Kev xaiv tshuaj tua kab mob yog txoj haujlwm ntawm tus kws kho mob. Vim muaj kev tiv thaiv ntau ntxiv ntawm cov kab mob ntawm ntau yam pathologies rau cov tshuaj tua kab mob, cov kws kho mob yuav tsum tau siv tshuaj tua kab mob ntau ntxiv hauv kev xyaum txhua hnub. Cov no yog cov tshuaj uas cov kab mob tsis tau tsim cov tshuaj tiv thaiv kab mob. Txawm li cas los xij, lawv muaj cov tshuaj lom ntau dua thiab cov kab mob ua haujlwm tau sai sai.
cov ntaub ntawv dav dav
Tshuaj tua kab mob yog ib yam khoom uas tau txais lawm, hluavtaws lossis semi-synthetically, muaj peev xwm ua kom puas ntau yam kab mob. Lawv tau siv los ua tshuaj txij li ib puas xyoo dhau los. Cov tshuaj tua kab mob hauv qab no tau paub: beta-lactams, aminoglycosides, tetracyclines, macrolides, fluoroquinolones, lincosamides thiab glycopeptides. Lawv muaj cov kab mob bacteriostatic thiab bactericidal.
WHO pawg tshuaj tua kab mob
Lub Koom Haum Ntiaj Tebkev kho mob, tag nrho cov tshuaj tua kab mob tau muab faib ua peb pawg thiab cov lus pom zoo tau muab rau thaum siv lawv. Nov yog rau:
- muaj tshuaj tiv thaiv kab mob;
- kho kom zoo rau kev kho mob ntawm cov kab mob sib kis;
- khaws cov tshuaj tua kab mob rau ntawm cia los kho cov kab mob tshwm sim los ntawm ntau cov kab mob tiv thaiv kab mob.
Cia peb saib kom ze:
- Pab pawg thib ob suav nrog cov tshuaj pom zoo raws li khaws cia thiab xaiv cov tshuaj tua kab mob rau kev kho mob ntawm qee yam kab mob. Kev siv tshuaj hauv pab pawg no ua rau muaj kev pheej hmoo ntawm kev tiv thaiv. Yog li ntawd, kev siv "Ciprofloxacin" rau kev kho mob ntawm cov kab mob tsis yooj yim, xws li cystitis lossis kab mob bronchitis yuav tsum raug txwv. Txwv tsis pub, txoj kev pheej hmoo ntawm kev txhim kho ntxiv ntawm cov tshuaj tiv thaiv kab mob nce ntxiv.
- Pab pawg thib peb suav nrog Colistin thiab qee cov tshuaj los ntawm pawg cephalosporin. Cov tshuaj no hu ua reserve los yog "kawg kab". Lawv raug qhia tias siv rau kev kis mob hnyav thiab mob hnyav thaum lwm yam kev kho mob ua tsis tiav.
Txoj hauv kev no rau kev siv cov tshuaj tua kab mob tso cai:
- siv tshuaj tua kab mob kom zoo thiab muaj kev xav;
- nce kev kho tau zoo;
- txo qis kev txhim kho ntawm kev tawm tsam rau lawv.
Tus nqi ntawm cov tshuaj tiv thaiv cia
Thaum siv cov nyiaj no, muaj qhov tshwm sim ntau ntawm kev txhim khomicrobial tsis kam rau lawv. Tshwj xeeb yog sai sai nws txhim kho rau cov tshuaj xws li:
- Rifampicin;
- "Oleandomycin";
- "Streptomycin".
Slower rau "Levomitsetin" thiab tshuaj ntawm pab pawg penicillins thiab tetracyclines. Tsis tshua muaj rau polymyxins. Tsis tas li ntawd, muaj kev tiv thaiv kev sib tw, thiab, ntxiv rau, nws siv tsis tau rau cov neeg sawv cev siv, tab sis kuj rau cov tshuaj zoo ib yam li nws hauv cov qauv molecular. Qhov kev pheej hmoo ntawm kev tiv thaiv tsawg tsawg yog tias cov cai hauv qab no tau ua raws:
- laj thawj;
- xaiv koob tshuaj zoo tshaj;
- sijhawm nkag mus sib raug rau qhov hnyav ntawm cov kab mob;
- sib xyaw ua ke ntawm cov tshuaj tua kab mob txaus.
Thaum tiv thaiv cov tshuaj tua kab mob tseem ceeb, nws raug hloov mus rau qhov tshwj tseg.
Colistin
Qhov no yog tshuaj tua kab mob ntawm qhov chaw kawg, nws tau qhia thaum lwm cov tshuaj tua kab mob tsis muaj txiaj ntsig. Ua ntej siv Colistin, cov kab mob pathogenic raug kuaj pom thiab kuaj pom cov tshuaj tua kab mob. Cov tshuaj belongs rau pawg ntawm polymyxins, thiab raws li cov qauv tshuaj nws yog ib tug cyclic polypeptide. Cov tshuaj nquag yog sodium colistimethate. Nws cov kab mob bactericidal yog qhia rau gram-negative microorganisms. Nws cuam tshuam kev ua haujlwm ntawm cov txheej txheem sab nrauv thiab cytoplasmic membranes, thiab kuj hloov nws cov qauv. Thaum noj qhov ncauj, cov tshuaj yog xyaum tsis absorbed nyob rau hauv lub plab hnyuv ib ntsuj av, nws yog excreted los ntawm txoj hnyuv. Siv nyob rau hauv cov ntaub ntawv noj tshuaj hauv qab no:
- Powder for solution for inhalation - qhia rau kev kho mob ntawm cov kab mob ua pa ntawm tus kab mob,
- Pills - kho thiab tiv thaiv kab mob plab.
Tshuaj tua kab mob "Colistin" ua haujlwm rau cov kab mob tshwm sim los ntawm cov kab mob uas nkag mus rau nws cov tshuaj nquag. Nws tau raug pov thawj tias muaj txiaj ntsig zoo hauv cystic fibrosis. Hauv kev xyaum, cov tshuaj tsis tshua siv los kho cov kab mob. Ib qho ntawm cov teebmeem tsis zoo yog nephrotoxicity, piv txwv li cov teebmeem tshuaj lom rau lub raum, ua rau lawv puas tsuaj thaum siv rau cov neeg uas muaj lub raum tsis ua haujlwm thiab puas plab hnyuv mucosa.
Txoj kev siv tshuaj tua kab mob suav nrog hauv qhov cia
Tshuaj tua kab mob ntawm pab pawg tshwj xeeb yog qis dua hauv ib lossis ntau lub zog rau cov tseem ceeb, piv txwv li lawv muaj:
- kev loj hlob sai ntawm microbial tsis kam rau lawv;
- kev ua si me me;
- ntau yam xwm txheej phem.
Kev sib txuas nrog cov saum toj no, lawv tau qhia rau kev tsis haum lossis tsis kam ntawm cov kab mob mus rau pawg tseem ceeb ntawm cov tshuaj tua kab mob.
Txhawm rau cuam tshuam cov kab mob tiv thaiv kab mob, cov kws kho mob pom zoo cov tshuaj khaws cia hauv qab no:
- Macrolides - Oleandomycin, Erythromycin.
- Combined - "Adimycin", "Sigmamycin", "Oletetrin", "Tetraolean".
Antimicrobials suav nrog hauv pab pawg khaws cia siv thaum lub sijhawmkev kho mob
Hauv qab no yog cov npe me me ntawm cov tshuaj tua kab mob.
- "Tetracycline" tau sau tseg hauv cov xwm txheej tsis tshua muaj, vim tias cov kab mob microbial tiv thaiv nws sai sai. Yog li ntawd, nws belongs rau pawg tseg thiab qhia thaum lwm cov tshuaj tua kab mob tsis zoo. Kev lag luam kws tshuaj tsim tawm ob qho tib si sab nraud thiab sab hauv cov ntaub ntawv ntawm "Erythromycin". Nws yog siv rau hauv cov kab mob pathological tshwm sim los ntawm staphylococcus aureus.
- "Levomycetin" yog hais txog cov nyiaj tshwj xeeb hauv kev sib txuas nrog cov kev mob tshwm sim loj - granulocytopenia, reticulocytopenia, aplastic anemia, xaus rau kev tuag. Yog li, noj cov tshuaj tua kab mob no yuav tsum tau saib xyuas tsis tu ncua ntawm lub xeev ntawm cov kab mob hematopoietic. Txhawm rau txo qhov cuam tshuam tsis zoo, nws raug sau tseg rau kev kho luv luv. Kev txais tos rov qab "Levomitsetin" tsis pom zoo. Nws yog siv los kho tus mob typhoid fever, brucellosis, thiab tsuas yog nrog kev kho tsis zoo nrog lwm cov tshuaj tua kab mob.
- Gentamicin, Monomycin, Kanamycin, Neomycin yog cov tshuaj ntawm pawg aminoglycoside uas muaj zog toxicity. Lawv kev txais tos yog ua raws li kev saib xyuas nruj ntawm tus kws kho mob thiab tshwj tsis yog contraindications rau kev siv rau txhua tus neeg.
- Vancomycin muaj qhov muaj zog tshaj ototoxicity.
Feem ntau, "Gentamicin" raug tshuaj los tua tus kab mob purulent. Cov tshuaj "Monomycin" tsuas yog pom zoo rau kev kho mob ntawm daim tawv nqaij leishmaniasis.
Reserve tshuaj tua kab mob:lis
Cov tshuaj tua kab mob suav nrog hauv pab pawg tshwj xeeb suav nrog cov tshuaj hauv qab no. Lawv tsuas yog siv hauv tsev kho mob:
- "Amicacin";
- Ceftazidime;
- YCiprofloxacin;
- Cefepim;
- Imipenem;
- Miropenem;
- Vancomycin;
- Rifampicin;
- "Amphotericin B".
Tshuaj tua kab mob siv los kho cystitis
Fluoroquinolones ntawm tiam tom ntej yog cov tshuaj xaiv los kho tus kab mob no:
- thib peb - "Sparfloxacin", "Levofloxacin";
- plaub - Moxifloxacin.
Cov tshuaj no nkag tau zoo heev thiab tsim kom muaj kev sib haum xeeb hauv cov ntaub so ntswg. Lawv tau siv ib hnub ib zaug, txij li fluoroquinolone cov tshuaj tua kab mob muaj lub neej ntev ntev. Muab cov tshuaj nyob rau hauv qhov siab tshaj plaws pub rau noj txhua hnub. Vim muaj kev siv ntau ntawm fluoroquinolones hauv kev xyaum ua haujlwm sab nraud, tau muaj kev nce ntxiv hauv kev tiv thaiv cov kab mob hauv cov zis rau lawv.
Yog tias muaj kev txwv tsis pub noj cov tshuaj tua kab mob ntawm pab pawg no lossis tau txais cov ntaub ntawv ntawm kev tiv thaiv, tus kws kho mob kho cov kev kho mob thiab pom zoo cov tshuaj thib ob los ntawm pawg macrolides lossis tetracyclines, piv txwv li khaws cov tshuaj tua kab mob. Nrog cystitis nyob rau hauv tsev kho mob, lub sij hawm ntawm kev kho mob yog los ntawm kaum mus rau kaum plaub hnub. Qee zaum, Meropenem, uas belongs rau carbapenems, yog muab los ntawm pawg tseg. Cov txiaj ntsig ntawm kev kho mob yog ntsuas los ntawmbacteriological kab lis kev cai ntawm cov zis, nrog rau normalization ntawm theem ntawm cov qe ntshav dawb nyob rau hauv cov zis.
Tshuaj tua kab mob khaub thuas thiab SARS
Kuv puas tuaj yeem noj tshuaj tua kab mob rau kev ua pa? Tus kws kho mob uas tuaj koom tau pom zoo kom siv tshuaj tua kab mob rau tus mob khaub thuas, SARS tom qab kuaj pom thawj cov tsos mob ntawm mob ntsws, sinusitis, tonsillitis, thiab lwm yam. Cov tshuaj penicillin tau sau tseg thaum tsis muaj kev fab tshuaj rau lawv. Nrog rau cov tshuaj tiv thaiv penicillins, nyiam yog muab rau fluoroquinolones, thiab cov no yog cov tshuaj cia. Lawv qhov kev txais tos yog txwv rau cov menyuam yaus, cev xeeb tub thiab lactating cov poj niam. Cephalosporins raug pom zoo rau ntau yam pathologies ntawm kev ua pa. Rau kev kho mob ntawm cov teeb meem ntawm cov kab mob ua pa nyuaj, cov tshuaj xaiv yog macrolides, uas yog cov tshuaj tshwj xeeb. Cov tshuaj tua kab mob rau SARS yuav tsum tau muab tshuaj tsuas yog thaum:
- Kev mob ntawm tus neeg mob tsis zoo.
- Kev nkag mus ntawm tus kab mob.
- -tsos ntawm purulent tawm.
- Kub kub uas kav ntev tshaj peb hnub.
Yuav kom xaiv cov tshuaj tua kab mob kom zoo, ua tiav kab lis kev cai tiv thaiv kab mob.
Zoo kawg
Txhawm rau tiv thaiv kev txhim kho ntawm cov kab mob resistant, nws yog ib qho tsim nyog los hloov cov tshuaj tua kab mob uas siv dav siv nrog cov tshiab, tsis tshua siv thiab tsim tshiab. Cov tshuaj no hu ua reserve antibiotics. Ib qho ntawm cov haujlwm tseem ceeb tshaj plaws yog kev tsim cov tshuaj tshiab nrog cov lus pom zoo xaiv, uas yuav muaj kev ua haujlwm tiv thaiv cov kab mob microbes thiab muajYam tsawg kawg uas tsis zoo rau lub cev ntawm tus kheej.
