Imithi elwa namagciwane engu-8 edala uC

Imfundo Yezempilo

Ukwethulwa kwama-antibiotic okwelapha izifo ngokungangabazeki kwaguqula ezokwelapha eminyakeni eyikhulu edlule. Kodwa ezinye zalezi zidakamizwa ezimangazayo, njengoba zazibizwa kanjalo, nazo zingashiya umzimba usengozini yesifo esithathelwanayo esibizwa ngeC.Difficile.

Yini uC. Diff?

AmaClostridioides difficile , ebikade yaziwa ngokuthi IClostridium difficile , noma uC. Diff, uyi- amagciwane athathelanayo lokho kungadala isifo sohudo esibi. Ezinye izimpawu ezijwayelekile ze-C.Diff zifaka phakathi umkhuhlane, isicanucanu, ukungathandi ukudla, nobuhlungu besisu.

Kulinganiselwa ukuthi kungadala cishe 500,000 izifo e-United States nase Ukufa kwabantu abangu-15,000 unyaka ngamunye, ngokusho kwe- Izikhungo Zokulawulwa Nokuvikelwa Kwezifo . Okwamanje ihlukaniswe yiCDC njenge Usongo Oluphuthumayo —Izinga eliphakeme kakhulu lokusongela lamaCentre- ukuya empilweni yomuntu kusuka kuma-pathogen athathelanayo e-U.S. (I-CDC ihlela ukukhipha umbiko obuyekeziwe maqondana nale datha ekwindla 2019.)

Yimaphi ama-antibiotic abangela uC.

Ngakho-ke ukusetshenziswa kwama-antibiotic kumenza kanjani umuntu abe sesichengeni sokusongela impilo njengoC. Diff? Uma uthatha i-antibiotic, isebenza ukubulala ukutheleleka kwebhaktheriya emzimbeni wakho. Ngokwenza lokhu, le mithi ingabhubhisa namagciwane aphilile agcina abahlaseli abanjengoC. Diff behlola. Kubalulekile ukuqaphela, akuwona wonke ama-antibiotics abangela i-C.Diff, futhi akuwona wonke umuntu onengozi efanayo. Yize cishe noma imuphi umuthi olwa namagciwane ungawubanga, okuyisona esibi kunazo zonke, kuleli cala, kuvame ukuba yimithi elwa namagciwane ebanzi. Labo abasengozini enkulu yiziguli ezineminyaka engama-65 noma ngaphezulu ebisendaweni yokunakekelwa kwezempilo, njengesibhedlela noma ikhaya labahlengikazi.

Ama-antibiotic ebanzi anemisebenzi ngokumelene nohla [olukhulu] lwama-bacteria ahlala emathunjini, kuchaza UDkt. UHana Axelrod , umsizi kaprofesa wezokwelapha eMkhakheni Wezifo Ezithathelwanayo e IGeorge Washington School of Medicine neSayensi Yezempilo . Kubaluleke kakhulu ukuba nabantu abanempilo nabahlukahlukene bala magciwane. Lapho abantu benikezwa ama-antibiotic ebanzi, amabhaktheriya abo esiswini ayaphela, okwenza ukuthi kube nezinhlobo ze-pathogenic, ezinjenge-C.Diff, ezakha kakhulu ukwanda kwamagciwane anolaka akhiqiza ubuthi obonakalisa amathumbu futhi kudale ukugula okunzima kakhulu.

U-Erika Prouty, Pharm.D., Owayenguprofesa wesikhashana e IWestern New England University College of Pharmacy eSpermfield, eMassachusetts, iyayihlakaza ngokuqhubekayo: Ama-antibiotic ebanzi angaba yingozi kwiziguli ngoba azihloseli nje kuphela amabhaktheriya amabi esizama ukuwaqeda, kodwa futhi abulala namagciwane amaningi amahle asesimisweni sethu sokugaya ukudla .

Bobabili uDkt. Akselrod noDkt. Prouty bakhomba i-clindamycin ne-fluoroquinolones njengezinye zezaphulamthetho ezimbi kakhulu. Uhlu lwama-antibiotic ukuthi kungadala uC kuhlanganisa:

• cephalosporins
• clindamycin ( UCleocin )
• ciprofloxacin ( ECyprus )
• umagazine ( I-Levaquin )
• umagazine ( I-Avalox , Vigamox )
• amokfillin (Amoxil)

Kuyishwa, kusho uDkt. Akselrod, ngoba lawo ma-antibiotic asetshenziswa kakhulu kuyo yonke into kusuka kunyumoniya kuya ezifweni zomgudu womchamo. Olunye udaba yisidingo semithi elwa namagciwane ethile ye-IV esetshenziswa njalo odokotela emakamelweni okuphuthumayo esibhedlela, nawo awela ngaphansi kwesambulela esibanzi. Le mithi ihlanganisa:

• piperacillin / tazobactam (Zosyn)
• meropenem (Ngithatha)

Ama-antibiotic e-IV ajwayelekile esimweni se-ER ngoba asetshenziswa njengokwelashwa komugqa wokuqala lapho iziguli zifika zigula futhi aziqiniseki ukuthi yini ebangela ukutheleleka, kuchaza uDkt Akselrod. Kepha njengodokotela ocwilisiwe kulo mkhakha, uyazi kahle ukuthi odokotela abasebenza kahle kumele bahambe ngakho konke ukwelapha ukugula okuseduze, ngenkathi bengalethi ukutheleleka okwengeziwe. Ngokuhamba kwesikhathi siye sabona ubungozi obuhambisana nezinzuzo zalolu hlobo lokwelashwa okujwayelekile, usho kanjalo. Kungaba ucingo olunzima ukuthi ungawaqala noma cha ama-antibiotic e-IV. Okusisiza ukuthi sithathe isinqumo esifanele indlela ehlakaniphile yokuzama ukuba nesizathu esithile sokunikeza ama-antibiotic.

Yimaphi ama-antibiotic mancane amathuba okuthi abangele uC.

Uma usengozini enkulu ka-C.Diff, kufanelekile ukukhuluma nodokotela wakho ngokukhetha ukwelashwa okuyingozi kakhulu. Imithi elwa namagciwane eyi mancane amathuba okuthi abangele uC.Diff faka:

• azithromycin ( I-Zithromax , Z-Pak )
• kucofe (IBiaxin)
• umagazine ( I-Oracea , I-Vibramycin )
• erythromycin ( Kufakiwe )
• fidaxomicin ( Ubunzima )
• i-minocycline (IMinocin, Solod )
• i-metronidazole (i-Flagyl)

Imiphi imishanguzo elapha uC.

Yize imishanguzo ebanzi iphezulu ohlwini lwezimbangela zikaC. Diff, kunezinhlobo ezimbalwa kuphela zama-antibiotic kaC. Diff akwazi ukwelapha lesi sifo. I-Vancomycin iyimithi elwa namagciwane esetshenziswa kakhulu kuC. C. Diff, kusho uDkt. Prouty, ecaphuna ukubaluleka komlomo, ngokungafani ne-IV, ukwelashwa: I-IV empeleni ayingene ohlelweni lwamathumbu, ngakho-ke ayisebenzi kangako. Futhi njengoba konke ukutheleleka kubangelwa amagciwane ahlukahlukene (ibhaktheriya elibanga izifo), akuwona wonke ama-antibiotic azobhekisa kulawo magciwane futhi awabulale, usho kanjalo. Ngakho-ke, izidakamizwa ezithile kufanele zisetshenziswe ekwelashweni kweC.

Kuphakanyisiwe ukuthi amazinga we-C.iff awe phansi eminyakeni yamuva okungenani ngokwengxenye ngenxa ye- izinhlelo zokuphatha ama-antibiotic ezibhedlela, ezifuna ukunciphisa ukunikezwa kwemithi elwa namagciwane engadingekile. Kepha uma kukhulunywa ngeziguli ezisebenza ngokuvikela uC. Diff, uDkt. Akselrod uthi into yokuqala abangayenza ukuba nengxoxo engagunci nomhlinzeki wabo wezokwelapha mayelana nokuthi bayayidinga yini ngempela leyo antibiotic, futhi banciphise isikhathi esichithwe phezu kwakho.