I-Fluoroquinolones yi-antibiotics ebanzi
Ukuba ufunda le nqaku, unokube u-ciprofloxacin (Cipro), i-levofloxacin (i-Levaquin) okanye enye uhlobo ye-fluoroquinolone yokunyangwa kwintsholongwane yebhakteria (cinga ukuphefumula okanye ukutheleleka kwiphepha). Ngokubanzi, eli liyeza likhuselekile kwaye lisebenza ngokubhekiselele kwiqela elibanzi le-gram-positive kunye ne-gram-negative bacterial pathogens ezenza ukhetho olufanelekileyo lwenkqubo yonyango okanye yomzimba jikelele.
Kwinqanaba lazo zonke i-fluoroquinolones-kubandakanywa neziyobisi ezifana neproplolocacin kunye nevofloxacin-zi-2 zeeloni zelungu zithandathu ezixhomekeke kwi-atom ye-fluoride. La machiza asebenza ngokujolise kwi-2 enzymes ebhaktheriya ejongene nokukhangela, ukubola kunye nokutywinwa kweDNA ngexesha lokuphendula: i-DNA gyrase kunye ne-topoisomerase IV. Ngenxa yokuba i-fluoroquinolones yangoku ibophelela kwi-enzyme e-2 eyahlukeneyo, kunzima ukuba iibhaktheriya ziguqule kwaye zibalekele izenzo zamachiza.
Nalu uluhlu lweebhaktheriya ezenza i-fluoroquinolones zisebenzisana nazo:
- Staphylococci
- I-Streptococcus pneumoniae (i-levofloxacin kunye ne-moxifloxacin inempumelelo kakhulu)
- Staphylococci viridans
- I-Bacillus anthracis (i-ciprofloxacin ivunyelwe ukuphatha i-anthrax)
- I-Chlamydia (i-levofloxacin kunye ne-moxifloxacin inempumelelo kakhulu)
- Enterococcus faecalis
- Listeria monocytogenes
- Iintlobo zeNocardia
- I-Neisseria meningitides kunye ne-gonorrhoeae
- Haemophilus influenzae
- I-Enterobacteriaceae
- I-Pseudomonas aeruginosa (i-ciprofloxacin iphumelela kakhulu)
- Iintlobo zeVibrio.
Ngokukodwa, i-fluoroquinolones iyasebenza malunga ne-aerobes kunye ne-anaerobes enezixhobo. Nangona kunjalo, ii-Anaerobes zihlala zinganyangeki kule miyeza.
Nalu uluhlu lweentsholongwane ze-bhakteria ezinokuthi i-fluoroquinolones ifana ne-ciprofloxacin kunye ne-levofloxacin:
- Pneumonia
- Bronchitis
- Anthrax
- I-bacterium gastroenteritis (isisu somkhuhlane)
- Izifo zogqirha
- Izifo ezithandwayo
- Septicemia
- Izifo eziphambene nepelvic
- Izifo ezihlangeneyo kunye namathambo
- Sinusitis
- Izifo ezihlangeneyo kunye namathambo
- Izifo zesisu esiswini
Ukongeza kwi-cover-spectrum ye-bacterial coverage, i-fluoroquinolones iphinda idlale nezinye iipropati ezenza i-antibiotics ezinkulu. Okokuqala, zithathwa ngomlomo (kwaye kungekhona ngejoza). Okwesibini, basasaza kakuhle kwiindawo ezahlukeneyo zomzimba. Okwesithathu, i-fluoroquinolones inesiqingatha-sobomi esivumele ukuba bahlulwe kanye okanye kabini ngosuku. Okwesine, i-ciprofloxacin kunye nevofloxacin zixutywe kakhulu yizintso ezenza zibe zikhulu ekukhuseleni izifo zogcino.
Ngokona nxalenye, i-fluoroquinolones yipilisi ekhuselekileyo. Nangona kunjalo, zinokubangela iziphumo ezithile ezibi ezibandakanya:
- Ukuphazamiseka kwamathumbu (isisu esicasulayo)
- Ukuphendula okuvakalayo (ukugqithisa kwesikhumba)
- Intloko
- Ukuxhamla
- Hallucinations
- Ukongezwa kwe-QT (ukuphazamiseka kombane kwintliziyo ebonakalayo kwi-ECG)
- Tendon rupture
- I-Angioedema (ukuvuvukala kwekhumba)
- Iifayili
Ukongezelela kwimiphumo emibi ingentla, ngokugqithiseleyo, i-fluoroquinolones inokubangela ukulimala kwesibindi nokwandisa i-enzyme yesibindi. I-fluoroquinolones yangaphambilini yayidume ngokubangela ukulimala kwesibindi (cinga gatifloxacin kunye ne-trovafloxacin) kwaye emva koko ihoxiswe kwimarike.
Kule mihla, ithuba lokuba nayiphi na i-fluoroquinolone ebangela ukulimala kwesibindi ngowona-1 kwabangu-100,000 abantu abachaziweyo. Ngenxa yokuba i-levofloxacin kunye ne-ciprofloxacin yiyona ndlela echazwe kakhulu yi-fluoroquinolone antibiotics, yinto ebangela kakhulu ukulimala kwesibindi se-idiosyncratic. Ukulimala okunjalo kwesibindi kubonakala emva kweeveki ezi-1 ukuya kwezi-4 emva kokulawulwa kwe-fluoroquinolone.
Nangona ukuxhatshazwa kwe-fluoroquinolones kuninzi kuninzi kunokuba kunqandeke kwezinye i-antibiotics, kusenokwenzeka ngokukodwa phakathi kwe-staphylococci (MRSA), iPseudomonas aeruginosa, neSerratia marcescens. Kwaye emva kokuba ubuncinci bebhaktheriya bungaxhatshali nxamnye ne-fluoroquinolone ngoko ke kunqabile kubo bonke.
Ukuba wena okanye othandekayo umiselwe i-fluoroquinolone-okanye nayiphina i-antibiotics yolu hlobo-kunyanzelekile ukuba ugqibe ikhosi yakho yonyango. Ngokuyeka unyango phakathi-emva kokuba 'uzive' kangcono-uncedisa ekukhetheni, ukusinda kunye nokusasazeka kweebhaktheriya ezingaphephekiyo ezinokuthi zibe yinkxalabo enzulu yoluntu. Khumbula ukuba sisoloko silwa nemfazwe ngokuchasene namayeza, kwaye silahlekelwa yimfazwe emva kokuxhathisa.
Imithombo:
Deck DH, Winston LG. Sulfonamides, Trimethoprim, & Quinolones. Ku: Katzung BG, Trevor AJ. eds. I-Basic & Clinical Pharmacology, 13e . New York, NY: McGraw-Hill; 2015. Kufumaneke ngoMatshi 29, 2015.
Guglielmo B. I-Anti-Infective Anti-Infective Chemotherapeutic & Antibiotic Agents. Ku: Papadakis MA, McPhee SJ, Rabow MW. eds. Ukuxilongwa kweZonyango kunye neNyango ka-2015 . New York, NY: McGraw-Hill; 2014. Kufumaneke ngoMatshi 29, 2015.
RYAN KJ, RAY C. Agent Antibacterial, kunye noNqaba. Ku: RYAN KJ, RAY C. eds. I-Sherris Medical Microbiology, I-Sixth Edition . New York, NY: McGraw-Hill; 2014. Kufumaneke ngoMatshi 29, 2015