Mishonga ndivo ichangobva chizvarwa yakafara-chakarondedzera

Pakati mishonga ipi inokosha nzvimbo yokupedzisira chizvarwa mishonga vanoshingaira pamusoro utachiona zhinji. Ivo inoshandiswa pakurapa zvirwere pathologies, izvo yekudyidzana kwakaderedza vanourayiswa wevarwere kubva banal kufambidzana pneumonias uye pyelonephritis. Nokuda mishonga nokuti akwanise uye nokukurumidza kupora ari bronchitis, sinusitis, uye zvakakwanisika kuita zvakaoma maoparesheni. Kunyange ndakakuvadza Zvirwere vari vakabudirira kubatwa nemishonga.

Mishonga inorwisa mabhakitiriya (ABSHS)

chikamu ichi zvinosanganisira inorwisa utachiona yomuchipatara tichishingaira pamusoro giremu negative uye giremu-akanaka zvinenge. Wokutanga ndiwo causative vaishandira intestinal zvirwere, anogumbura pathologies pamusoro urogenital uye kufema nehurongwa. Giremu-akanaka zvinenge vanowanzorwara kukonzera ronda noutachiona uye svitsanisa panowanikwa postoperative yematambudziko ari kuvhiyiwa.

List ABSHS yakasiyana kusunungurwa nguva

Vamwe chakarondedzera mushonga azvino chizvarwa vari kushingaira pamusoro protozoal zvirwere. Mienzaniso inosanganisira nitroimidazole nomukaka - tinidazole, metronidazole uye ornidazole. Yainyanya kushandiswa metronidazole nokuda affordability. Kirasi ake analogue - tinidazole - zvakafanana chakarondedzera inorwisa utachiona basa, asi haana kuiswa parenterally. Kazhinji, mapoka ose mishonga inorwisa mabhakitiriya dzinoturwa sezvinotevera:

• dzinongoitika penicillins;
• ingibitorzaschischennye aminopenicillin;
• pseudomonas penicillins, kusanganisira ingibitorzaschischennye;
• cephalosporins III rudzi cephalosporins IV nechizvarwa ;
• aminoglycosides boka;
• tetracycline mishonga ;
• macrolide mishonga;
• Kuwanda carbapenem mishonga inorwisa mabhakitiriya;
• chloramphenicol;
• fosfomycin;
• rifampin;
• dioxidine;
• sulfonamides;
• quinolones, fluoroquinolones;
• nitrofurans boka;
• nitroimidazole mishonga dzakatevedzana.

Iyi ndaza haina kupiwa mazita mapoka ezvitanda-mishonga inorwisa mabhakitiriya. Vane wakananga vashoma tupukanana uye dzinobudirira kuzorwa navo. yakamanikana-chakarondedzera madhiragi hazvigoni kushandiswa pakurapa superinfection uye haana kuiswa empirically. Vari senzira yokutanga-mutsetse mishonga panguva ushandiswe utachiona hwakakura.

The mazita vekare ABSHS

The pamusoro inorwisa utachiona yomuchipatara nhengo dzakasiyana-siyana zvinodhaka. Izvi gurupu ose zvinhu basa pamusoro giremu-akanaka uye giremu negative utachiona. Zvisinei, mazita rine zvose ichangobva chizvarwa inorwisa mabhakitiriya uye vamiririri kwokutanga veboka. Pakati vamiririri matsva marudzi pamusoro ndedzinotevera mumapoka zvinodhaka:

• aminopenicillin husingakwanisi Beta-lactamase ( "Sulbactam", "Ampicillin", "clavulanate" "Amoxicillin");
• cephalosporins zvizvarwa III uye IV ( "Cefotaxime" "Cefoperazone" "Ceftazidime" "ceftriaxone" "cefpirome" "Cefepime");
• Chizvarwa III aminoglycoside mishonga ( "Amikacin" "Netilmicin");
• 14- uye 15-membered Semi-chakaita zvokugadzirwa macrolides ( "Roxithromycin" "Clarithromycin," "Azithromycin");
• Natural 16-membered macrolide mishonga ( "midecamycin");
• fluoroquinolones III uye IV zvizvarwa ( "levofloxacin" "sparfloxacin" "Gatifloxacin" "Trovafloxacin" "Moxifloxacin");
• carbapenems ( "meropenem" "Imipinem-cilastatin" "Ertapenem");
• nitrofurans ( "Nitrofurantoin" "Furazidin", "ersefuril").

Mishonga kuti havachafaniri ndandanda

Izvi kare akadzivirira antipseudomonal penicillins vane Zvisinei, munhu chakarondedzera basa, ndikarangarira chete kuzorwa P. aeruginosa tichifunga nezvokudiwa kuderedza fungidzira kuonana azvino zuva uye simba mushonga. Kanoita ngozi zvahunoitwa nemishonga kwemabhakitiriya. The efficacy chikuru pamusoro Pseudomonas chirwere hworatidza "tazobactam." Apo neapo "Piperacillin" uye "clavulanate" akashandiswa azvino chizvarwa inorwisa mabhakitiriya kuti nemabayo kunokonzerwa kuchipatara okuva nayo utachiona.

Uyewo pachikwata hapana mishonga okupedzisira chizvarwa boka rwokuzvarwa uye Anti-staphylococcal penicillins. Aimbova hazvigoni kushandiswa murwere mabatiro nokuda vanoda kugara intravenous kana intramuscular yaitonga. Forms kuti kuvatendera kutora zvokuvataurira nomuromo, haako. Mamiriro ezvinhu akafanana aripo pamwe cephalosporins. With chete chakarondedzera basa sezvo penicillins, haagoni kupiwa nomuromo nokuti kuparadzwa mudumbu.

Cephalosporins uye penicillins parenteral kushandiswa - ndicho ichangobva chizvarwa zvinobudirira nemishonga inorwisa mabhakitiriya kuti nemabayo. NASB masayendisiti akabudirira kuva chipimo chemushonga muchimiro enteral yaitonga. Zvisinei, tsvakurudzo haisati kushandisa, uye zvinodhaka zvinogona kushandiswa saka kure chete mira zvoutano masangano.

Zvikuru vanobudirira mishonga vana

Exploring ichangobva chizvarwa inorwisa mabhakitiriya, pamazita zvinodhaka varumbidzwa vana, kujekesa yekudyidzana. In muduku, unogona chete kushandiswa nevamiririri anoverengeka aminopenicillins ( "Amoxicillin", "clavulanate"), cephalosporins ( "Ceftriaxone" "Cefepime"), macrolides ( "Azithromycin", "midecamycin" "Roxithromycin", "Clarithromycin"). Fluoroquinolone mishonga, carbapenems uye nitrofurans hazvigoni kushandiswa nokuda kokumanikidza kukura mapfupa, chiropa uye itsvo toxicity.

System nitrofurans hadzina aishanda nokuda kwokushayiwa nesayenzi hwokutsigira kuchengeteka kurapwa. The chete Kunze ndiko "furatsillina", akakodzera omunzvimbo mishonga maronda. Modern uye kwazvo vakarongeka mishonga yokupedzisira rudzi rwavana sezvinotevera: macrolides, penicillins, cephalosporins (mazita zvinodhaka dzinopiwa pamusoro). The yasara boka inorwisa utachiona yomuchipatara hadzina yakarumbidza nekuda chepfu maturo, uye skeletal zvirwere.

ABSHS kuvakadzi vane mimba

Maererano FDA kupatsanura (US), chete shomanana azvino chizvarwa mishonga inogona kushandiswa pakurapa vakadzi vane pamuviri, inova chaizvo diki mazita. Vanopinda Mapato A uye B, kuti ngozi kwete yasimbiswa kana kwete teratogenic migumisiro muzvidzidzo mhuka.

Zvinhu pamwe unproven migumisiro iri mudumbu, uyewo kuvapo chepfu mugumisiro chete kunogona kushandiswa kana kwokupararira kuchirapa maturo pamusoro divi (chikamu C uye D). Kugadzirira X chikamu wakasiyana nekusimba teratogenic migumisiro iri mudumbu, kana zvakakodzera, nokuti kushandiswa kwavo hazvo pamuviri.

Panguva pamuviri, zvinotevera mishonga okupedzisira chizvarwa yakafara-chakarondedzera Mahwendefa: akadzivirirwa aminopenicillin ( "Amoklav", "Amoxiclav"), cephalosporins ( "Cefazolin" "Ceftriaxone" "Cefepime"). Macrolides ( "Azithromycin", "Clarithromycin", "midecamycin" "Roxithromycin") vanobvumirwa kushandisa rechitatu trimester kuti gestation nokuti kuti avo teratogenic kushanda haina zvizere kudzidza, uye kuishaya hazvigoni zvisingarevi zvakawanda kutaura. Uyewo, vakadzi vane pamuviri zvakachengeteka kushandisa kuti penicillin mishonga tisina Kurwara.

Kushandiswa inorwisa mabhakitiriya pakurapa bronchitis

mishonga All wokupedzisira chizvarwa yakafara-chakarondedzera, mu pfungwa, vanogona kushandiswa bronchitis uye nemabayo kana avo pharmacodynamic maitiro Zvakanyanya Kunaka Panguva Yepamuviri iyi. Zvisinei, pane optimum pamisungo pfungwa kurapa zvirwere zvakadaro. Ivo kufungawo zvakasiyana vanobudirira mubatanidzwa tupukanana kuitira akasiyana mishumo microbial utachiona.

Nitrofurans, nitroimidazole nomukaka uye sulfonamides safunga kushandiswa anogumbura zvirwere kufema hurongwa. Anobudirira zvikuru Tikafunga bronchitis kana nemabayo, zvemapapu aibuda kunodzivirirwa macrolide ne aminopenicillin ( "Amoklav" + "Azithromycin"). Mazhinji bronchitis zvinoda kugadzwa cephalosporin pachinzvimbo aminopenicillin ( "Ceftriaxone" + "Azithromycin"). Pazano ichi, kuti macrolide anogona kutsiviwa nomumwe kirasi analoginen nokuti "midecamycin" "Clarithromycin" kana "Roxithromycin".

Zvose izvi azvino-chizvarwa mishonga kuti bronchitis vane raidudzwa chaizvoizvo, kunyange zvazvo kurapwa zviratidzo chirwere anogona kuramba kuvapo. Chokuratidza kubudirira kurapwa - nechitarisiko chikosoro pamwe phlegm zvishoma vakachenesa uye fivhiri ruyamuro. In COPD uyewo simba dyspnea, kudya nani, akaderedza chikosoro maitikiro zvido.

Zvinobudirira mabatiro nemabayo

Nemabayo kuti nyoro kurapwa pachishandiswa bronchitis, asi nokushandiswa cephalosporin uye macrolide. Kana mwero kune zvikuru munharaunda-akawana nemabayo chakangomuka yakatarwa cephalosporin ( "Ceftriaxone" kana "Cefepime") ne dzinoverengeka fluoroquinolones ( "Ciprofloxacin" kana "Levofloxacin"). mishonga ava okupedzisira chizvarwa yakafara-chakarondedzera zvakanaka Vanodzivisa microflora munharaunda-akava nokuitika yavo kushandiswa iri kuoneka pazuva kurapwa rechipiri.

chizvarwa chanhasi ichangobva inorwisa mabhakitiriya nokuda nemabayo (zita rakapiwa pamusoro) chokuita nayo utachiona, ayo anokosha nokuda kudzvanyirira kana chokumuuraya. Okutanga zvinhu vanonzi bacteriostatic, bactericidal uye yokupedzisira zvinodhaka. Cephalosporins, uye fluoroquinolones aminopenicillin - bactericides, uye macrolides - bacteriostats. Uyezve wemishonga inorwisa mabhakitiriya vaida kuwedzera kwete chete kuwanda mabasa, asi zvinoenderana nemitemo tichibatanidza mumwe mushonga chete bactericidal bacteriostatic mumwe.

Treatment chakakomba nemabayo muna HITD

In yevanorwara zvikuru, apo pangava varwere zvikuru nemabayo uye nenhamo chirwere pamusoro pakanyorwa kudhaka. Mupiro mukuru kune kwokuomerwa mamiriro varwere dzakadaro kunoita pathogenic microflora kuti husingakwanisi tupukanana vakawanda. Mumamiriro ezvinhu akadaro, shandisa carbapenems ( "Imipinem-cilastatin," "Tienam", "Meropenem"), havasi kushanda kuti kushandiswa muna outpatient marongero.

Mabatirwo sinusitis uye sinusitis

chizvarwa chanhasi ichangobva inorwisa mabhakitiriya kuti sinusitis kana sinus kushandiswa kuuraya utachiona. Muzviitiko zvakadaro, mumwe anogona kushandisa bactericidal mushonga. Zvisinei, kana sinus chikuru chinetso ndiko kuwana nzvimbo inorwisa utachiona kuzvimba. Naizvozvo, vazhinji inowanzoshandiswa zvinodhaka cephalosporin. Muenzaniso ndiye "Ceftriaxone" kana "Cefepime." Inogonawo kupiwa fluoroquinolone III chizvarwa - "Levofloxacin".

Mabatirwo angina tupukanana ano

ichangobva chizvarwa inorwisa mabhakitiriya nokuda kwazvo huro vanogadzwa kuti chinangwa chete. Uyezve, uye sinus, uye zvakafanana Anti-microbial yomuchipatara angashandiswa pa tonsillitis. Musiyano chete ndechokuti panyaya kuzvimba tonsils zvinogona kushandiswa uye antiseptics Somuenzaniso, "furatsillina" - kugadzirira wandei nitrofurans. Kunyange zvazvo angina aminopenicillins inogonawo kushandiswa zvinobudirira kuchengetedzwa sulbactam kana clavulanic asidhi ( "Amoklav" "Amoksiklav" "Ospamoks"). Uye zvinodhaka anofanira kuzviita kwemazuva 10-14.

Mabatirwo pyelonephritis uye zvirwere zviri genitourinary hurongwa

Nokuda kuti kusvibiswa nezvezvimwe zvinetso zvedundira turakiti kubudikidza utachiona, ichangobva chizvarwa inorwisa mabhakitiriya ari pyelonephritis zvakakodzera kuti kurapwa kwavo. Mukuru kuchirapa ukoshi pano vari cephalosporins, fluoroquinolones uye nitrofurans. Cephalosporins zvinoshandiswa tichishandisa zvishoma kwazvo pyelonephritis, uye fluoroquinolones ( "Ciprofloxacin", "Levofloxacin", "Ofloxacin", "Moxifloxacin") - ari kudzikira necheseri vane mishonga.

Anobudirira zvikuru chinodhaka, yakakodzera zvose monotherapy uye kuti akabatana "Ceftriaxone" ndiko mumiririri dzingaverengwa nitrofurans - "FURAMAG"). Uyewo quinolone zvinogona kushandiswa - "Nalidixic asidhi". Recent kusika yakakwirira kuwanda munyika weti uye zvinoshingaira pamusoro causative vaishandira Urinary zvirwere. Uyewo, dzimwe nguva kana gardnelleze dysbacteriosis nepanhengo uye vakashandisa "Metronidazole".

Kurapika uye zvainoita

Nokuda dzose kuchinja majini zvinhu zvigare, kunyanya utachiona, vakawanda inorwisa utachiona kushanda ari yekudyidzana ipfupi. Kuwana kuramba zvinodhaka, bacteria akagadzirira kugona kurarama mumuviri womunhu kuburikidza muyananisi kudzikisirana kwezvirwere zvinotapuriranwa. Izvi Hunoita vanotsvakurudza kutsvaka uye kushandisa mishonga itsva chizvarwa rokupedzisira.

Panguva nokuvapo inorwisa utachiona yomuchipatara yakatanga inenge 7000 zvinhu mune imwe nzira zvinoshandiswa mukurapa. Vazhinji vavo vakabuda kushandiswa nokuda munhu akaora chinokosha nemishonga kana nokuda kuzviwanira microbial nemishonga kwavari. Nekuti nhasi mushonga akashandisa vanenge 160 zvinodhaka. About 20 vavo - ndiwo ichangobva chizvarwa inorwisa mabhakitiriya, mazita dzichitaridzika mune zvokurapa mabhuku ose anorwisa tupukanana kurapa zvirwere zvinotapukira.