Kodi ndiyenera kumwa maantibayotiki a chimfine ndi chimfine?

Katswiri aliyense womaliza maphunziro a zachipatala amadziwa bwino kuti maantibayotiki a chimfine ndi chimfine alibe tanthauzo. Madokotala ndi madotolo akumaloko omwe amagwira ntchito m'zipatala akudziwa izi. Komabe, maantibayotiki amalembedwa, ndipo nthawi zambiri amachita ngati njira yodzitetezera. Ndiiko komwe, wodwala amene wapita kwa dokotala amayembekezera chithandizo kuchokera kwa iye.

Ngati mutafunsa dokotala ngati kumwa mankhwala a chimfine ndi chimfine, yankho lidzakhala loipa kwambiri. Mankhwala onse a ARVI amatsikira kokha kumwa madzi ochuluka, kupumula kwa bedi, kumwa mavitamini, zakudya zabwino, kuyeretsa mphuno, kugwedeza, kutulutsa mpweya ndi mankhwala ochiritsira. Mankhwala oletsa mabakiteriya safunikira, koma nthawi zambiri wodwalayo amaumirira, akufunsa dokotala nthawi yomweyo.

Muzochita za ana, mankhwala oletsa antibacterial nthawi zambiri amaperekedwa kuti apeze reinsurance, kuti vuto la bakiteriya lisachitike motsutsana ndi maziko a matenda a virus. Choncho, dokotala amalimbikitsa mankhwala othandiza kwa makolo, kuwatcha "antibiotic" ya ana, kuti adziteteze ku mafunso osafunika. Komabe, mavuto angapewedwe mwa kungopatsa mwanayo madzi akumwa panthaŵi yake, kunyowetsa mpweya umene amapuma, kutsuka mphuno zake ndi kugwiritsa ntchito mankhwala ena osonyeza zizindikiro. Thupi, ndi chithandizo chokwanira chotero, lidzatha kuthana ndi matendawa palokha.

Funso ndilachilengedwe chifukwa chake dokotala wa ana amalemberabe mankhwala a antibacterial a fuluwenza ndi SARS. Chowonadi ndi chakuti chiwopsezo cha zovuta za chimfine ndi chimfine m'masukulu am'mbuyomu ndizokwera kwambiri. Chitetezo chawo cha chitetezo cha mthupi chimakhala chopanda ungwiro, ndipo thanzi lawo nthawi zambiri limasokonezedwa ndi kusowa kwa zakudya m'thupi, kusakhala bwino kwa chilengedwe, etc. Choncho, ngati vuto likukula, dokotala yekha ndi amene ali ndi mlandu. Ndi iye amene adzaimbidwa mlandu wolephera, ngakhale kuimbidwa mlandu ndi kutaya ntchito sikuchotsedwa. Izi ndizomwe zimapangitsa madokotala ambiri a ana kuti alimbikitse maantibayotiki panthawi yomwe atha kuperekedwa.

Chizindikiro cha kukhazikitsidwa kwa maantibayotiki ndikuwonjezera matenda a bakiteriya, omwe ndi vuto la chimfine ndi chimfine. Izi zimachitika pamene thupi silingathe kulimbana ndi kachilomboka palokha.

Kaya ndikotheka kumvetsetsa pakuwunikiridwa, ndi maantibayotiki ati omwe amafunikira?

N'zoona kuti n'zotheka kumvetsetsa kuchokera ku kufufuza kuti chithandizo cha antibacterial chikufunika.

Komabe, sizimachitidwa muzochitika zonse:

• Kusonkhanitsa mkodzo kapena sputum kwa chikhalidwe ndi mayeso okwera mtengo, omwe ma polyclinics amafuna kusunga bajeti yomwe ilipo;

• Nthawi zambiri, kupaka kumatengedwa kuchokera m'mphuno ndi pharynx ndi zilonda zapakhosi. Swab imatengedwa pa ndodo ya Lefler, yomwe imayambitsa kukula kwa diphtheria. Komanso, madokotala amatha kutumiza wodwalayo kuti atenge swab kuchokera ku tonsils kuti adziwe chikhalidwe cha bakiteriya ngati wodwalayo akuvutika ndi zilonda zam'mimba. Kusanthula kwina wamba ndi kusankha mkodzo chikhalidwe kwa pathologies a kwamikodzo dongosolo;

• Kuwonjezeka kwa ESR ndi mlingo wa leukocytes, komanso kusintha kwa leukocyte kumanzere, ndi chizindikiro chosadziwika kuti kutupa kwa bakiteriya kumachitika m'thupi. Mutha kuwona chithunzichi poyezetsa magazi.

Kodi mungamvetsetse bwanji mwakukhala bwino kuti zovuta zachitika?

Nthawi zina mumatha kumvetsetsa kuti vuto la bakiteriya ladzipangira nokha.

Izi zidzawonetsedwa ndi zizindikiro zotsatirazi:

• Chinsinsi chomwe chimasiyanitsidwa ndi ziwalo za ENT kapena kuchokera m'maso chimakhala chamtambo, chimakhala chachikasu kapena chobiriwira. Nthawi zambiri, kutulutsa kuyenera kukhala kowonekera;

• Choyamba pali kusintha, ndiyeno kutentha kumakweranso. Kudumpha kwachiwiri mu kutentha kwa thupi sikuyenera kunyalanyazidwa;

• Ngati mabakiteriya akuukira dongosolo la mkodzo, ndiye kuti mkodzo umakhala wamtambo, sediment ingapezeke mmenemo;

• Ngati matenda a bakiteriya akhudza matumbo, ndiye kuti ntchofu kapena mafinya adzakhalapo mu chopondapo. Nthawi zina ngakhale zonyansa zamagazi zimapezeka, malingana ndi kuopsa kwa matendawa.

Ponena za matenda obwera chifukwa cha kupuma kwa ma virus, kuwonjezera kwa zomera za bakiteriya kumatha kuganiziridwa ndi zizindikiro zotsatirazi:

• Potsutsana ndi chimfine chomwe chinapezeka kale, kutentha kwa thupi kunali kowonjezereka, komwe kunayamba kuchepa pa tsiku la 3-4, koma kenako kunalumphanso kumtunda wapamwamba. Nthawi zambiri izi zimachitika pa tsiku la 5-6 la matenda, ndipo thanzi labwino limayambanso kuwonongeka kwambiri. Chifuwa chimakhala champhamvu, kupuma movutikira kumachitika, kupweteka pachifuwa kumawonekera. Nthawi zambiri, vutoli limasonyeza kukula kwa chibayo. Onaninso: zizindikiro za chibayo;

• Diphtheria ndi tonsillitis ndizovuta za SARS. Mukhoza kukayikira awo isanayambike ndi zilonda zapakhosi, zomwe zimachitika motsutsana maziko a kuchuluka kutentha thupi, wosanjikiza zolengeza mitundu pa tonsils. Nthawi zina pamakhala kusintha kwa ma lymph nodes - amawonjezeka kukula ndikukhala zowawa;

• Kutuluka kwa khutu ndi maonekedwe a ululu umene umawonjezeka pamene tragus mbamuikha zizindikiro za otitis TV, amene nthawi zambiri akukula ana aang'ono;

• Ngati ululu umapezeka pamphumi, m'dera la nkhope, mawu amakhala m'mphuno ndi rhinitis, ndiye kuti sinusitis kapena sinusitis iyenera kuchotsedwa. Chizindikiro chotero monga kuwonjezeka kwa ululu pamene mutu umapendekera kutsogolo ndi kutaya fungo kungatsimikizire kukayikira.

Ngati vuto la bakiteriya likukayikira, ndizotheka chifukwa cha zizindikiro za matendawa ndi kuwonongeka kwa ubwino, ndiye kuti katswiri yekha angasankhe antibacterial wothandizira.

Izi zimakhudzidwa ndi zinthu zambiri, kuphatikizapo:

• Localization kutupa;

• Zaka za wodwalayo;

• Mbiri yachipatala;

• Kusalolera kwamunthu pamankhwala enaake;

• Kukana kwa tizilombo toyambitsa matenda ku mankhwala ophera tizilombo toyambitsa matenda.

Pamene maantibayotiki si anasonyeza chimfine kapena wosavuta SARS?

• Rhinitis ndi purulent-mucous kumaliseche, kumatenga zosakwana 2 milungu;

• Viral conjunctivitis;

• Tonsillitis wa ma virus chiyambi;

• Rhinopharyngitis;

• Tracheitis ndi bronchitis wofatsa popanda kutentha kwa thupi;

• Kukula kwa matenda a herpetic;

• Kutupa kwa kholingo.

Ndi liti pamene kuli kotheka kugwiritsa ntchito maantibayotiki pa matenda ovuta kupuma?

• Ngati pali zosokoneza pakugwira ntchito kwa chitetezo chamthupi, monga momwe zimasonyezedwera ndi zizindikiro zenizeni. Izi ndi zinthu monga HIV, khansa, nthawi zonse okwera thupi kutentha (subfebrile kutentha), tizilombo matenda amene amapezeka kuposa kasanu pachaka, kobadwa nako matenda mu chitetezo cha m'thupi.

• Matenda a hematopoietic system: aplastic anemia, agranulocytosis.

• Ngati tikukamba za mwana mpaka miyezi isanu ndi umodzi, ndiye kuti akulimbikitsidwa kumwa maantibayotiki motsutsana ndi maziko a rickets, osakwanira kulemera kwa thupi ndi zolakwika zosiyanasiyana.

Zizindikiro poika maantibayotiki

Zizindikiro za kukhazikitsidwa kwa ma antibiotic ndi:

• Angina, chikhalidwe cha bakiteriya chomwe chatsimikiziridwa ndi mayesero a labotale. Nthawi zambiri, chithandizo chimachitika pogwiritsa ntchito mankhwala a gulu la macrolides kapena penicillin. Onaninso: maantibayotiki a angina kwa munthu wamkulu;

• Bronchitis pachimake siteji, laryngotracheitis, muyambirenso matenda chifuwa, bronchiectasis amafuna kumwa mankhwala ku gulu macrolide Mwachitsanzo, Macropen. Pofuna kupewa chibayo, x-ray pachifuwa amafunika kutsimikizira chibayo;

• Kutenga mankhwala oletsa mabakiteriya, kuyendera dokotala wa opaleshoni ndi hematologist kumafuna matenda monga purulent lymphadenitis;

• Kukambirana kwa otolaryngologist pankhani yosankha mankhwala kuchokera ku gulu la cephalosporins kapena macrolides kudzakhala kofunikira kwa odwala omwe ali ndi vuto la otitis media pachimake. Dokotala wa ENT amachitiranso matenda monga sinusitis, ethmoiditis, sinusitis, zomwe zimafuna kuikidwa kwa antibiotic yokwanira. N'zotheka kutsimikizira kusokonezeka koteroko mwa kufufuza kwa X-ray;

• Kuchiza ndi penicillin kumasonyezedwa kwa chibayo. Panthawi imodzimodziyo, kulamulira kokhazikika kwa chithandizo ndi kutsimikizira kwa matendawa ndi chithandizo cha X-ray fano ndikoyenera.

Chosonyeza kwambiri ponena za kusakwanira kwa mankhwala a antibacterial wothandizira ndi phunziro lomwe linachitidwa mu imodzi mwa zipatala za ana. Choncho, kusanthula zachipatala mbiri 420 ana a m'badwo wa pulayimale m'badwo wa pulayimale anasonyeza kuti 89% a iwo anali ndi ARVI kapena pachimake kupuma matenda, 16% anali pachimake chifuwa, 3% otitis TV, 1% chibayo ndi matenda ena. Panthawi imodzimodziyo, mankhwala opha maantibayotiki amaperekedwa mu 80% ya milandu ya matenda opatsirana ndi mavairasi, ndi bronchitis ndi chibayo mu 100% ya milandu.

Madokotala a ana apezeka kuti akudziwa kuti matenda a virus sangachiritsidwe ndi maantibayotiki, komabe amapereka maantibayotiki pazifukwa monga:

• Kalozera woyika;

• Ana ochepera zaka 3;

• Kufunika kopewa zovuta;

• Kupanda chikhumbo choyendera ana kunyumba.

Panthawi imodzimodziyo, maantibayotiki akulimbikitsidwa kuti amwedwe kwa masiku 5 komanso ang'onoang'ono, ndipo izi ndizowopsa pakukula kwa mabakiteriya kukana. Kuonjezera apo, palibe zotsatira zoyesa, kotero sizidziwika kuti ndi tizilombo ting'onoting'ono timene timayambitsa matendawa.

Pakadali pano, mu 90% ya milandu, ma virus ndi omwe adayambitsa malaise. Ponena za matenda a bakiteriya, nthawi zambiri amakwiya ndi pneumococci (40%), Haemophilus influenzae (15%), staphylococci ndi mycotic zamoyo (10%). Tizilombo tating'onoting'ono monga mycoplasmas ndi chlamydia sizinathandize kuti matendawa ayambe.

Mutha kumwa mankhwala aliwonse oletsa mabakiteriya pokhapokha mutakambirana ndi dokotala. Ndi dokotala yekha amene angadziwe bwino kuyenera kwa kusankhidwa kwawo atatenga anamnesis, poganizira zaka za wodwalayo komanso kuopsa kwa matendawa.

Mutha kugwiritsa ntchito ma antibacterial agents awa:

• Kukonzekera kwa mndandanda wa penicillin. Semisynthetic penicillin tikulimbikitsidwa pakalibe ziwengo kwa iwo. Itha kutsuka Amoxicillin ndi Flemoxin Solutab. Ngati matendawa ndi aakulu, ndiye kuti akatswiri amalangiza kutenga penicillin otetezedwa, mwachitsanzo, Amoxiclav, Augmentin, Flemoclav, Ecoclave. Pokonzekera izi, amoxicillin amawonjezeredwa ndi clavulanic acid;

• mankhwala a macrolide amagwiritsidwa ntchito pochiza chibayo ndi matenda opuma omwe amayamba chifukwa cha chlamydia ndi mycoplasmas. Izi ndi Azithromycin (Zetamax, Sumamed, Zitrolid, Hemomycin, Azitrox, Zi-factor). Ndi bronchitis, kuyika kwa Macropen ndikotheka;

• Kuchokera ku cephalosporin mankhwala ndizotheka kupereka Cefixime (Lupin, Suprax, Pantsef, Ixim), Cefuroxime (Zinnat, Aksetin, Zinacef), etc.;

• Kuchokera mndandanda wa fluoroquinolone mankhwala Levofloxacin (Floracid, Glevo, Hailefloks, Tavanik, Flexid) ndi Moxifloxacin (Moksimak, Pleviloks, Aveloks). Ana omwe ali mu gulu ili la mankhwala sanalembedwe konse chifukwa chakuti mafupa awo amapangidwabe. Kuphatikiza apo, fluoroquinolones ndi mankhwala omwe amagwiritsidwa ntchito makamaka pazovuta kwambiri, ndipo amayimira malo osungira omwe mabakiteriya a mwana wamkulu sangakane.

Mfundo zazikuluzikulu

• Kugwiritsira ntchito mankhwala ophera tizilombo toyambitsa matenda a chimfine omwe ali ndi mavairasi sikungopanda phindu, komanso kuvulaza. Amafunika kuchiza matenda a bakiteriya.

• Mankhwala oletsa mabakiteriya ali ndi mndandanda wa zotsatira zoyipa: amatha kusokoneza magwiridwe antchito a chiwindi ndi impso, angayambitse kukula kwa ziwengo, amafooketsa chitetezo chamthupi, ndikusokoneza microflora yachibadwa m'thupi.

• Pazifukwa za prophylactic, kugwiritsa ntchito mankhwala oletsa antibacterial sikuvomerezeka. Ndikofunika kuwunika momwe wodwalayo alili ndikumupatsa maantibayotiki pokhapokha ngati vuto la antibacterial likuchitika.

• Mankhwala oletsa mabakiteriya sagwira ntchito ngati kutentha kwa thupi sikuchepa pakadutsa masiku atatu kuyambira chiyambi chake. Pankhaniyi, chidacho chiyenera kusinthidwa.

• Nthawi zambiri munthu akamamwa maantibayotiki, mabakiteriyawo amayamba kukana maantibayotiki mwachangu. Pambuyo pake, izi zidzafuna kukhazikitsidwa kwa mankhwala owopsa kwambiri omwe amawononga osati pamagulu a tizilombo toyambitsa matenda, komanso pathupi la wodwalayo.