I-Cephalosporins ingenye yeeklasi ezikhankanywe kakhulu kwiimviwo kwihlabathi. Kungenzeka ukuba uye wahlangabezana nale mijelo- antibiyoti nangona ungaqhelekanga igama. Ngokomzekelo, phakathi kwezinye izinto, uKeflex (cefalexin) isetyenziselwa ukunyanga izifo zesikhumba. Ukongezelela, iRocephin (ceftriaxone) isetyenziselwa ukunyanga i- pneumonia .
Kukho izizukulwana ezintlanu ze-cephalosporins.
Yintoni iCephalosporins?
I-Cephalosporins yafunyanwa kuqala kwindawo yokuhambisa amanzi emdeni waseSardinia ngowama-1945. Ngo-1964, i-cephalosporin yokuqala yayimiselwe.
I-Cephalosporins yakha ngokufanayo nezinye i-antibiotics. Njengama-penicillins, i-cephalosporins ine-ring ya-beta-lactam eqhotyoshelwe kwindandatho ye-dihyrdothiazole. Ukuxhoma kule ndandatho ye-dihyrdothiazole iindidi ezahlukeneyo zecala, ukubunjwa okwenza i-cephalosporins ehlukeneyo kunye ne-pharmacology eyahlukeneyo kunye nomsebenzi we-antimicrobial.
I-Cephalosporins ineendlela ezintathu ezahlukeneyo zokwenza:
- Ukubophelela kwiiprotheni ezithile ezibopha i-penicillin.
- Ukuvinjelwa kwesalathisi sesalathisi seeseli.
- Ukusetyenziswa kwee-enzymes ezizimeleyo (ezizilimazayo) kwisalathisi seselintshi
I-Cephalosporins ihlulwe ngezizukulwana ezihlanu. Nangona kunjalo, i-cephalosporins eyahlukileyo kwisizukulwana esifanayo ngamanye amaxesha ikhemikhali engahambelani kunye neentlobo ezahlukeneyo zomsebenzi (cinga i-cephamycins).
I-generalization efundiswa kwiinkonzo ezininzi zononophelo lwezempilo kukuba ngezizukulwana ezilandelayo ze-cephalosporins, ukukhutshwa kwegram-positive kuyancipha xa i-gram-negative coverage isanda.
Elinye kwiipesenti ezi-3 zabantu bonke liyakuncipha kwi-cephalosporins. Enyanisweni, nangona kunjalo, le nombolo mhlawumbi iphakamileyo kuba abantu abaneepenicillin zinyanzeliso abaqhelekanga ukuba bafumane i-cephalosporins.
I-Generation Generation Cephalosporins
I-cephalosporins yesizukulwana sokuqala iza kwiifom zomlomo nezangaphakathi. Basebenzisana ne-Viridans streptococci, iqela A hemolytic streptococci, iStaplocloccus aureus, E. coli , iKlebsiella kunye ne-proteus bterteria. Njengawo onke amanye ama-cephalosporins, i-cephalosporins yokuqala yokuzalwa ayisebenzi kwi-entococci.
Imizekelo ye-cephalosporins yesizukulwana sokuqala ibandakanya oku kulandelayo:
- Cephalexin (Keflex)
- Cephradine
- Cefadroxil
- Cefazolin (intravenous and intramuscular)
Ngokubanzi, i-cephalosporins yesizukulwana sokuqala isetyenziselwa ukulwa nolusu kunye nezinye izifo ezithintekayo, izifo zokuphefumula, kunye nezifo zokungena emanzini. I-cephalosporins yesizukulwana sokuqala isingeniso ingasetyenziswa njengeprophylaxis emva kokucoca okucwangcisiweyo. Ingqwalasela ethile, ukusabalalisa kwe- MRSA kuye kwanciphisa ukuphumelela kwe-cephalosporins yokuqala njengezibonelelo zeprophylaxis kunye nonyango.
I-Second-Generation Cephalosporins
Ngokuqhelekileyo, i-cephalosporins yesizukulwana sesibini isebenza ngokubhekiselele kwimizimba yegram-negative, eyenza ibe luncedo kwiimeko ezininzi zeeklinikhi.
Ngokomzekelo, i-cephalosporins yesizukulwana sesibini isebenza ngokuchasene nemida yeProteus neKlebsiella. I-cephalosporins yesizukulwana sesibini ilwa noH.
umkhuhlane-imbangela ye-pneumonia, i-sepsis, kunye ne-meningitis. Nangona kunjalo, i-cephalosporins yesizukulwana sokuqala isabhetele ngakumbi ekuphatheni izifo ezigulane.
Imizekelo ye-cephalosporins yesizukulwana sesibini ibandakanya oku kulandelayo:
- Cefoxitin (cephamycin)
- ICefotetan (cephamycin)
- I-Cefuroxime (ngomlomo kunye ne-intravenous)
- Cefprozil
Isibini-generation cephalosporins siphatha oku kulandelayo:
- Sinusitis
- Otitis media (usulelo lwe-intloko)
- Izifo ezixubileyo ze-anaerobic ziquka i-peritonitis kunye ne-diverticulitis
- Prophylaxis emva kokuhlinzwa ngokugqithisileyo
I-cephalosporins yesizukulwana sesibini ayinanto eyenziwa noPseudomonas aeruginosa.
I-Third Generation Cephalosporins
Inzuzo enkulu ye-antibiotikthi yesithathu kunye neyesine i-antibiotic isandiswa ngokubanzi ngokubhekiselele kwiibhakteria ze-gram-negative.
Ukongezelela, isizukulwana sesithathu sesi-cephalosporin ceftazidime sisebenza ngokumelene nePseudomonas aeruginosa, ibhaktheriya enokubangela ukukhuselwa kwezikhumba kubantu abanamasosha omzimba aqhelekileyo (cingisisa emva kokungcola kwi-tub okanye i-pool echithwa ngaphantsi kwe-chlorinated) kunye ne-pneumonia, ukusuleleka kwegazi kwaye ukuphuma kulabo abaneenkqubo zokuzivikela ezibuthathaka (cinga izigulane zangemva kokugula kunye nezibhedlele).
Kukho izizukulwana ezithathu zepephalosporins. Ukuxoxisana nabo bonke bekuya kuba ngaphandle kweli nqaku. Masi-ke sigxininise kwi-ceftriaxone (Rocephin) eneendlela ezininzi ezibandakanya:
- Izifo ezithintekayo zokuphefumula
- Izifo zesikhumba kunye nezifo ezincinci
- I-gonorrhea engaxakekanga
- Izifo zogqirha
- Otitis media
- Izifo eziphambene nepelvic
- Iprophylaxis yokuphanda
- I-bacteria septicemia (unyango lwegazi)
- Meningitis
- Izifo zengqondo
- Izifo ezihlangeneyo
- Izifo zesisu esiswini
I-cephalosporin yesine
I-Cefepime iyona kuphela ekhoyo (i-FDA-ivunyiwe) i-cephalosporin yesizukulwana sesine. Njengesizukulwana sesithathu sesi-cephalosporin ceftazidime, ukuqhaqhaqhaqhaqa kusebenza ngokumelene nePseudomonas aeruginosa. Ukongezelela, i-cefepime isebenza ngokuthe ngqo kwi-enterobacter kunye ne-citrobacter bactteria. Ekugqibeleni, i-cefepime ine-gram-positive coverage efana ne-ceftriaxone.
Nazi ezinye zeeklinikhi ezisetyenziselwa ukunyuka:
- I-moderate ukuya kwi-pneumonia
- Usulelo oluphezulu lwezonyango
- Izifo zesikhumba kunye nezifo ezincinci
- Ukwelashwa kwe-intra-esiswini
I-Fifth-Generation Cephalosporin
Ngo-2010, i-FDA ivume iCeftaroline (iTeflaro), kuphela i-cephalosporin yesihlanu okanye isizukulwana esiphambili. Njenge-cefepime, i-ceftaroline yinto ephambili ye-antibiotics ekufuneka igcinwe ukusuleleka. Ngokukodwa, isebenza ngokuchasene nezifo ezinokungaxhatshazwa ngamagciwane anjenge-MRSA (i-metricillin-resistant S. aureus ) kunye ne-VRSA (i-vancomycin-resistant S. aureus) . Le nkunkuma iphinde ijojowe kwaye imiselwe ukulwa nesifo se-pneumonia kunye nolwaphulo olunzulu lwesikhumba kunye nezifo ezincinci. Ngethamsanqa, i-ceftaroline ikhuselekile kwaye ayikwazi ukunyusa ukunqandwa.
Njengoko unokuyayiqonda ngoku, i-cephalosporins yinkalo eyahlukeneyo yee-antibiotiki ezininzi. Nangona kunjalo, njengokuba kukho ezininzi antibiotics, ukuchasana kwamachiza kukuxhalabisa kwiikliniki ezininzi, izigulane ze-epidemiologists, izikhulu zempilo karhulumente, izigulane nokunye.
Ukuxhatshazwa kwamabhaktheriya kubangelwa ngenxa yamagqirha aphezulu; nangona kunjalo, thina njengezigulane, sinokukunceda ukulwa nokuphuhliswa koxhathiso. Ngokomzekelo, akufanele uhlale ulindele okanye ufune ukuba umyalelo wakho unike iziza-antibiotics ukunyanga isifo esingaba sisifo sentsholongwane. (Ii-antibiotics azikwazi ukulwa neentsholongwane.) Ngaphezulu koko, xa u-antibiotics ochaziweyo, kuyimfuneko ukuba ugqibe ikhosi yonke nokuba "uzive ungcono."
Imithombo:
Guglielmo B. I-Anti-Infective Anti-Infective Chemotherapeutic & Antibiotic Agents. Ku: Papadakis MA, McPhee SJ, Rabow MW. eds. Ukuxilongwa kweZonyango kunye neNyango ka-2015 . ENew York, NY: McGraw-Hill
Inqaku elibizwa ngokuthi "Ukuxilonga kunye noLawulo lwe-Hypersensitive Response to Cephalosporins" ngo-MH Kim noJM Lee kwi- Asthma, i-Allergy & Immunology Research epapashwe ngo-2014.
Umboniso othi "Ukusetyenziswa nokuBaluleka kweCephalosporins kwiMithi yoLuntu" nguJH Amandla kwi-FDA.