Ama-Macrolides nama-penicillin aphakathi kwamaqembu aphephile futhi asebenzayo kakhulu emithi elwa namagciwane. Zisetshenziselwa ukwelapha izifo zezitho zangaphakathi, izicubu ezithambile nesikhumba. Ngokuya izinkomba zokusetshenziswa kanye ne-ejenti yokubangela yesifo, udokotela angayalela uKlacid noma i-Amoxiclav, kanye nezidakamizwa ezifanayo ekwakhiweni nasemphumeleni kuzo (Clarithromycin, Augmentin, Sumamed).
Isimo sikaKlacid
Isakhi esisebenzayo seKlacid yi-macrolide antibiotic clarithromycin. I-spectrum yomsebenzi wayo we-antibacterial ifinyelela kuma-pathogens ajwayelekile wezifo ezithathelwanayo. Ama-microorganisms azwelayo afaka:
- igciwane le-aerobic le-gram-positive ne-gram-negative aerobic (streptococci, pneumococci, moraxella, hemophilus bacillus, listeria, njll.);
- ama-pathogens we-anaerobic (clostridia, njll);
- ama-ejenti we-causative we-STDs (chlamydia, mycoplasma, ureaplasma);
- i-toxoplasma;
- Borrelia
- Helicobacter pylori (H. pylori);
- i-mycobacteria (ayikhombisi ukusebenza okwanele kuphela uma itheleleke ngesifo sofuba i-microbacteria).
I-Klacid ne-Amoxiclav isetshenziselwa ukwelapha izifo zezitho zangaphakathi, izicubu ezithambile nesikhumba.
I-wide spectrum yesenzo ye -cacithromycin ikuvumela ukuthi unqume iKlacid ngezinkomba ezilandelayo:
- ukutheleleka kwamagciwane ezingxenyeni ezingenhla nezingezansi zohlelo lokuphefumula (i-sinusitis, i-tonsillitis, i-pharyngitis, imidiya ye-otitis, i-tracheobronchitis, i-pypumonia ye-atypical, njll.);
- i-folliculitis, erysipelas, ezinye izilonda zamagciwane zesikhumba nezicubu ezingaphansi;
- izifo zasekhaya nezokuhleleka ezibangelwa i-mycobacteria (ngaphandle kwe-bacchus kaKoch);
- i-prophylaxis ye-mycobacterial ukutheleleka okucasulwe nguM. avium ezigulini ezine-HIV ezinokuqukethwe okuphansi kwabasizi be-T;
- izilonda zesisu kanye ne-duodenal ulcer (ukuze kuncishiswe ukuqina kwe-H. pylori njengengxenye yenkambo ye-antibacterial ehlangene);
- Ama-STI abangelwa ngamagciwane azwela i -cacithromycin;
- ukuvimbela izinkinga zamagciwane ngemuva kwezinqubo zamazinyo (kufaka phakathi i-sepsis ne-endocarditis).
Ngokuya kokuxilongwa kanye nobudala isiguli, udokotela angakunikeza eyodwa yalezi zindlela ezilandelayo zokukhishwa kweKlacid:
- amaphilisi (umthamo wesithako esisebenzayo - 250 no-500 mg);
- ukumiswa (inani lama-antibiotic ku-5 ml womkhiqizo ophelile yi-125 noma 250 mg);
- i-powder yokulungiswa kwekhambi lokufakwa kwe-infusion (umthamo we -cacithromycin - 500 mg kwibhodlela elingu-1).
Isakhi esisebenzayo seKlacid yi-macrolide antibiotic clarithromycin.
I-Klacid ayinqunyelwe uhlobo lomjovo: ukuphathwa kwe-macrolide okwenziwa ngehora kwenziwa ngesipikili ihora noma isikhathi eside.
Ukuxhumana ngokusetshenziswa kwe -cacithromycin yilezi:
- i-hypersensitivity yezidakamizwa ze-macrolide ne-ketolide, izithako eziziwayo zomuthi;
- ukwehluleka kwenhliziyo, izifo zenhliziyo ezi-coronary, i-ventricular arrhythmia ne-tachycardia, ukuba khona kwezinto ezi-proarrhythmogenic kanye nengozi ekhulayo yokwandisa isikhathi sokuphumula se-QT (ngokwesibonelo, ukuntuleka okukhulu kwe-potassium ne-magnesium);
- ukuhlanganiswa kokuhluleka kwezinso nezinso;
- i-cholestatic jaundice, icasulwe ukusetshenziswa kwalesi sifo (umlando);
- ukucaphuka
- ukukhulelwa (ku-trimester engu-2-3, kungenzeka ukusebenzisa ngokulandela izinkomba eziqinile);
- iminyaka engaphansi kwezinyanga eziyisithupha;
- isifo se-porphyrin;
- ukwelashwa ngezidakamizwa ezingahambisani ne -cacithromycin (Ergotamine, Colchicine, Ticagrelor, Midazolam, Ranolazine, Cisapride, Astemizole, Terfenadine, ama-statins, njll.).
Uma kwenzeka ukungasebenzi kahle kwesibindi nezinso (uma uClinininine engaphansi kokujwayelekile, kepha kungaphezu kwama-30 ml / min), ukwelashwa kwe -cacithromycin kufanele kwenziwe ngaphansi kokuqashwa kwezokwelapha kanye nokuqapha i-biochemistry yegazi. Lapho kunquma ukumiswa kukaKlacid ezigulini ezinesifo sikashukela, inani le-sucrose kumthamo onconyelwe womuthi kufanele ubhekwe.
Lapho kunquma ukumiswa kukaKlacid ezigulini ezinesifo sikashukela, inani le-sucrose kumthamo onconyelwe womuthi kufanele ubhekwe.
Izici ze-Amoxiclav
I-Amoxiclav iqukethe isakhi se-antibacterial (amoxicillin) kanye ne-beta-lactamase inhibitor (clavulanic acid). I-Clavulanic acid ivimba isenzo sama-enzyme angamagciwane adiliza indandatho ye-beta-lactam antibiotic ring. Ukuhlanganiswa kwalezi zinto ezimbili kukuvumela ukuthi wenze okubandakanya namagciwane amancane amelana nama-penicillin angavikelekile.
I-spectrum yomsebenzi we-amooticillin ifinyelela kulezi ziguli ezilandelayo:
- i-gram-positive aerobic microorganisms (staphylococci, streptococci, pneumococci);
- gram-negative aerobic cocci (hemophilic ne-Escherichia coli, moraxella, Klebsiella, enterobacteria).
Izinkomba zokusetshenziswa kwomuthi yilezi zindlela ezilandelayo:
- ukutheleleka ngegciwane kwendlela ephezulu yokuphefumula ephansi nengaphansi;
- izinqubo zokuvuvukala zomgudu womchamo obangelwa ama-aorganobacteria;
- izifo zesisu (izilonda esiswini kanye ne-duodenal, ukuvuvukala komqhumo we-gallbladder kanye ne-bile ducts);
- izifo ezithathelwanayo zohlelo lokuzala;
- ukutheleleka kwe-odontogenic, ukuvimbela izinkinga zamagciwane ngemuva kokuhlinzwa kwamazinyo;
- i-osteomyelitis, isifo esithinta izicubu;
- izilonda zamagciwane zesikhumba nezicubu ezingaphansi;
- ukuphathwa kwe-Amoxiclav kwe-intravenous: I-STD (i-gonorrhea, i-chancre emnene), ukuvuvukala esiswini, ukuvimbela izinkinga ezithathelwanayo ngemuva kokuhlinzwa.
I-Amoxiclav itholakala ngezindlela eziningi zomthamo:
- amaphilisi (umthamo we-amooticillin ungama-250, 500 noma ama-875 mg);
- amaphilisi we-dispersible (soluble) (aqukethe ama-500 noma ama-875 mg we-antibiotic);
- i-lyophilisate yokwenziwa kwamalungiselelo we-intravenous (umthamo wengxenye ye-antibacterial ebhodleleni eli-1 le-lyophilisate ngu-500 mg noma 1 g);
- i-powder yokwenziwa kokumiswa (i-5 ml yomuthi ophelile uqukethe i-125, 250 noma i-400 mg yento esebenzayo, ngokuya ngomthamo okhonjisiwe).
I-Amoxiclav iqukethe isakhi se-antibacterial (amoxicillin) kanye ne-beta-lactamase inhibitor (clavulanic acid).
Ukuxhumana kokuthathwa kokuthatha i-Amoxiclav kukhona ama-pathologies afana nalawa:
- hypersensitivity izidakamizwa zamaqembu e-penicillin nama-cephalosporin, kanye ne-monobactam ne-carbapenem;
- ukungahambi kahle komzimba nokuphazamiseka kwe-metabolic zezingxenye ezingeziwe ze-Amoxiclav (phenylketonuria);
- i-monocytic tonillitis;
- i-lymphocytic leukemia;
- umsebenzi we-hepatic okhubazekile ngenxa yokwelashwa kwe-amooticillin (umlando);
- lapho unquma amaphilisi e-Amoxiclav asabalalisa: isisindo esingaphansi kwama-40 kg, iminyaka yezingane (kuze kube yiminyaka eyi-12), ukwehluleka okunzima kwe-renal (Cl creatinine <30 ml / min.).
Ngokuqapha, i-Amoxiclav imiselwe ama-pathologies wesibindi nezinso, ukwelashwa ngama-anticoagulants, ngomlando wezifo zesisu okubangelwa ukwelashwa kwe-antibacterial, i-lactation nokukhulelwa.
Ukuqhathanisa kweKlacid ne-Amoxiclav
Izinkomba zokuqokwa kwe-Amoxiclav neKlacid ziyefana. Imvamisa ehlukile yokusebenzisa yingoba umehluko ekubonakaleni kwemisebenzi ye-antibacterial, izindleko nokuphepha kwezidakamizwa.
Ukufana
Izici ezifanayo kuzo zombili lezi zidakamizwa yilezi:
- Ububanzi besenzo se-antibacterial.
- Isikhathi esinconyelwayo sokwelashwa (izinsuku ezingama-5-14) kanye nemvamisa yokuthatha i-antibiotic (izikhathi ezi-2 ngosuku).
- Isimo sekhefu kusuka kumakhemisi (on kadokotela).
- Ukusebenza kokulwa namagciwane akhiqiza i-beta-lactamases.
- Ukufaka isicelo ekwelashweni okuyinkimbinkimbi kwezilonda esiswini okucasulwe uH. Pylori.
Uyini umehluko
Umehluko phakathi kweKlacid ne-Amoxiclav ubaluleke ngokwengeziwe. Ukwahluka kwezidakamizwa kuyabonakala kulezi zinto ezifana:
- Isigaba Sokuphepha se-FDA. I-Amoxicillin ithandiwe ukusetshenziswa ngabesifazane abakhulelwe.
- Amandla okusebenzisa ngenkathi yokuqunjelwa. I-Amoxiclav ivunyelwe ukusetshenziselwa ukuncelisa ibele, kanti uKlacid akanconywa.
- Ubudala obuncane lapho umuthi ungasetshenziswa khona. Ama-ejenti asuselwa ku-Amoxicillin angabekelwa izingane kusukela ezinsukwini zokuqala zokuphila. UKlacid ubekelwe izingane ezingaphansi kwezinyanga eziyisithupha.
- Umthamo wansuku zonke wokwelapha we-antibiotic. Uma welashwa nge-Amoxiclav, ngu-750-1750 mg, noKlacid - 500-1000 mg.
- Ukuphendula okungafani kanye nokuphikisana. IClacid ibonakala ngemiphumela emibi ejwayelekile evela ohlelweni lwezinzwa oluphakathi (ukhubazeka kwezindlebe nokuhogela, ukuqwasha, ikhanda elibuhlungu).
Yikuphi okushibhile
Ngokwesikhathi esifanayo sokwelashwa, uKlacid uzokubiza kakhulu izikhathi eziphindwe kabili kwezingu-2 kune-Amoxiclav. Ukulinganiselwa kwezindleko zenkambo yokwelashwa kuncike ohlotsheni lwe-antibiotic.
Yikuphi okungcono: Klacid noma Amoxiclav
Ukuzikhethela komuthi kwenziwa ngudokotela ngokuya ngokuxilongwa kwesiguli, uhlobo lomenzeli onegciwane kanye nomlando wezokwelapha.
I-Amoxiclav ithathwa njengomuthi wokuzikhethela ekwelashweni kwezifo zohlelo lokuphefumula olubangelwa ngamagciwane ajwayelekile kakhulu. Kuphephile amaqembu asengozini kakhulu yeziguli.
IKlacid imvama ukubekelwa iziguli zabantu abadala abane-STDs, izifo ezomzimba ezinzima nezasendaweni.
Ukubuyekezwa kweziguli
UMaria, oneminyaka engama-31 ubudala, u-Astrakhan
Umntwana uvame ukuba nezinkinga ngomphimbo (i-tonsillitis, pharyngitis). Phambilini, udokotela ubeke i-Amoxicillin nezimpawu zayo, kepha kulokhu i-antibiotic ayisizanga, ayizange futhi yehlise izinga lokushisa. Ngemuva kwezinsuku ezintathu zokugula, umuthi washintshwa waba nguKlacid. Kakade ngosuku lwesibili lokwamukelwa, izinga lokushisa lehle kakhulu, futhi ingane yaqala ukululama.
Ngigculisekile ngomphumela, kepha umuthi unomphumela omubi oqinile - isicanucanu.
U-Olga, oneminyaka engama-28 ubudala, uKrasnodar
I-Amoxiclav yi-ejenti ebanzi-ebonakalayo ebhekana ngokuphumelelayo nomsebenzi wayo. Umuthi wawubekelwe ukugula kwendodana yakhe, lapho yayineminyaka kuphela ubudala. Ingane yayijabule ukuphuza umuthi ngendlela yokumiswa, futhi ngemuva kwezinsuku eziyi-1-2 umphumela wawusuvele ubonakele.
Umuthi nawo kufanelekile kubantu abadala, ngakho-ke kufanelekile ukugcina amaphilisi kanye ne-powder kwikhabethe lomuthi wasekhaya.
Odokotela babuyekeza ngeKlacid ne-Amoxiclav
Bakieva E.B., Udokotela Wamazinyo, Ufa
IKlacid isidakamizwa esihle, esisebenzayo esivela kumkhiqizi waseJalimane. Isebenza ngempumelelo emelana namagciwane amaningi amelana nemithi elwa nendabuko. Ine-tropism ephezulu yezicubu zamathambo nezamazinyo, ngakho-ke isetshenziswa ngenkuthalo kudokotela wamazinyo nasekuhlinzeni.
Nginikeza lo muthi ezigulini ezine-osteomyelitis, i-periostitis, i-sinontogenic sinusitis nezifo eziyizimbangela zamagciwane ohlelo lokuphefumula (i-tonsillitis, pharyngitis).
Ukuphazamiseka kwenhloso kuvama ukuvela okuphindaphindiwe okuvela kuphephabhuku lesisu (isifo sohudo, i-dyspepsia, isicanucanu).
I-Almasri A.M., i-gastroenterologist, eMoscow
I-Amoxiclav imvama ukubekelwa izifo zokuphefumula, kepha umuthi unikeza ukuguquguquka okuhle kwezinye izimo (ngokwesibonelo, ngezilonda, i-cholecystitis, njll.). I-antibiotic itholakala ngezindlela eziningi futhi kulula ukuyisebenzisa. Inzuzo eyengeziwe intengo engabizi.
Ngesikhathi sokwelashwa, ukuphazamiseka kwesisu kungenzeka, futhi ama-candidiasis avame ukuvela emva kokuphatha.
