manje antibiotic kungukuthi ukhululeka Pharmacy ngaphandle kadokotela ukuze uthole bonke unga. Lokhu kusho ukuthi i-self futhi lapho umuntu enezinkinga ezihambisana (usebenzisa sonke isikhathi isidakamizwa efanayo, kokuphazamiseka abangenangqondo okwelashwa, umthamo engalungile nokunye.) Ingabe uhlale, ukudala izimo ukutshala olumelana nemithi.

Kulapha ukuhlala futhi-esibhedlela flora, zinethuba ngenkuthalo ukuxhumana izidakamizwa ehlukahlukene baziqambela izindlela ezintsha ukuwanqoba.

Yini okumelwe uyenze? Musa self-medicate, ukusebenzisa izincomo udokotela ukuba khona: ukuthatha imithi nje okudingekayo, futhi kule ngemithamo efanele. Nge flora nosocomial ukulwa Yiqiniso, kunzima kakhulu, kodwa noma kunjalo kungenzeka. Kokuqina nezindinganiso zempilo kanye nokuqaliswa yabo esiqinile ngabe unciphise amathuba ukudala izimo ezikahle ezifanelekayo ukufuya flora nemithi.

A amazwi ambalwa esiphethweni

Isihloko ubanzi kakhulu - beta-lactam antibiotic. Yezemithi (isayensi yemithi kanye nethonya layo umzimba) anikezele kubo izahluko ezimbalwa ukuthi abahlanganisi kwaphela isici jikelele iqembu, kodwa futhi aqukethe incazelo enhle eyaziwa kakhulu ka nabameleli bayo. Lesi sihloko akuhloselwe ukuba esibanzi, kodwa imizamo ukwethula amaphuzu avelele, ukwazi ukuthi yiziphi imithi kuyadingeka.

Hlala uphilile futhi ungakhohlwa: ngaphambi kokusebenzisa lolu noma ukuthi imithi elwa namagciwane ukufunda kahle imiyalelo kanye ngokuqinile izincomo, noma kangcono nokho, ubonane onguchwepheshe.