Kuyini ukuphathwa kwama-antibiotic? Ungakujwayeza kanjani

Imininingwane Yezidakamizwa

Uthole ukukhwehlela okubi, ikhala eligcwele, nomphimbo obuhlungu. Uvakashela umhlinzeki wakho wezempilo bese ucela ama-antibiotic. Umhlinzeki wakho wokunakekela oyinhloko wenqaba ukukunikeza incwadi kadokotela futhi uchaze ukuthi unegciwane. Okusho ukuthi, ukwelashwa okuhle kakhulu ukuphumula, uketshezi, kanye neminye imithi ye-OTC. Yini enikezayo? Lesi yisibonelo sobuphathi obuhle bemithi elwa namagciwane.

Uma lokho onakho kunegciwane ngempela, khona-ke ama-antibiotic ngeke asebenze —Zenzelwe kuphela ukutheleleka ngamagciwane. Ungahle ushiye ihhovisi lomhlinzeki wakho wezokunakekelwa kwezempilo likhungathekile ukuthi unamathele kudokotela ukuze ulale futhi unike amanzi esikhundleni sowodwa amokfillin . Kepha, ngokuthembela ekwahlulelweni kukadokotela wakho, wenza ubuphathi obuhle bemithi elwa namagciwane, futhi.

Kubalulekile ngoba ukusetshenziswa okungafanele kwama-antibiotic kungaholela ezinkingeni eziningi kubahlinzeki bezempilo kanye neziguli ngokufanayo. Nayi ingqophamlando yokuthi kusho ukuthini ukwenganyelwa kwama-antibiotic nazo zonke izindlela ongadlala ngazo indima ekuziqhakambiseni.

Kusho ukuthini ukuphatha i-antibiotic?

Ubuphathi be-antibiotic, kwesinye isikhathi obubizwa nangokuthi ubuphathi be-antimicrobial, ngumzamo ohlanganyelwe wabahlinzeki bezokunakekelwa kwempilo ukwamukela ukunqunywa okunesibopho kwama-antibiotic. Lokho kubandakanya ukufaka ama-antibiotic kuphela lapho edingeka (okungukuthi, ngezifo ezibangelwa amagciwane, hhayi amagciwane), ukunquma ama-antibiotic afanele okutheleleka okutholakele, nokubeka isilinganiso esifanele futhi isikhathi sokwelashwa kwama-antibiotic , phakathi kwezinye izinto.

Ngokusho kweCenters for Disease Control and Prevention (CDC), egxile kwi ukusetshenziswa okufanele kwemithi elwa namagciwane :

• Kuthuthukisa ukwelashwa kwezifo ezibangelwa amagciwane
• Kuvikela iziguli emiphumeleni emibi engadingekile
• Kukhawulela uhlobo lokusetshenziswa ngokweqile okuholela kuma-bacterium amelana nama-antibiotic noma ama-superbugs

Ukuhlinzeka odokotela kusho kahle-bafuna ukulungisa abantu, futhi ukwehla kwesikhashana kwama-antibiotic amaningi kuncane ngoba ngokuvamile kuphephile futhi akubizi, kuchaza IMethodist yaseHouston uchwepheshe wezifo ezithathelwanayo uRichard Harris, MD.

Inkinga, kusho uDkt. Harris, ifika lapho iningi leziguli ozama ukuzilungisa empeleni zingadingi ukwelashwa osinikezayo: Ufuna ukwenza isiqiniseko sokuthi awulahlekelwa okuthile, kodwa ugcina usudlulisa ngokweqile ama-50 [ iziguli] ngesiguli ngasinye esidinga ukwelashwa.

Kwaqala nini ukuphatha i-antibiotic?

Ngenxa yokuthi kuningi ukusetshenziswa kweziguli ezingalaliswanga futhi ezingalaliswanga iziguli, izinhlelo zokuphatha sezakhiwe ezweni lonke ukunciphisa ukunikezwa kwale mithi ngokungadingekile. Akucaci kahle ukuthi lezi zinhlelo zisebenza kanjani cishe kuzo zonke izibhedlela ezinkulu kanye nezikhungo zezempilo e-United States, kepha uDkt.Harris uthi lolu hlelo seludlulelwe yisikhathi (kusukela ngo-2018, cishe Izibhedlela ezingama-85% ezweni lonke behlangabezana nemihlahlandlela ye-CDC).

I-Society for Healthcare Epidemiology of America ( SHEA ) ngenye inhlangano ekhuthaza izinhlelo zokuphatha ama-antimicrobial, ukuhlinzeka ngamathuluzi nezinsizakusebenza kochwepheshe bezokunakekelwa kwezempilo ukuze zisetshenziswe ezibhedlela ezinakekela kakhulu nasezikhungweni zokunakekelwa zesikhathi eside ezweni lonke. Ngokwenza ngcono ukusetshenziswa kwama-antimicrobial, i-SHEA ithi lezi zinhlelo zithuthukisa imiphumela yesiguli, zinciphise ukumelana namagciwane, futhi zinciphise izifo ezihlobene nokunakekelwa kwezempilo phakathi kokunye ukuthuthukiswa kwekhwalithi.

UKathryn A. Boling, MD, ongumhlinzeki wokunakekelwa oyinhloko nge Isikhungo Sezokwelapha Somusa eBaltimore, iyavuma, ukubiza ukushintshwa kokugxila ekusetshenzisweni kwama-antibiotic ushintsho oluncane ekuphenduleni ukwanda kwezinto eziphikisayo, isidingo esandayo sokusebenzisa ama-antibiotic anamandla, afaka imithambo yegazi esikhundleni semilomo ejwayelekile yomlomo, nezinye izinto zemvelo.

Abantu baphonsa ama-antibiotic abo phansi ethoyilethi noma bekhipha amanani amancane ale mithi, futhi kungcolisa amanzi esiwaphuzayo, usho kanje. [Zonke lezo zinto zihlangene] bezanele ukwenza umphakathi wezokwelapha uthi 'uh-oh.'

Ku-2014, i-CDC yaqala ukukhipha imihlahlandlela ethile nezincomo zokuthi izikhungo zokunakekelwa kwezempilo, kusukela ezibhedlela kuya emahhovisi eziguli ezingalapha, zingafundisa kanjani odokotela neziguli ngokusetshenziswa okufanele kwama-antibiotic ngokusebenzisa izinhlelo zokuphatha.

Izinhlobo ezi-3 zokungenelela kokuphathwa kwama-antibiotic

Ku- Ama-Core Elements we-Hospital Antibiotic Stewardship Izinhlelo , i-CDC ibeke izinhlobo ezintathu eziyinhloko zokungenelela kobuphathi okungathuthukisa ukusetshenziswa kwama-antibiotic: ukungenelela okubanzi, ukungenelela okuqhutshwa ngamakhemisi, kanye nokungenelela okuthile kwezifo nama-syndromes.

1. Ukungenelela okubanzi kufaka phakathi ukuthola imvume kwangaphambili yokunikeza ama-antibiotic athile, ukwenza ucwaningo ezimweni ezibandakanya ama-antibiotic, nokuhlola kabusha ama-antibiotic anqunyiwe ngenkathi ulwazi lokuxilonga luqoqwa. Isibonelo, unikezwa i-ciprofloxacin egumbini eliphuthumayo lokutheleleka okusolwayo kwezinso ngenkathi umsebenzi wegazi lakho uthunyelwa ebhodini; uma nje imiphumela yakho ibuyile, udokotela okuchazayo ubuyekeza imininingwane yakho ukuze abone ukuthi ngabe leyo kuseseyi-antibiotic engcono yini kuwe.
2. Ukungenelela okuqhutshwa ikhemisi kufaka phakathi ukulungisa imithamo yama-antibiotic, ukubheka izindlela zokwelashwa eziyimpinda nokuhlangana kwezidakamizwa, nokusiza ngokushintshwa kusuka ku-IV kuye kuma-antibiotics omlomo.
3. Ukungenelela okukhethekile kokutheleleka / isifo nikeza imiyalo ecacile yabadokotela yokusebenzisa ama-antibiotic ukwelapha izifo eziningi ezinomlando wokusetshenziswa ngokweqile kwama-antibiotic, kufaka phakathi: inyumoniya etholwe ngumphakathi, izifo ezithwala umchamo, izifo zesikhumba nezithambile, Ukutheleleka kwe-MRSA , Izifo zeClostridium difficile (C. diff), kanye nokutheleleka kwegazi okuye kwafakazelwa yisiko.

Uma konke lokhu kungenelela kwethathu kusetshenziswa, kulandela ukuthi isibhedlela sizobona ukuthi ukusetshenziswa kwaso ngemithi elwa namagciwane kuyathuthuka. Kepha lokhu kungenelela akutholakali ngokumane uphakamise induku yomlingo. Izibhedlela kufanele zitshale imali ekwakheni uhlelo oluqinile lokuphatha ama-antibiotic olususelwa ezintweni eziningana ezingumgogodla ezichazwe yi-CDC. Lezi zinto zisebenza ngokuhlukile kwezinye izilungiselelo zokunakekelwa kwezempilo, kepha ngokuvamile zihlala zifana noma ngabe uhlelo lobuphathi luyenzeka ezikhungweni zabagulayo noma ezigulisa iziguli.

Isici	Isibhedlela	Ikhaya lokuhlengwa	Isilungiselelo Sokugula Kwangaphandle
Ubuholi	Zibophezele ekuhlinzekeni izinsiza ezingabantu, ezezimali nezobuchwepheshe	Zibophezele ekwenzeni ngcono ukusetshenziswa kwama-antibiotic futhi udlulise lokho kuzibophezela kubasebenzi, abahlali, kanye nemindeni	Qoka umholi oyedwa kanye / noma faka umphathi kuzincazelo zomsebenzi
Ukuziphendulela	Kuqokwe umholi oyedwa wodokotela	Bandakanya umqondisi wezokwelapha, umqondisi wabahlengikazi, nabanye abasebenzi abalulekile ekusekeleni imizamo	Xhumana kabanzi neziguli ngemizamo yakho ngokusebenzisa amaflaya nezingxoxo ubuso nobuso
Ubungoti bezidakamizwa	Kuqokwe umholi oyedwa wemithi	Thintana futhi ubambisane nabachwepheshe bomphakathi ezifweni ezithathelwanayo	Nikeza odokotela amathuba okubonisana nochwepheshe abasendaweni noma abangekho kusayithi
Isenzo	Sebenzisa okungenani ukungenelela okukodwa okungahlolwa njalo	Thuthukisa amasu wokusebenza wokungenelela okukodwa noma okungaphezulu kokuthathu	Sebenzisa ukunqunyelwa okusekelwe ebufakazini, ukulinda okulindile, kanye nohlobo lokuya ngaphandle kwesiza ngezifo ezibangelwa amagciwane
Ukulandelela	Gcina umkhondo wamaphethini wokunquma nokumelana	Landelela ukusetshenziswa kwama-antibiotic nezinyathelo zomphumela	Zihlole futhi usebenzise okungenani uhlelo olulodwa lokulandelela / lokubika
Ukubika	Bonke abasebenzi abafanele bayaziswa ngenqubekela phambili	akekho	Zihlole futhi usebenzise okungenani uhlelo olulodwa lokulandelela / lokubika
Ezemfundo	Bonke abasebenzi abafanele baqeqeshelwe ukunquma ngendlela efanele	Sebenzisa amaflaya, imihlahlandlela, ama-imeyili, nezindawo zokusebenzela ukufundisa bonke abasebenzi, izakhamizi nemindeni	Fundisa iziguli ngezinto zokwakha nezingxoxo phakathi kwabantu; unikeze ngamathuba okuqhubeka emfundo odokotela

Kungani kubalulekile

Izinzuzo zezinhlelo zokuphatha ama-antibiotic, ngale kokuncipha okusobala ekusetshenzisweni ngokweqile kwale mithi, zisebenza kubo bobabili abantu kanye nomphakathi wonkana, kusho uDkt Boling.

Ezigulini ngazinye, ukusebenzisa kabi ama-antibiotic kungasho wena:

• Yiba nesikhathi esinzima ukususa ukutheleleka uma kubuya
• Ugule ngesifo esingazweli kalula esilwa namagciwane
• Qeda ngemiphumela engemihle yokulwa namagciwane, kusuka ekucanuzelweni kwenhliziyo nohudo kuye imvubelo izifo , i-anaphylaxis, ukwehluleka kwezinso, noma ukutheleleka nge-C. diff (ibhaktheriya elibanga uhudo oluqhubekayo nokuvuvukala kwamakholoni)

Ezingeni elibanzi, lempilo yomphakathi, echaza ngokungafanele ama-antibiotic:

• Kukhulisa ukumelana nama-antibiotic kanye nokutheleleka okungu-difficile kukonke
• Kukhuphula izindleko zokunakekelwa kwempilo
• Yehlisa imiphumela yokuphepha kweziguli
• Ishiya wonke umuntu esengozini yalezo superbugs ezimbi

Lapho izibhedlela zanda nezindlela zokunakekelwa kweziguli ezingalali ezisebenzisa izinhlelo zokuphatha ama-antibiotic, iba namandla kakhulu imizamo yenhlanganyelo. Ukuphela kwento ekhohlisayo ukuhlola ukusebenza kwalezi zinhlelo. UDkt. UBoling noHarris bobabili bathi njengamanje, ayikho indlela esemthethweni yokubona ukuthi iyasebenza yini imizamo. Uma isibhedlela singabika ukwehliswa kokusetshenziswa kwama-antibiotic-noma ukwehliswa kwemicimbi emibi ngenxa yokusebenzisa ama-antibiotic-lokho kuthathwa njengokuwina.

UDkt. Boling wengeza ukuthi odokotela abasebenza kahle ukuphatha ama-antibiotic nabo bangazihlola: Njengodokotela ngamunye, ungabheka imethrikhi yakho siqu. Imvamisa ngikwazi ukutshela [umehluko phakathi kokutheleleka ngegciwane negciwane] ngokuhlolwa kwami, kodwa uma nginesiguli esiphikelela ngokuthile okwengeziwe okwenzekayo, ngiyalela i-X-ray yesifuba ukuqinisekisa. Kuyaqabukela kakhulu ukuthi leso siguli sidinge ama-antibiotic.

Ukuthi iziguli nabahlinzeki bangasebenzisana kanjani

Uma uzibuza ukuthi ungayenza kanjani ingxenye yakho ukukhawulela ukunikezwa kwama-antibiotic, kulula kunokuba ungacabanga.

1. Ungenzi i-aphoyintimenti yayo yonke into encane. Iziguli zingayeka ukucela ama-antibiotic umzuzu lapho zithola khona ukuhogela, kusho uDkt Boling. Uma ungenawo umkhuhlane noma ukugula kungakaqhubeki izinsuku eziyi-10 noma ngaphezulu, amathuba aphansi udinga ama-antibiotic.
2. Ungafoneli ihhovisi lomhlinzeki wakho wezokunakekelwa kwempilo bese ucela abasebenzi ukuthi bafonele incwadi kadokotela ngaphandle kokuhlolwa. Izifo eziningi ezihlotshaniswa nokusetshenziswa ngokweqile kwama-antibiotic, njengezifo zomgudu womchamo, kufanele kutholakale kunesiko ngaphambi kokuba kubhalwe incwadi kadokotela.
3. Thembela umhlinzeki wakho wokunakekela oyinhloko. UDkt.Harris uthi uma abantu abaningi bethembele ekwahluleleni kukadokotela wabo, bemelana nesifiso sokuphoxeka lapho udokotela wabo ethi ukugula kwabo kunamagciwane kuphela, odokotela bangazizwa bengaphansi kwengcindezi yokwelapha iziguli zabo ngokungadingekile ngama-antibiotic.
4. Hlala usesikhathini ngemigomo yakho. Eminyakeni yami yokusebenza, into ezuzisa kakhulu esiza iziguli ezinezifo ezithathelwanayo yimithi yokugoma, kusho uDkt Harris. Ukutheleleka okuncane kwegciwane okutholayo, mancane amathuba okuthi ube nokufuna ama-antibiotic lapho ungazizwa kahle, wehlisa amathuba akho okuthola incwadi kadokotela ongayidingi ngempela.

Okunye futhi: Njalo ngoNovemba, iWorld Health Organisation (i-WHO) igubha iSonto Lokuqwashisa Nge-Antibiotic, ikhuthaza zonke izikhungo zokunakekelwa kwezempilo, abahlinzeki, kanye nomphakathi jikelele ukuthi bandise imfundo yabo ngamandla we-antibiotic — nokuthi kanjani, uma lawo mandla engasetshenziswa kahle, kungaholela emiphumeleni ebanzi.

Ngo-2020, kuzogujwa Isonto Lokuqwashisa Nge-Antibiotic kusukela ngoNovemba 11 kuya ku-17. Vakashela i-WHO iwebhusayithi ukuze ufunde kabanzi mayelana nokuthi ungayisebenzisa kanjani ekhaya lakho, ehhovisi likadokotela, esibhedlela, noma emphakathini.