Lithibela-mafu li moloko morao-rao tsa sephara-manyenyane

Har'a lithethefatsi ka lula e le oa bohlokoa molokong o mong ho qetela lithibela-mafu a sebetsang a khahlanong le likokoana-hloko tse ngata. Di sebediswa bakeng sa kalafo ya pathologies tšoaetsanoang, eo haholo fokolitse ho shoa ha bakuli ho tswa banal ho letsatsi pneumonias le pyelonephritis. Ka lebaka lithibela-mafu bakeng sa go tlhofofadiwa le potlakisa hlaphoheloa ka la bronchitis, sinusitis, 'me e e-ba bonolo ho phetha rarahaneng mekgwatshebetso ya ho buoa. tsoaetsanang esita le qetellong ba ka katleho tšoaroa ka lithibela-mafu.

Sephara-manyenyane lithibela-mafu (ABSHS)

sehlopha sena se akarelletsa mahlahana loantsang likokoana a sebetsang a khahlanong le a mob mobile-mpe le a mob mobile ea HIV tse phelang. Pele ke mahlahana causative tsa mafu a mala pathologies hlabang tsa urogenital le tsamaiso ea ho hema. Mob mobile ea HIV tse phelang ka mehla bakela mafu a tsoaetsanang leqeba le kena dipakeng tsa ho ba ketsahalo e sa la mathata postoperative ka buuoa.

List ABSHS fapaneng ho lokolloa nako

Ba bang ba sephara a manyenyane lithibela-mafu sa moloko morao-rao li mafolofolo khahlanong le tšoaetso ea protozoal. Mehlala e kenyeletsa derivatives nitroimidazole - tinidazole, metronidazole le ornidazole. Ka ho fetisisa ho pharaletseng a sebelisa metronidazole ka lebaka la ditheko tse tlase. sehlopha sa hae manaka - tinidazole - tšoanang manyenyane la mosebetsi loantsang likokoana, empa se sebelisoa parenterally. Ka kakaretso, lihlopha tsohle tsa lithibela-mafu tse sephara-manyenyane tse hlahisoang ka tsela e latelang:

• penicillins tlhaho;
• ingibitorzaschischennye aminopenicillin;
• pseudomonas penicillins, ho akarelletsa le ingibitorzaschischennye;
• cephalosporins III isa molokong o mong cephalosporins IV isa molokong o mong ;
• aminoglycosides sehlopha;
• tetracycline lithibela-mafu ;
• macrolide lithibela-mafu;
• nomoro ea lithibela-mafu carbapenem;
• chloramphenicol;
• fosfomycin;
• rifampin;
• dioxidine;
• sulfonamides;
• quinolones, fluoroquinolones;
• nitrofurans sehlopha;
• nitroimidazole lithibela-mafu sa letoto lena.

lethathamo lena ha le boleletsoe mabitso a lihlopha ea lithibela-mafu e moqotetsane-manyenyane. Ba itseng ho ba fokolang ka palo ya likokoana-hloko 'me ke e atlehang khahlanong le bona. moqotetsane-manyenyane lithethefatsi ke ke sebediswa bakeng sa kalafo ya superinfection le ha ba etsa kōpo ea empirically. Di sebelisoa e le lithibela-mafu pele moleng e pathogen balletsweng.

Lenane la meloko e fetileng ABSHS

Tse ka holimo mahlahana loantsang likokoana ho matleng a sa tšoaneng ea lithethefatsi. Sena ke lethathamo feletseng tsa lihlopha tsa dintho le mosebetsi khahlanong le a mob mobile ea HIV le a mob mobile-mpe libaktheria. Leha ho le joalo, lethathamo la e na le bobeli moloko morao-rao ea lithibela-mafu le baemeli ba pele ho moo oa sehlopha seo. Tsa baemeli ba meloko e morao-rao tse ka holimo li ka lihlopha tsa lithethefatsi tse latelang:

• aminopenicillin tse manganga ho beta-lactamase ( "Sulbactam", "Ampicillin", "clavulanate" "Amoxicillin");
• cephalosporins ea meloko e III le IV ( "Cefotaxime" "Cefoperazone" "Ceftazidime" "ceftriaxone" "cefpirome" "Cefepime");
• molokong o mong ka III aminoglycoside lithibela-mafu ( "Amikacin" "Netilmicin");
• 14- le 15-membered seka-maiketsetso macrolides ( "Roxithromycin" "Clarithromycin," "Azithromycin");
• Natural 16-membered macrolide lithibela-mafu ( "midecamycin");
• fluoroquinolones III le IV meloko e ( "levofloxacin" "sparfloxacin" "Gatifloxacin" "Trovafloxacin" "Moxifloxacin");
• carbapenems ( "meropenem" "Imipinem-cilastatin" "Ertapenem");
• nitrofurans ( "Nitrofurantoin" "Furazidin", "ersefuril").

Lithibela-mafu tse thoko ho tswa lenaneng

Tsena tse neng a sireletsa penicillins antipseudomonal na le manyenyane sephara ea mosebetsi, leha ho le joalo, etsa kopo feela khahlanong P. aeruginosa ka lebaka la ho hlokahala hore a fokotsa ho ikopanya probable le letsatsi morao-rao le e le tse matla lithibela-mafu. Sena se thibela kotsi ea libaktheria lithethefatsi manganga. The bohlokwa ba tsamaiso khōlō ka ho fetisisa khahlanong le Pseudomonas tshwaetso bontša "tazobactam." Ka linako tse ling "Piperacillin" le "clavulanate" e sebelisoa e le moloko morao-rao ea lithibela-mafu bakeng sa serame sa matšoafo e bakoang ke mefuta sepetlele ya pathogen ena.

Hape lethathamong na sehlopha lithibela-mafu isa molokong o mong ho qetela ea penicillins tlhaho le-ba khahlanong le staphylococcal. Tsa pele li ke ke tsa sebelisoa ka kalafo le mamello e loketseng ho hloka khafetsa intravenous kapa intramuscular tsamaiso. Liforomo hore ba lumella hore ba nka ka molomo, ha e yo. Boemo bo tšoanang teng le cephalosporins. Le a manyenyane e tšoanang ea mosebetsi e le penicillins, ba ile ba e ke ke ya laolwa ka molomo hobane timetso ka mpeng.

Cephalosporins le penicillins tšebeliso parenteral - ho moloko morao-rao ea lithibela-mafu e atlehang bakeng sa serame sa matšoafo. Albalad bo-rasaense ba atleha ho ba le litekanyetso li behoa foromo ya tsamaiso enteral. Leha ho le joalo, phuputso e-s'o sebelisa, 'me palo ya ea lithethefatsi ka sebelisoa ho fihlela joale feela ema diinstitusene tsa tlhokomelo ea bophelo.

lithibela-mafu Haholo e atlehang bakeng sa bana

Hlahloba moloko morao-rao ea lithibela-mafu, lenane la lithethefatsi kgothaletswa bakeng sa bana, narrowed haholo. Bongoaneng, le ka feela sebelisoa ke baemeli ba aminopenicillins 'maloa ( "Amoxicillin", "clavulanate"), cephalosporins ( "Ceftriaxone" "Cefepime"), macrolides ( "Azithromycin", "midecamycin" "Roxithromycin", "Clarithromycin"). lithibela-mafu Fluoroquinolone, carbapenems le nitrofurans sitoa ho sebelisoa ka lebaka la khatello ea kgolo ya masapo, sebete le liphio toxicity.

System nitrofurans ha ba etsa kōpo ea ka lebaka la ho haella ha bopaki bo saense tšehetsa polokeho tsa phekolo. Kantle feela ke "furatsillina", a loketse bakeng sa kalafo ea moo ea maqeba. Morao-rao le e tlotloang sebetsang hantle lithibela-mafu bakeng sa moloko qetela tsa bana ka tsela e latelang: macrolides, penicillins, cephalosporins (mabitso a lithethefatsi tse fanoeng ka holimo). Sehlopha se setseng ba mahlahana loantsang likokoana tse sa kgothaletswa ka lebaka la phello nang le chefo e, 'me maloetse a ya marapo.

ABSHS bakeng sa basali ba baimana

Ho latela FDA tlhophiso (US), tse seng kae feela tsa lithibela-mafu molokong o mong ka morao-rao e ka sebediswa ea ho phekola ba bakhachane, e leng lethathamo nyenyane haholo. Ba ho matleng a dihlopha A le B, hore na le kotsi ea hore ba se ke a tiisa kapa che litla teratogenic ka lithuto tsa liphoofolo.

Dintho le litla unproven ka lesea le, hammoho le ka ho ba teng ha e le hantle tse chefo e ka feela ka sebelisoa tabeng ea ata tsa ama batho phekolo fetang lehlakoreng (sehlopha C le D). Litokisetso X sehlopha fapana proven litla teratogenic ka lesea le, ha ho hlokahala, ka lebaka la ho sebelisa ha bona ho hlile ho ntša mpa.

Nakong ea bokhachane, le lithibela-mafu tse latelang isa molokong o mong ho qetela matlapa sephara-manyenyane: sireletswa aminopenicillin ( "Amoklav", "Amoxiclav"), cephalosporins ( "Cefazolin" "Ceftriaxone" "Cefepime"). Macrolides ( "Azithromycin", "Clarithromycin", "midecamycin" "Roxithromycin") a lumelloa ho sebelisa ka trimester boraro ea emara e loketseng ha e le hantle hore e le hantle bona teratogenic ha e so ka ithuta ka botlalo, 'me ho hloka hore a ke ke a unambiguously bua. Hape, basali ba baimana ka tsela e sireletsehileng ho sebedisa ka penicillin lithibela-mafu ka ho ba sieo ha kulisoa.

Ho sebelisoa ha lithibela-mafu ka ho phekola la bronchitis

lithibela-mafu kaofela isa molokong o mong ho qetela sephara-manyenyane, ka khopolo, ka sebelisoa bakeng sa la bronchitis le serame sa matšoafo ha litšobotsi tse bona pharmacodynamic homolog bakeng sa sena. Leha ho le joalo, ho na le Optimum maano a ea phekolo e bohlale ea mafu a joalo. Ba nka ka diphapano akhaonteng tlhakantsuke katleho bolaeang likokoana-hloko ho etsa bonnete ba fana ka kgaso ka bophara tsa mefuta tse sa bonahaleng tse.

Nitrofurans, derivatives nitroimidazole le sulfonamides utloahaleng sebelisoa ka mafu a hlabang ea tsamaiso ea ho hema. Ha e kopana le atlehileng ka ho fetisisa ea ho la bronchitis kapa serame sa matšoafo, matšoafo phallo le sirelelitsoe macrolide le aminopenicillin ( "Amoklav" + "Azithromycin"). Nako e telele la bronchitis hloka ho khethoa ha cephalosporin ho fapana aminopenicillin ( "Ceftriaxone" + "Azithromycin"). Ka morero ona, e macrolide e ka nkeloa sebaka ka sehlopha sa 'ngoe analoge: bakeng sa "midecamycin" "Clarithromycin" kapa "Roxithromycin".

Kaofela ha lithibela-mafu tsena tsa morao-rao-molokong o mong ka lebaka la bronchitis ba le phello e phatlalatsoe, le hoja lipontšo tsa tleleniki ea lefu lena le le ka tsoela pele ho ba teng. The criterion tsa katleho ea phekolo - ponahalo ea khohlela le tlala likhohlela butle-butle hloekisa le phomolo feberu. Ka COPD hape fokolisa dyspnea, takatso ea botona kapa ea ntlafala, fokotswa khohlela maqhubu a litakatso tsa bona.

kalafo e atlehang ea serame sa matšoafo

Serame sa matšoafo tsa maikutlo a tšoaroa ka lebaka la la bronchitis, empa le ho sebelisa ha cephalosporin le macrolide. Ha e leka-lekaneng ho e matla serame sa matšoafo se hlahang ho yona e behiloeng cephalosporin ( "Ceftriaxone" kapa "Cefepime") le a 'maloa a fluoroquinolones ( "Ciprofloxacin" kapa "Levofloxacin") sechabeng-se fumaneng. Tsena lithibela-mafu ha moloko qetela sephara-manyenyane hantle gatelele microflora sechabeng-e fumanweng, 'me phello ea ho sebelisa ha bona ke bonahaleng ka letsatsi la bobeli ea phekolo.

Kajeno moraorao moloko oa lithibela-mafu bakeng sa serame sa matšoafo (lebitso fanoeng ka holimo) ama pathogen, mesebetsi ea eona ea bohlokoa ka ho hatella kapa ho bolaea eena. Lintho tse pele ba bitsoa bacteriostatic, bactericidal le lithethefatsi qetellang. Cephalosporins, le fluoroquinolones aminopenicillin - bactericides, le macrolides - bacteriostats. Ho feta moo, ha e kopana le ea lithibela-mafu reretsoe ho se feela atolosa fapaneng ya mesebetsi, empa hape le ho etsa lintho tumellanong le melao ea kopantseng lithethefatsi e mong le bactericidal bacteriostatic ngoe.

Phekolo ea serame sa mats'oafo le khōlō HITD

O tlhokomelong ea matla, moo ho ka ba le bakuli ba serame sa matšoafo matla le lefu mahlomola ka semelo sa botahoa. Monehelo ka sehloohong ho tiea tsa boemo ba bakuli ba joalo etsa microflora pathogenic hore ke manganga ho bolaea likokoana-hloko ka ho fetisisa. Maemong a joalo, etsa kopo carbapenems ( "Imipinem-cilastatin," "Tienam", "Meropenem"), ha e sebetsang bakeng sa ho sebelisoa ka boemo outpatient.

Kalafo ya sinusitis le sinusitis

Kajeno moraorao moloko oa lithibela-mafu bakeng sa ho sinusitis kapa sinus sebelisoa ho bolaea likokoana-hloko. Maemong a joalo, e mong a ka sebelisa lithibela-mafu bactericidal. Leha ho le joalo, haeba sinus thatafalloa se seholo ke ho kena sebakeng sa ho ruruha loantsang likokoana. Ka hona, ka ho fetisisa e atisa ho sebelisoa lithethefatsi cephalosporin. mohlala e ke "Ceftriaxone" kapa "Cefepime." Ho ka 'na boela ho tsamaisoa fluoroquinolone III isa molokong o mong - "Levofloxacin".

Phekolo ea bolaea likokoana-hloko angina morao-rao

moloko morao-rao ea lithibela-mafu bakeng sa metso ba khethiloe ka morero oa e tšoanang. Ho feta moo, le ka sinus, 'me tšoanang mahlahana a khahlanong le likokoana-hloko tse ka sebediswa ka tonsillitis. Phapang feela ke hore tabeng ea ho ruruha ha tonsils le tsona li ka sebelisoa le ho antiseptics, ho etsa mohlala, "furatsillina" - ho ba lokisetsa ho ea tse 'maloa tsa nitrofurans. Leha aminopenicillins angina hape ka sebelisoa ka katleho e sireleditsweng sulbactam kapa acid e clavulanic ( "Amoklav" "Amoksiklav" "Ospamoks"). Le lithethefatsi lokela ho tsamaisoa ka matsatsi a 10-14.

Phekolo ea pyelonephritis le tšoaetso ea ea tsamaiso genitourinary

Ka lebaka la ho se silafale tsa pampitšana mosese ke likokoana-hloko, moloko morao-rao ea lithibela-mafu ka ho pyelonephritis hlokahalang bakeng sa kalafo bona. Moholo ka ho fetisisa ho phekola boleng mona ke cephalosporins, fluoroquinolones le nitrofurans. Cephalosporins li sebelisoa pyelonephritis batlang e le ka tlaase ho moo haholo, 'me fluoroquinolones ( "Ciprofloxacin", "Levofloxacin", "Ofloxacin", "Moxifloxacin") - ka senyeha ka morao na phekolo e.

Lithethefatsi atlehileng ka ho fetisisa, a loketse bakeng sa bobeli monotherapy le bakeng sa hammoho le oa "Ceftriaxone" ke moemeli ea palo efe kapa efe ea nitrofurans - "FURAMAG"). Hape quinolone ka sebelisoa - "acid e Nalidixic". Recent bopa concentrations phahameng ka moroto le ba mafolofolo khahlanong le mahlahana causative ea tšoaetso ea mosese. Hape, ka linako tse ling ha gardnelleze dysbacteriosis hara botshehadi 'me a sebelisa "Metronidazole".

hanyetsa lithethefatsi le phello ea oona

Ka lebaka la ho fetola kamehla ka lintho tse bonahalang le liphatsa tsa lefutso tsa microorganisms, haholo-holo libaktheria, ba bangata ba loantsang likokoana katleho e haholo tsa fokotswa. Fumana ho hanyetsa lithethefatsi, libaktheria lokisetsa bokhoni ba ho phela ka 'mele oa motho ke mediating senyeha ha ya mafu a tšoaetsanoang. Sena se qobelle bafuputsi ba ho batla le ho sebelisa lithibela-mafu tse ncha molokong o mong ho qetela.

Nakong ea boteng ba baemeli ba loantsang likokoana ntshetswa pele e ka bang ka 7000 dintho ka tsela e itseng li sebelisoa ka meriana. Boholo ba bona ba ile ba tsoa tsa tšebeliso e loketseng ho litla ya ea bongaka bohlokoa lehlakoreng kapa ka lebaka la ho bokella ho hanyetsa tse sa bonahaleng tse ho bona. Hobane kajeno ho moriana sebelisoa ka 160 lithethefatsi. About 20 ba bona ba - ke moloko morao-rao ea lithibela-mafu, bao mabitso hangata e hlaha ka libuka tsa bongaka tsa phekolo loantsang likokoana la mafu a tšoaetsanoang.