Apo Vana Vanoda Mishonga Inorwisa Mishonga
Mishonga inorwisa mabhakitiriya inowanzomirirwa zvisina kufanira nokuda kwekutonhora, chirwere, kurwisana uye bronchitis, uye hutachiona hwehuro, nezvimwewo.
Kunyanyisa Icho Chinetso Chikuru
Uku kunyanya kushandiswa kwemishonga inorwisa mabhakitiriya kunogona kutungamirira kune zvisingabatsiri migumisiro , kusanganisira chirwere uye zvinokonzerwa nezvinokonzera . Zvichida zvakanyanya kukosha, kushandiswa kwemishonga inorwisa mabhakitiriya kunotungamirira kune mamwe mabhakitiriya anokwanisa kukwanisa mishonga inorwisa mabhakitiriya.
Aya mabhakitiriya asingagoni kurwisa maitiro akaoma kurapa, kazhinji anoda mishonga inorwisa mabhakitiriya, uye anogona kukonzera zvirwere zvinopisa upenyu.
Iwe unogona kubatsira kudzivirira dambudziko remishonga inorwisa mabhakitiriya inogadzirisa nekuita kuti mwana wako atore chete mushonga unorwisa mabhakitiriya paanenge achida uye outora sezvaanorayirwa. Kunzwisisa mazano ekurapa maitiro ekurwisa mabhakitiriya uye zvirwere zve sinus, zvinosanganisira kusarudza kuchengeta mwana wako pasina antibiotics, zvingabatsirawo kuderedza kushandiswa kwemishonga inorwisa mabhakitiriya.
Mishonga inorwisa mabhakitiriya yemakumbo eNyendo
Utachiona hutachiona ndiyo yakajairika zvikuru iyo mishonga inorwisa mabhakitiriya inorayirwa vana.
Mirayiridzo yakabudiswa muna 2004 yakabatsira kuderedza mamwe emitemo iyo, sezvavakakurudzira "kutarisa nzira" kune vamwe vana vane hutachiona hwekunzwa. Ava vana vanogona kuchengetedzwa zvakachengeteka kwemazuva maviri kusvika matatu vasina kurapwa nemishonga inorwisa mabhakitiriya yaisanganisira avo vaiva nemakore maviri-uye vane zviratidzo zvishoma.
Muchirevo chinongororwa chinobva kuAAP, iyi "chisarudzo chekucherechedza" ikozvino yakatambanudzirwa kuvana vaduku sevana vane mwedzi mitanhatu. Ramba uchifunga kuti kuona pasina maantibiotics achiri chiitiko chakanaka kune avo vana vane:
- hutachiona hwehutara munzeve imwechete (unilateral) kana vana vane makore maviri-ane makore ane zviratidzo zvishoma uye hutachiona hwekunzwa munzeve mbiri (mbiri)
- hutachiona hwehutachiona kunze kwekunzwa hurairi (kutora)
- zviratidzo zvinyoro, kusanganisira avo vane kurwadziwa kwekunzwa chete, kutonhora kudarika 102.2 degrees F (39 degrees C)
- kuwanikwa kwechirongwa chekurapa kuraira kana zviratidzo zvevana zvichiwedzereka kana kuti hazvisi nani mumazuva maviri kusvika ku3
- vabereki vanobvuma kuronga kuchengeta pasina maantibiotirapi
Kune vana vane hutachiona hwehutano ivo vasiri mukana wakanaka wokucherechedza, kunyanya avo vane zviratidzo zvakakomba, saka chironga chemaantibhakitiriya chinoramba chichirumbidzwa.
Ndeipi maantibayoti?
Kana mwana wako asina kuva nemishonga inorwisa mabhakitiriya mumazuva makumi matatu apfuura uye haasi yegairogi, ipapo iye achangodaro anyorewa muzinga we amoxicillin. Zvimwe zvinogona kusanganisira high-dose amoxicillin-clavulanate (augmentin XR), cefdinir (Omnicef), cefpodoxime (Vantin), cefuroxime (Ceftin), kana kuti kusvika kune rimwe mazuva matatu e ceftriaxone (Rocephin) shots.
Izvo zvinyorwa zvitsva zvakare zvakawedzera zvirongwa zvitsva zvekurapa zvitsva apo mishonga yekutanga yakakundikana, kusanganisira ceftriaxone shots uye mazuva matatu e clindamycin pamwe kana asina kana chetatu cephalosporin antibiotic (cefdinir, cefuroxime, cefpodoxime, nezvimwewo). Kubatanidzwa kwema clindamycin uye chechizvarwa chechitatu cephalosporin antibiotic inosarudzo yakanaka kune vana ava.
Antibiotics yeSinus Utachiona
Kunyange zvazvo mishonga inorwisa mabhakitiriya yakave yakakurudzirwa kurapa sinusitis muvana, iyo inowanzoshandiswa zvisina kunaka apo vana vane unhu hwakaoma hwehutachiona hwepamusoro hutachiona hwezvirwere. Mishonga yekurapa yakabuda muna 2001 yakashanda kubatsira kubatsira kuderedza kushandiswa kwemishonga inorwisa mabhakitiriya kuburikidza nekupa zvirongwa zvekliniki yekuongororwa sinusitis. Pashure pezvose, kuti utarise utachiona hwakanaka, unotanga kuongorora zvirwere zvakanaka. Kana mwana wako ane mhino inoputika inokonzerwa nehuwandu hwehutano, saka haaine utachiona hwe sinus uye haadi chirongwa chinorwisa mabhakitiriya.
Nhungamiro iyoyo yakangobva kuongororwa, uye semitemo yeutachiona hwekunzwa iye zvino inosanganisira maitiro ekuona kusarudza vana. Icho chichiri kutanga nekunyorerwa kuti sinusitis inoratidzwa kuti yakakodzera, kunyange zvakadaro, kusanganisira iyo kuti iongororwe neacute sinusitis, mwana angave ane zviratidzo zvinoramba zvichiripo (mhepo inoputika uye / kana kukanganiswa kwemasikati kwemazuva anopfuura gumi pasina kubudirira), kuwedzera zviratidzo mushure mekunge yakanga yatanga kuva nani, kana zviratidzo zvakasimba kwemazuva matatu.
Kune avo vana vane zviratidzo zvinoramba zvichiripo, pane kungozvitsanangura ma antibiotics pakarepo, imwe sarudzo inogona kutarisa mwana kwemazuva matatu mamwe asina maantibiotics kuti aone kana iye ari nani. Kana iye asingaiti zviri nani, anowedzera kuipa, uye kune avo vana vanotanga kuonekwa kuti vane sinusitis uye zviratidzo zvakakomba kana kuti vari kutowedzera kuwedzera, saka mishonga yemishonga inorwisa mabhakitiriya ichiri kukurudzirwa.
Yakakurudzirwa maantibiotikiti nokuda kwetachiona chetachiona mumapepanhau eAAP anotevera anosanganisira:
- high-dose amoxicillin (first-line treatment)
- muzinga we amoxicillin (vana vanopfuura makore maviri-makore vasingasviki zuva)
- high-dose augmentin (inoshandiswa kare mishonga inorwisa mabhakitiriya)
- 1-3 zuva ceftriaxone shots (haizotori kana kushivirira muromo wekutanga remishonga inorwisa mabhakitiriya) inofanira kuteverwa nedzidzo yezuva 10 yemumwe wemishonga inorwisa remuromo pavanenge vava nani
Kufanana nehutachiona hwehutano, vana vane sinusitis vanogonawo kurapwa ne cefdinir, cefuroxime, kana cefpodoxime. Uye kana pasina hunovandudzwa mushure memazuva matatu (maawa 72), mishonga yemwana wako inogona kudiwa kuchinjwa kuva imwe yevamwe, kunyanya kana yakatanga kubuda paudxicillin.
Mishonga inorwisa mabhakitiriya kune zvinotyisa
Ichi chiri nyore. Vana vanowanzodikanwa vanoda maantibayoti pavanenge vane hoora kunze kwekuti vane boka A streptococcal (strep) chirwere. Nemhaka yokuti maperembudzi (pharyngitis) ndiwo anowanzokonzerwa nehutachiona hwehutachiona, chirwere che strep chinofanira kuitwa kuti chisimbise kugadziriswa vasati vasvika ma antibiotics.
Kana mwana ane ruzivo rwemitsipa, chirwere chinorwisa mabhakitiriya chinogona kusanganisira:
- Penicillin V
- muyero wero amoxicillin
- Benzathine penicillin G (a penicillin shot)
Vana vane penicillin allergies vanogona kurapwa ne cephalosporin yechizvarwa chekutanga, zvakadai se cephalexin (Keflex) kana cefadroxil (Duricef), clindamycin, azithromycin (Zithromax), kana clarithromycin (Biaxin).
Antibiotics yeBronchitis
Izvi zvichauya sechishamiso kuvabereki vakawanda kuti AAP Red Book inotaura kuti "kusava nechirwere chinokonzera kurwara / bronchitis pakati pevana, pasinei nehuwandu hwemakore, hazvibvumirisi kuti mishonga inogadzirisa zvirwere."
Ramba uchifunga kuti bronchitis yakaoma inogona kukonzera chifukidziro, icho chinogona kubereka, uye inogona kuramba ichikwanisa kusvika masvondo matatu. Uyezve, kushandiswa kwemishonga inorwisa mabhakitiriya hakurudzirwi kubata chirwere chakanyanya.
Mwana wako angangodaro akarayirwa mushonga unorwisa mabhakitiriya kana ane chikwefu kwenguva refu iyo inogara kwemazuva gumi kusvika ku14 kana kupfuura uye chiremba wako anofungidzira kuti inokonzerwa nechimwe chezvi bhakitiriya:
- Bordetella parapertussis
- Mycoplasma pneumoniae
- Chlamydophila pneumoniae
Chinonyanya kukosha, sezvo mishonga inorwisa mabhakitiriya inowanzoshandiswa zvakanyanya kurapa bronchitis, bvunza kana mwana wako anonyatsoda antibiotic kana aine chifuva.
Mishonga inorwisa mishonga yeChwere
Nepo mashizha nemamwe mamiriro ezvinhu eganda zvinowanzoonekwa nevana, nerufaro, vazhinji havadi kurapwa nemishonga inorwisa mabhakitiriya. Vamwe vanoita, kunyange zvakadaro, uye nekukura kwebhakitiriya isingagoni kurwisa, zvinokosha kuti mwana wako ane utachiona hweganda anorayirwa kodzero yekurapa maitiro.
Ganda uye zvirwere zvinyoro zvishoma zvinogona kusanganisira:
- cellulitis isina mvura yakachena (pus) - isina hanya neRSASA, saka anti anti-staph uye / kana anti-strep antibiotic inogona kushandiswa, yakadai se cephalexin kana cefadroxil.
- cellulitis nemafuta e purulent (pus) - mishonga inorwisa mabhakitiriya inobata MRSA , kusanganisira clindamycin, TMP-SMX (Bactrim), tetracycline (vana vane makore anenge 8), kana linezolid.
- abscess - antibiotics inobata MRSA, kusanganisira clindamycin, trimethoprim-sulfamethoxazole (Bactrim), tetracycline (vana vane makore anenge 8), kana linezolid.
- impetigo - mupirocin 2% mafuta anonyanya kushandiswa kana kuti mishonga inorambidza mishonga yakawanda (cephalexin kana cefadroxil).
Nhengo isina nyore inogona kurapwa pasina antibiotics kana inogona kuderedzwa, haisi kukura, uye mwana ane zviratidzo zvishoma. Chimwe chikwata chakakomba chinogona kudikanwa muchipatara, chirwere chokuvhiya uye IV ma antibiotic.
Bactrim, iyo inowanzoshandiswa kurapa MRSA, haina kubata beta-hemolytic streptococci bacteria, iyo inogona kukonzera dzimwe zvirwere zveganda. Izvo zvinoita kuti zvive zvakakosha kuti chiremba wako asaisa Bactrim kana asingatombofungi kuti mwana wako ane MRSA.
Mishonga inorwisa mabhairamu
Vabereki havawanzodi kutarisira mishonga inorwisa mabhakitiriya kana vana vavo vane chirwere. Mukuwedzera kunekuti chirwere chinowanzokonzerwa nehutachiona hwehutachiona, marasita, uye chepfu chekudya, nezvimwewo, kunyange kana zvakakonzerwa nebhakitiriya, haufaniri hako kunoda ma antibiotics.
Mune dzimwe nguva, mishonga inorwisa mabhakitiriya inogona kuita kuti mwana wako ave nechirwere chakaipisisa.
- Salmonellosis - Diarrhea inokonzerwa neBarcellella bacteria inowanzoenda yoga. Mishonga inorwisa mabhakitiriya inogona kuita kuti mwana wako atapukirwe kwenguva yakareba.
- Shigellosis - Diarrhea inokonzerwa nebhakitiriya reShigella inogona kubuda iri yoga, asi mhosva dzakaoma dzingada kurapwa nemishonga inorwisa mabhakitiriya. Yakakurudzirwa antibiotics yeShigella zvirwere zvinosanganisira azithromycin uye ceftriaxone kana kurwisana nemishonga yakawanda yemishonga inouraya, yakadai se amoxicillin uye trimethoprim-sulfamethoxazole inofungidzirwa.
- E. coli zvirwere - Diarrhea inokonzerwa na E. coli inowanzoenda yoga. Kana ukarapwa nemishonga inorwisa mabhakitiriya, vamwe, kufanana neShiga toxin-inobudisa E. coli (STEC), inogona kuisa mwana wako pangozi yeHUS (Hemolytic Uremic Syndrome - chirwere chinogona kutyisa upenyu chinosanganisira anemia uye kusaputsika kwetsvo).
- Campylobacteriosis - Diarrhea inokonzerwa nebhakitiriya raCampylobacter inoda kurapwa naAzithromycin kana mwana ane zviratidzo zvakakomba.
- Clostridium difficile - Vanhu vanotora mishonga inorwisa mabhakitiriya vari pangozi ye C. mazvirwere zvakasiyana , izvo zvinokonzera marara, uye zvinowanzofanira kurapwa nemishonga inorwisa mabhakitiriya yakafanana ne metronidazole.
Sezvo mishonga inorwisa mabhakitiriya inowanzodikanwa nokuda kwezvirwere zvakawanda zvinokonzera kurara, uye zvinogona, chaizvoizvo, zvinokonzera marwere, sezvimwe nezvimwe zvirwere, iva nechokwadi chekubvunza chiremba wako kana mwana wako achida chaizvo. Antibiotic haisi nguva dzose mhinduro kana mwana wako ari kurwara kana paunoshanyira chiremba.
Sources:
American Academy of Pediatrics Mushonga Wekuita Maitiro ekurapa uye Kutungamirirwa kweAacute Bacterial Sinusitis muvana Vakwegura 1 kusvika 18 Makore. Pediatrics Vol. 131 Nha. 7 July 1, 2013.
American Academy of Pediatrics Clinical Practice Guideline. Kuongororwa uye Kutungamirirwa kweAacute Otitis Media. Pediatrics Vol. 113 Nha. 5. pp. 1451-1465.
American Academy of Pediatrics Clinical Practice Guideline. Kuongororwa uye Kutungamirirwa kweAacute Otitis Media. Pediatrics Vol. 131 Nha. 3 March 1, 2013. pp. E964-e999.
American Academy of Pediatrics. Mitemo yeKushandiswa kwakakodzera kweUpper Respiratory Tract Infections. Red Book 2012: 802-805.
American Heart Association. Kudzivirirwa kweRheumatic Fever uye Kuziva uye Kurapa kweAacute Streptococcal Pharyngitis Kurwisa. 2009; 119: 1541-1551.
Infectious Diseases Society of America Clinical Practice Guideline. Kutungamira kwevarwere vane zvirwere Zvinokonzerwa naMethicillin-Resistant Staphylococcus Aureus. Clinical Infectious Diseases; 2011; 52: 1-38.