Vancomycin ke lithibela-mafu ea ho qetela
Vancomycin ke lithibela-mafu ea qetello ea ho qetela e atisang ho sebelisoa ho phekola mafu a manganga a manganga. Vancomycin e ne e qala ho aroloa ke mekhoa ea mobu oa Bornean lilemong tse fetang 50 tse fetileng. Qalong, lingaka tse fokolang li ne li sebelisa vancomycin ho e-na le ho khetha li-antibiotics tse ling tse nkoang li atleha (vancomycin e nka nako e teletsana ho nka penicillin) le e nyenyane e chefo.
Leha ho le joalo, ho qala mathoasong a bo-1980, lingaka le litsebi tse ling tsa tlhokomelo ea bophelo bo botle li ile tsa qala ho hlalosa thahasello e ncha ea lithethefatsi ena. Ts'ebetso ena e tsosolositsoeng e ne e le ka lebaka la bokhoni ba vancomycin ba ho loantša methapo ea methapo ea Staphylococcus aureus (MRSA) le bokhoni ba ho phekola lefu la ho kenngoa ha lefuba. Pseudomembranous colitis ke tšoaetso e kotsi ea colon (letšollo) e tšoaroang ka mor'a hore e phekoloe ka lithibela-mafu tse ling tse bolaeang limela tsa tlhaho tse tloaelehileng.
Vancomycin mekhoa ea liketso
Vancomycin ke tricyclic glycopeptide. E tlama mabota a sele ea libaktheria 'me e fetole leseli la sele le ho feta. E boetse e kena-kenana le libaktheria tsa RNA synthesis.
Ha o loantša likokoana-hloko tse ngata tsa gramme joaloka staphylococci le streptococci, liketso tsa vancomycin ke bacteriocidal. Ka mantsoe a mang, vancomycin e sebetsa ho bolaea libaktheria tse nang le gram. Leha ho le joalo, ha li loantša li-entococci, mofuta o mong oa sebōpeho sa gram-positive, liketso tsa vancomycin ke bacteriostatic, 'me e thusa ho thibela libaktheria ho ikatisa.
Vancomycin fana ka boitsebiso
Vancomycin e sebelisetsoa ho loantša mefuta e 'maloa ea likokoana-hloko tsa baktheria, tse ngata tsa tsona tse hanyetsanang le mefuta e meng ea lithibela-mafu tse akarelletsang:
- maloetse a matla a staphylococcal ho batho ba haelloang ke penicillin
- Staphylococcus aureus e thibelang methicillin (MRSA)
- Staphylococcus epidermidis e thibelang methicillin
- Streptococcus pneumoniae e sa thibeleng lithethefatsi
- li-enterococcal tse matla ho batho ba nang le khatello ea penicillin
- ho kena malapeng a mangata a mangata a hanyetsanang le penicillin
- Viridans streptococci
- meriana e mengata e thibelang lithethefatsi Corynebacterium jeikeium
- Clostridium difficile
Mafu a tšoaroa ke vancomycin
Vancomycin e sebelisetsoa ho tšoara mefuta e mengata ea tšoaetso e tebileng ho kenyeletsa:
- tšoaetso ea mafu a ho phefumoloha;
- mafu a lesapo, letlalo le a bonolo-lisele;
- peritonitis;
- endocarditis (tšoaetso ea pelo);
- enterocolitis le pseudomembranous colitis (mafu a malingo);
- prophylaxis ha a e-na le menoana, biliary, GI, mafu a ho phefumoloha le a tlhahiso ea mafu a tlhaho;
- ho hloka bokooa bokong (ho se sebelisoe ka lehare);
- ho tšoaetsoa ka linako tse ling (ho se sebelisoe ka lebokose);
- ho tšoaroa ke meningitis (ho se sebelisoe ka lebokose).
Tsamaiso ea Vancomycin le litekanyetso
Hobane vancomycin ha e sebetsane hantle le pampiri ea meno, hangata e sebelisoa e le ente. Leha ho le joalo, ha ho sebelisetsoa ho tšoara enterocolitis le pseudomembranous colitis, bobeli ba tšoaetso ea masapo, bakuli ba nka vancomycin ka molomo.
Vancomycin e atisa ho sebelisoa sebakeng se se nang sepetlele (sepetlele). Hobane li-dosing li rarahane 'me li itšetlehile ka tlhōrō ea litlhōrō le lihlahisoa tsa lihlahisoa, litlhare tsa bakuli ba nang le bokooa ba atisa ho bitsoa ho bala litekanyo.
Ho feta moo, kahobane vancomycin e etsoa ke liphio, ho sebelisa lithethefatsi ena ho thata haholoanyane ho batho ba nang le ho hlōleha ha lesoba.
Vancomycin liphello tse bohloko
Litla-morao tse tebileng tse bakoang ke vancomycin ha li fumanehe, 'me phello e mpe ka ho fetisisa ea vancomycin ke pheliso e fokolang ea hypersensitivity kapa ho itšoara ka tsela e fokolang. Leha ho le joalo, vancomycin e ka ba nephrotoxic 'me ea senya liphio ka ho khetheha ha e sebelisoa ka aminoglycosides, mofuta o mong oa lithibela-mafu. Ho feta moo, ha o sebelisoa ka aminoglycosides kapa tekanyo e phahameng ea erythromycin, hape e na le mofuta o mong oa lithibela-mafu, vancomycin e ka senya ho utloa (ototoxicity).
Qetellong, vancomycin e ka baka lefu la hyperemia kapa la motho a khubelu, e leng mofuta oa ho fofa; ho hlatsoa joalo ho ka fokotsoa haeba mokuli a fuoa antihistamine pele.
Vancomycin ts'oaetso e baka tlhokomelo e ntseng e eketseha ho lingaka, bafuputsi le li-epidemiologist ka tsela e tšoanang. Hobane vancomycin ke e 'ngoe ea litsela tsa rona tsa ho itšireletsa khahlanong le mafu a mangata a kotsi le a lithethefatsi, tebello ea hore ha e sa tla hlola e sebetsa ho loantša tšoaetso e tšosoa ebile e re siea ka mekhoa e seng mekae (nahana Zosyn le ceftaroline). Haholo-holo, likokoana-hloko tsa li-entococci tse sa mameleng vancomycin li kene lipetlele lefatšeng ka bophara. Kaha vancomycin e atisa ho etsoa lipetlele, ho ba le litsebi tsa tlhokomelo (SKFs), matlo a tlhokomelo le tse ling, ke habohlokoa hore litsebi tsa tlhokomelo ea bophelo li nke mehato ea ho fokotsa ho thibela vancomycin, e kang ho thibela ho feta ho fokotsa matla le ho fokotsa ho ata ha vancomycin ho bakuli ka bakuli ba nepahetseng ho itšehla thajana le bohloeki.
Mehloli e khethiloeng
Guglielmo B. Anti-Infective Chemotherapeutic & Antibiotic Agents. Ka: Papadakis MA, McPhee SJ, Rabow MW. eds. Tlhahlobo ea Bongaka ea Meriana le Kalafo ea 2015 . New York, NY: Hill ea McGraw; 2014. Fumaneha ka la 07 April, 2015.
Mosby's Drug Reference bakeng sa Bophelo bo Botle, Khatiso ea Bobeli e hatisitsoeng ke Mosby / Elsevier ka 2010.