UVancomycin yintsholongwane yokugqibela
I-Vancomycin yintsholongwane yokugqibela isetyenziswa rhoqo ekuphatheni izifo ezikhuselekanga iziyobisi. UVancomycin waqala ukuxhomekeka kwiisampula zomhlaba waseBorne ngaphezu kweminyaka engama-50 edlulileyo. Ekuqaleni, oogqirha abambalwa basebenzisa i-vancomycin kunokuba bakhethe ezinye i-antibiotics ezacatshangelwa ukuba zisebenziseke ngakumbi (i-vancomycin ithatha ixesha elide ukwenza izinto kuneepenicillins) kwaye ingekho yicyhefu.
Nangona kunjalo, ukususela ekuqaleni kwee-1980, oogqirha kunye nabanye abaqeqeshi bempilo baye baqalisa ukubonisa umdla olutsha olutsha. Le nzala ehlaziywayo yenziwa ngenxa yokukwazi ukulwa ne- vancomycin yokulwa nesifo se- Staphylococcus aureus (MRSA) esingamelana ne-methicillin kunye nokukwazi ukuphatha i-colitis epseudomembranous. I-colitis epseudomembranous is a infection inferior of colon (isifo sohudo) esithatha emva kwonyango kunye nezinye iziza-antibiotics ezibulala izityalo eziqhelekileyo.
Indlela yokusebenza kaVancomycin
UVancomycin yi-tricyclic glycopeptide. Ibopha kwiindonga zee-btteria kunye neenguqu ze-cell membrane. Kuphazamisa ukusetyenziswa kwe-RNA ebhaktheriya.
Xa ulwa nempilo eninzi yegram-positive njenge staphylococci kunye ne-streptococci, izenzo ze-vancomycin ziyi-bacteriocidal. Ngamanye amazwi, i-vancomycin isebenza ngokucacileyo ukubulala ibhaktheriya enesigama. Nangona kunjalo, xa ulwa ne-enterococci, olunye uhlobo lwegri-positive, izenzo zakwa-vancomycin ziyi-bacteriostatic, kwaye isebenza ukuvimbela ii-bacterial reproduction.
IVancomycin
I-Vancomycin isetyenziselwa ukulwa neendidi ezininzi ze-bacterial pathogens, ezininzi zazo ezichasene nezinye iintlobo ze-antibiotics eziquka:
- Izifo ezinzulu zesifo se-staphylococcal kubantu abaphikisayo kwi-penicillin
- i- Staphylococcus aureus engamelana ne-methicillin (MRSA)
- I- Staphylococcus epidermidis engamelana ne- methicillin
- I- Streptococcus pneumoniae enganyangekiyo
- izifo ezibangelwa i-enterococcal infections kubantu abaphikisayo kwi-penicillin
- izifo ezinzima zokungena kwi-enterococcal ezingaxhomekanga kwi-penicillin
- Viridans streptococci
- I-anti-drug resistant Corynebacterium jeikeium
- Clostridium difficile
Izifo eziphathwe nge-vancomycin
UVancomycin isetyenziselwa ukuphatha iintlobo ezininzi zeentsholongwane ezinzulu ezibandakanya:
- izifo zokuphefumula;
- amathambo, isikhumba kunye nezifo ezithambileyo;
- peritonitis;
- i-endocarditis (intsholongwane yenhliziyo);
- i-enterocolitis kunye ne-colitis epseudomembranous (izifo zentsholongwane);
- i-prophylaxis xa ihlaselwa ngamazinyo, i-biliary, i-GI, izifo zokuphefumula kunye ne-genitourinary;
- Ukungabikho kwengqondo (ukungabikho kweleyile);
- ukusuleleka kwezifo (ukusetyenziswa kweleyile ngaphandle);
- i-meningitis (ekusetyenzisweni kwelebula).
Ulawulo lweVancomycin kunye neeritha
Ngenxa yokuba i-vancomycin ayifumananga kakuhle yindlela yokuxhamla isisu, idla ngokusetyenziswa njengejoza. Nangona kunjalo, xa zisetyenziselwa ukuphatha i-enterocolitis kunye ne-pseudomembranous colitis, zombini izifo zesisu, izigulane zithatha i-vancomycin yomlomo.
UVancomycin udlalwa kwisibhedlele (esibhedlele). Ngenxa yokuba i-dosing iyinkimbinkimbi kwaye ixhomekeka kwinqanaba lokuphakanyiswa kweengcambu kunye neengcambu, iifesimente zonyango zihlala zibizwa ukuba zibale amanani.
Ukongezelela, ngenxa yokuba i-vancomycin idityaniswe yizintso, ukulandelwa kwezi zi yobisi kunzima nakakhulu kubantu abanokungaphumeleli kwintliziyo.
Imiphumo emibi yeVancomycin
Iziphumo ezinobungozi ezinobungozi ezibangelwa yi-vancomycin azinqabile, kwaye i-impact ye-vancomycin echaphazelekayo imiphumo emibi kakhulu yinto engaphelelangayo okanye i-reaction response. Nangona kunjalo, i-vancomycin ingaba nephrotoxic kwaye ibonakalise iintso ngakumbi xa ilawulwa yi-aminoglycosides, enye uhlobo lwe-antibiotics. Ngaphezu koko, xa kulawulwa i-aminoglycosides okanye i-high-dose intravenous erythromycin, nenye inhlobo ye-antibiotic, i-vancomycin ingonakalisa ukuva (ukuchithwa komzimba).
Ekugqibeleni, i-vancomycin ingabangela i-hyperemia okanye i-red-man syndrome, uhlobo lokutshiza; Ukuhlanjululwa okunjalo kunokunciphisa ukuba isigulane sinikezelwa kuqala ngama-antihistamines.
Ukuxhatshazwa kweVancomycin kubangela ukukhathazeka okukhulayo phakathi kweekliniki, abaphandi kunye neengxaki ze-epidemiologists ngokufanayo. Ngenxa yokuba i-vancomycin enye yeendlela zokugqibela zokukhusela kwisifo esiyingozi kunye neziyobisi, ithemba elingasayi kuphinda lisebenze ukulwa nokusuleleka luloyiko kwaye lusishiya ezinye izinto ezinokukhetha (cinga iZosyn kunye ne-ceftaroline). Ngokukodwa, iintlobo ze-entococci ezinqandekayo ze-vancomycin ziye zanyuka kwiibhedlele emhlabeni wonke. Ngenxa yokuba i-vancomycin idlalwa kwizibhedlele, ii-SKFs, ii-nursing homes (ii-SKFs), amakhaya angamahlengikazi kunye nokunye, kubalulekile ukuba ootitshala bezempilo bathathe amanyathelo okunciphisa ukumelana ne-vancomycin njengokunciphisa i-overprescription kunye nokunciphisa ukusasazeka kwe-vancomycin ekumanyeni kwizigulane kwisigulane esifanelekileyo ukwahlukana kunye nococeko.
Imithombo ekhethiweyo
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. Kufumaneka ngo-Ephreli 07, 2015.
I-Mosby's Drug Reference Imisebenzi yezeMpilo, yoLwazi lwesiBili olupapashwe nguMosby / Elsevier ngo-2010.