Cephalosporins ndeimwe yezvikamu zvakanyanya zvakanyatsorongwa zvemishonga munyika. Mikana ndeyokuti wakasangana nemishonga inorwisa mabhakitiriya iyi kunyange iwe usingazivi zita racho. Somuenzaniso, pakati pezvimwe zvinhu, Keflex (cefalexin) inoshandiswa kurapa zvirwere zveganda. Uyezve, Rocephin (ceftriaxone) inoshandiswa kurapa pneumonia .
Kune zvizvarwa zvishanu zve cephalosporins.
Chii Cephalosporin?
Cephalosporins yakatanga kuwanika mumvura yakashambidza mvura kubva kugungwa reSardinia muna 1945. Pakazosvika 1964, cephalosporin yekutanga yakarongerwa.
Cephalosporins yakarongeka yakafanana nemamwe maantibayoti. Kufanana nepenicillin, cephalosporins ine beta ye-beta-lactam inowanikwa neyeri dihyrdothiazole. Kuteerera iri rin'i dihyrdothiazole kune dzakasiyana-siyana maketani, iyo yakagadzirirwa iyo inokonzera cephalosporin dzakasiyana nemasikiriniki akasiyana uye antimicrobial activity.
Cephalosporin ine nzira nhatu dzakasiyana dzekuita:
- Kuzvisunga kune zvakananga penicillin-kusunga mapuroteni.
- Inhibition ye cell cell wall synthesis.
- Kushanda kweivoi (self-damaging) enzyme muBacterial cell wall
Cephalosporins yakakamurwa kuva zvizvarwa zvishanu. Zvisinei, zvakasiyana-siyana cephalosporins muchizvarwa chimwechete dzimwe nguva makemikari asingabatanidzi uye ane spectra yakasiyana yebasa (funga cephamycins).
A generalization inodzidziswa kune vashandi vakawanda vehutano ndeyekuti nezvizvarwa zvinotevera zve cephalosporins, gram-positive coverage inoderera apo gram-negative coverage inowedzera.
Rimwe chete kune 3 muzana yevanhu vose rinokonzera cephalosporins. Muzvokwadi, zvisinei, nhamba iyi inogona kunge yakakwirira nokuti vanhu vane penicillin mishonga inowanzosarudzwa cephalosporins.
Chokutanga-Chizvarwa Cephalosporins
Chizvarwa-chokutanga cephalosporin chinouya mumuromo uye mukati maitiro. Vanopesana neViridans streptococci, boka A hemolytic streptococci, Staphylococcus aureus, E. coli , Klebsiella uye mabhakitiriya eProteus. Kungofanana nedzimwe dzose cephalosporins, chizvarwa chekutanga cephalosporins hachibatsiri pavanococci.
Mienzaniso yezera rekutanga cephalosporin rinosanganisira zvinotevera:
- Cephalexin (Keflex)
- Cephradine
- Cefadroxil
- Cefazolin (intravenous and intramuscular)
Muzhinji, chizvarwa chekutanga cephalosporins chinogona kushandiswa kurwisana neganda nemamwe zvirwere zvakanyorova, zvirwere zvekupemha zvirwere, uye urinary tract infections. Chirwere chekutanga cephalosporins chinogona kushandiswa chinogona kushandiswa seprophylaxis mushure mekuvhiya kwakachena. Pamusoro pekucherechedza, kupararira kweMMSA kwakaderedza kushanda kwechizvarwa chekutanga cephalosporin senzira dzeprophylaxis uye kurapa.
Chechipiri-Generation Cephalosporins
Muzhinji, wechipiri-chizvarwa cephalosporins inonyanya kurwisana nemararamiro e gram-negative, zvichiita kuti zvive zvakakosha mumatambudziko akawanda emakiriniki.
Somuenzaniso, yechipiri-chizvarwa cephalosporins inoshanda mukurwisana nematambudziko eProteus naKlebsiella. Yechipiri-chizvarwa cephalosporins zvakare inorwisa H.
furuwenza-chinokonzera pneumonia, sepsis, uye meningitis. Kunyange zvakadaro, chizvarwa chekutanga cephalosporins inowanzova nani mukurapa zvirwere-gram-positive.
Mienzaniso yechipiri chizvarwa cephalosporin inosanganisira zvinotevera:
- Cefoxitin (cephamycin)
- Cefotetan (cephamycin)
- Cefuroxime (muromo uye mukati)
- Cefprozil
Chechipiri-chizvarwa cephalosporins itai zvinotevera:
- Sinusitis
- Otitis media (ear infection)
- Mixed anaerobic zvirwere zvinosanganisira peritonitis uye diverticulitis
- Prophylaxis mushure mekuvhiya kwakanyanya
Chipiri-chizvarwa cephalosporins hachina basa nePseudomonas aeruginosa.
Chechitatu-Generation Cephalosporins
Kubudirira kukuru kwechizvarwa chechitatu nechina chema antibiotics zvakanyanya kuwedzerwa kuparadzirwa nemaitiro e-gram-negative.
Uyezve, chizvarwa chechitatu cephalosporin ceftazidime chinoshanda pakurwisa Pseudomonas aeruginosa, mabhakitiriya anogona kukonzera zvirwere zvepachiona kuvanhu vane maitiro ezvirwere zvekuzvidzivirira (funga mushure mekutsvaga kune chinyorwa chinopisa chlorinated hot tub kana dziva) uyewo pneumonia, zvirwere zveropa uye kubva kune avo vane simba rekuzvidzivirira mumuviri (funga mushure mekuvhiya uye muchipatara varwere).
Kune zvikamu zvitatu zvechizvarwa cephalosporins. Kukurukura navo zvose zvaizova kunze kwenzvimbo ino. Ngatitangei tifunge nezve ceftriaxone (Rocephin) ine mabasa akawanda anosanganisira:
- Pasi pamapfupa ekufuridzira zvirwere
- Ganda uye zvirwere zvishoma
- Kusagadzikana gonorrhea
- Urinary tract infections
- Otitis media
- Chipembenene chirwere chinoputira
- Surgical prophylaxis
- Bhakitiriya septicemia (utachiona hweropa)
- Meningitis
- Zvirwere zvepfupa
- Joint zvirwere
- Intra-mimba infections
Fourth-generation cephalosporin
Cefepime ndiyo chete inowanikwa (FDA-inogamuchirwa) yechina chizvarwa cephalosporin. Kufanana nezera rechitatu cephalosporin ceftazidime, cefepime iri kushanda nePseudomonas aeruginosa. Uyezve, cefepime inonyanya kurwisa zvirwere zve enterobacter uye citrobacter. Pakupedzisira, cefepime ine gram-positive coverage yakaenzana ne ceftriaxone.
Heano mamwe emakiriniki anoshandiswa kwechifepime:
- Zvine mwero kune zvakanyanya pneumonia
- Yakanyanya kukanganisa urinary maitiro
- Ganda uye zvirwere zvishoma
- Zvakaoma mukati mechizvamuviri zvepamuviri
Chishanu-Chizvarwa Cephalosporin
Muna 2010, iyo FDA yakagamuchira Ceftaroline (Teflaro), iyo yega yechishanu-kana yekare yakakura cephalosporin. Kungofanana nechefepime, ceftaroline inorwisa mabhakitiriya inofanirwa kuchengetedzwa nehutachiona hwakakomba. Kunyanya, inoshanda mukurwisa zvirwere zvinopesana nemishonga seMRSA (methicillin-resistant S. aureus ) uye VRSA (vancomycin-resistant S. aureus) . Ichi chinodhaka chinosanganisa uye chinorayirwa kurwisana nemagariro-akawana pneumonia uye zvakakomba zveganda uye zviduku zvine utachiona. Nenzira yakanaka, ceftaroline yakachengeteka uye hs zvishoma kukwanisa kukonzera kushorwa.
Sezvaunokwanisa iye zvino kuonga, cephalosporins ikirasi yakasiyana-siyana yemishonga inorwisa mabhakitiriya ine ruzivo rwakakura. Zvisinei, sezvinorwarisa mishonga inorwisa mabhakitiriya, mishonga inorwisa mabhakitiriya inofanirwa nevechiremba vazhinji, epidemiologists, vakuru vehutano, varwere nezvimwe zvakadaro.
Kugadziriswa kwebhakitiriya kune chikamu pamusana pechiremba kudarika; zvisinei, isu, sevarwere, tinogonawo kubatsira kurwisana nekuvandudzwa kwekumanikidza. Semuenzaniso, haufaniri kutarisira nguva dzose kana kutarisira kuti prescriber yako inokupa antibiotics kuti utarame utachiona hunogona kunge huri hutachiona hwemhuka. (Mishonga inorwisa mabhakitiriya haikwanisi kurwisana nemirwere.) Uyezve, kana yakatemwa nemishonga inorwisa mabhakitiriya, zvakakosha kuti iwe upedze iyo yose iyo kunyange iwe "uchinzwa zviri nani."
Sources:
Guglielmo B. Anti-Infective Chemotherapeutic & Antibiotic Agents. Mu: Papadakis MA, McPhee SJ, Rabow MW. eds. Ikozvino Kurapa Kurapa Nekurapa 2015 . New York, NY: McGraw-Hill
Nyaya iyi inonzi "Kuongorora uye Kutungamirirwa Kwekukurumidza Hypersensitivity Reactions kuCephalosporins" naMH Kim naJM Lee kubva kuAsphma, Allergy & Immunology Research yakabudiswa muna 2014.
Mharidzo yakanzi "Kushandisa uye Kukosha kweCephalosporin muHindu Medicine" neJH Powers paDFA.