Vancomycin waa antibiyootikada ugu dambeeya
Vancomycin waa antibiyootikada ugu dambeeysay ee lagu isticmaalo daaweynta caabuqyada u adkaysta daawooyinka. Vancomycin waxaa markii hore laga soo saaray shaybaarrada caanaha ee Bornean in ka badan 50 sano ka hor. Ugu horreyntii, dhakhaatiir yaryar ayaa isticmaala minikootikinta halkii ay doorbidaan daawooyinka kale ee antibiyootigyada kuwaas oo loo tixgeliyey inay waxtar badan yihiin (vancomycin waxay qaadataa waqti dheer si ay uga dhaqmaan penicillins) iyo sunta yar.
Si kastaba ha noqotee, bilowgii hore 1980s, takhaatiirta iyo xirfadlayaasha kale ee daryeelka caafimaadka ayaa bilaabay inay muujiyaan xiisaha soo noqoshada daroogada. Xiisadan dib loo cusbooneysiiyay waxay ahayd sababtoo ah awoodda fayoobka ah ee loo yaqaan 'vancomycin' si ay ula dagaallanto methicillin-resistant Staphylococcus aureus (MRSA) iyo awoodda lagu daweeyo cudurrada pseudomembranous colitis. Colse Pseudomembranous waa infakshan fara badan oo ka mid ah xiidmaha (shubanka) kaas oo qabta daaweyn ka dib daaweyn kale oo antibiyootiko ah oo dila ubaxa mindhicirka caadiga ah.
Hannaanka waxqabadka ee Vancomycin
Vancomycin waa tricyclic glycopeptide. Waxay ku xidhan tahay bakteeriyada unugyada unugyada waxayna bedelaysaa xargaha xuubka unugyada. Waxa kale oo ay faragelisaa jeermisyada RNA-synthesis.
Markaad la dagaalamayso sida ugu badan ee loo yaqaan 'staphylococci' iyo 'streptococci', tallaabooyinka vikrosikinta waa bakteerid. Si kale haddii loo dhigo, vancomycin wuxuu u shaqeeyaa inuu si toos ah u dilo bakteeriyada naxaasta leh. Si kastaba ha noqotee, markaad la dagaalanto enterococci, nooca kale ee firfircoonida naxwaha leh, ficillada vancomycin waa bacteriostatic, waxana ay ka shaqeysaa in la joojiyo bakteeriyada.
Caymiska Vancomycin
Vancomycin waxaa loo isticmaalaa in lala dagaallamo noocyada kala duwan ee bakteeriyada bakteeriyada, kuwaas oo intooda badan ay u adkaystaan noocyada kale ee antibiyootigyada ay ka mid yihiin:
- infekshinka staphylococcal ee daran ee dadka xasaasiyad ku leh penicillin
- daawada methicillin-resistant Staphylococcus aureus (MRSA)
- daawada methicillin-resistant Staphylococcus epidermidis
- Streptococcus pneumoniae ee daawada u adkeysata
- infekshinka infakshanka ku dhaca dadka waaweyn ee xasaasiyadda ku leh penicillin
- infakshannada infakshanka ku dhaca ee infakshanka keena ee adkaynaya penicillin
- Viridans streptococci
- jeermiska cudurada badan ee daroogada ee Corynebacterium jeikeium
- Clostridium difficile
Cudurku waxaa lagu daaweeyaa vikniko
Vancomycin waxaa loo isticmaalaa in lagu daaweeyo noocyo kala duwan oo cudur qaadis ah oo ay ka mid yihiin:
- caabuqyada neef-mareenka;
- lafaha, maqaarka iyo infekshannada jilicsan;
- peritonitis;
- endokarditis (caabuqa wadnaha);
- enterocolitis iyo colse pseudomembranous (cudurada mindhicirka);
- kiniiniga ka hortagga uur-jiifka marka la isticmaalo ilkaha, biliary, GI, caabuqyada neef-mareenka iyo jeermiska-jimicsiga;
- maqaarka maskaxda (isticmaalka off-label);
- Infakshannada perioperative (isticmaalka off-label);
- qoorgooyaha (isticmaalka off-label).
Maamulka Vancomycin iyo qiyaasta
Sababtoo ah vancomycin ayaa si liidata u soo noqnoqda mareenka caloosha iyo mindhicirka, waxaa badanaa la qaataa sida duritaanka. Si kastaba ha noqotee, marka loo isticmaalo in lagu daaweeyo enterocolitis iyo colse pseudomembranous, labadaba infekshanka mindhicirka, bukaanku waxay qaataan faleebo afka ah.
Vancomycin waxaa badanaa lagu maamulaa goobaha bukaan jiifka (isbitaalka). Sababtoo ah qiyaasta daaweyntu waa mid adag waxayna ku xiran tahay xajmiga ugu sarreeya iyo xarriiqyada, farmashiyaha bukaan-jiifka waxaa badanaa loogu yeeraa in lagu xisaabiyo qiyaasta.
Intaa waxaa dheer, sababtoo ah vancomycin ayaa ka soo baxa kelyaha, daaweynta daroogada ayaa aad ugu adag dadka qaba xanuunka kelyaha.
Waxyeellada xun ee wabiga ee Vancomycin
Dhibaatooyinka xun ee waxyeelada leh ee loo yaqaan 'vancomycin' waa dhif iyo naadir, sida ugu badan ee foosha 'vancomycin' waxyeellada ugu badani waa mid xad-dhaaf ah ama dareen-celin xasaasiyadeed. Hase yeeshee, vancomycin waxay noqon kartaa nephrotoxic waxayna dhaawici kartaa kelyaha gaar ahaan marka la qaado aminoglycosides, nooc kale oo ah antibiyootiko. Intaa waxaa dheer, marka la maamulo aminoglycosides ama xad-dhaaf ah erythromycin intravenous, sidoo kale nooc kale oo antibiyootiko ah, vancomycin wuxuu dhaawici karaa maqalka (ototoxicity).
Ugu dambeyntii, vancomycin wuxuu sababi karaa hyperemia ama casaan-cirridka, oo ah nooca neefta; Daadinta noocan oo kale ah waa la yareyn karaa haddii bukaanku ugu horeyn la siiyo daawada antihistamines.
Diidmada Vancomycin waxay ka dhalataa walaac sii kordhaya oo ka dhexjira rugaha caafimaadka, cilmi baarayaasha iyo daaweeyayaasha epidemiyaba. Sababtoo ah vancomycin waa mid ka mid ah khadadka ugu dambeeya ee difaaca ee ka hortagga cudurada halista ah ee daroogada u leh, rajada ah in aysan sii shaqeyn doonin si looga hortago infakshanka waa mid aan caqli gal ahayn oo naga tago fursado kale oo aan ku fakarno (ka fikir Zosyn iyo ceftaroline). Gaar ahaan, suxufiyeyaasha vanticisin-resistococci resistant ayaa ku duugay cusbitaalada adduunka oo dhan. Maadaama ay badanaa laga helayo baaskiil-wadeyaasha, xarumaha kalkaalinta xanaanada (SKFs), guryaha waayeelka iyo wixii la mid ah, waa lagama maarmaan in xirfadlayaasha daryeelka caafimaadku ay qaadaan tallaabooyin ay ku xakameynayaan caabbinta foosha xumaha sida xakameynta daawada dheeraadka ah iyo xaddididda faafidda kahortaga jiritaanka vancomycin ee bukaanka iyada oo loo marayo bukaanka saxda ah go'doominta iyo ficillada nadaafadda.
Ilaha la Xushay
Guglielmo B. Qalabka anti-Infektive Chemotherapeutic & Antibiyootiko. In: Papadakis MA, McPhee SJ, Rabow MW. eds. Cilmi-baarista Caafimaadka & Daaweynta ee 2015 . New York, NY: McGraw-Hill; 2014. Helitaanka Abriil 07, 2015.
Khabiirka Mukhaadaraadka ee Mosby ee Xirfadaha Caafimaadka, daabacaadda Labaad waxaa daabacay Mosby / Elsevier 2010.