Clarithromycin yog ib qho khoom siv los ntawm erythromycin tshuaj. Nws tau ua tiav tsim los ntawm Taisho Corporation ntawm Nyij Pooj thaum ntxov xyoo 1990 thiab sau npe hauv lub npe lag luam Clarith. Tom qab ntawd, Taisho thawj zaug hloov nws lub tshuab rau Abbott ntawm Tebchaws Meskas rau kev tsim khoom. Nws tau teev tseg hauv tebchaws Ireland thiab Ltalis xyoo 1990. Thaum Lub Kaum Hli 1991, nws tau pom zoo los ntawm FDA ua tshuaj tshiab rau IB qeb. Hom tshuaj npe yog Biaxin. Xyoo 1993, nws tau teev tseg hauv Hong Kong, Suav teb raws li Klacid.
Lub npe khoom lag luam nyob hauv Europe thiab Asia yog Klaxian. Nws tau teev nyob hauv ntau lub tebchaws, thiab kev faib khoom lag luam tau nce zuj zus, thiab nws tau ua lub luag haujlwm tseem ceeb hauv kev kho mob. Clarithromycin muaj cov yam ntxwv ntawm kev ua haujlwm siab, yooj yim nqus los ntawm kev tswj hwm qhov ncauj, thiab ruaj khov acid zoo. Cov tshuaj muaj zog ua haujlwm tiv thaiv kab mob gram-positive, ruaj khov rau cov enzymes, thiab muaj qhov siab hauv cov ntshav thiab cov leeg nqaij. Nws tau tshuaj pom zoo hauv tsev kho mob tias kev ua haujlwm hauv vivo yog 6-10 npaug li ntawm erythromycin tshuaj thiab 14-35 npaug ntawm josamycin.
Nws yog tus yam ntxwv los ntawm kev txhim kho kev noj qab haus huv zoo, kev faib tawm zoo hauv cov ntaub so ntswg thiab cov hlwb, ntev ib nrab ntawm lub neej, thiab nws cov txiaj ntsig tsis zoo tsuas yog 3%. Nws yog siv rau kev kho mob ntawm txoj hlab ntsws sab saud thiab qis thiab daim tawv nqaij thiab cov nqaij mos. Nws tau dhau los ua kev hloov pauv rau erythromycin ntawm macrolide hmoov tshuaj tua kab mob. Ib qho ntxiv, Asmeskas FDA tau pom zoo ua ke ntawm clarithromycin thiab poob raws li txoj kev kho mob rau lub plab thiab duodenal ulcers los ntawm Helicobacter pylori; cov tshuaj no tseem yog thawj qhov kev xaiv rau kev kho mob ntawm cov neeg mob AIDS.
Clarithromycin yog 14-membered ring macrolide tshuaj tua kab mob. Cov kab mob tua kab mob zoo ib yam li erythromycin thiab roxithromycin, tab sis cov tshuaj tua kab mob rau cov kab mob Gram-positive xws li Streptococcus, pneumococcus, thiab staphylococcus zoo dua me ntsis, thiab nws tseem muaj qee yam cuam tshuam rau cov kab mob erythromycin-resistant.
Clarithromycin thiab nws cov metabolites hauv lub cev tau txhim kho cov kab mob tiv thaiv kab mob khaub thuas bacilli. Clarithromycin kuj tseem muaj qee qhov cuam tshuam rau Neisseria gonorrhoeae, Listeria, Campylobacter jejuni, thiab muaj cov txiaj ntsig muaj zog ntawm Legionella pneumoniae, Mycoplasma pneumoniae, Chlamydia trachomatis, Ureaplasma urealyticum, thiab lwm yam tshaj li erythromycin.
Ib qho ntxiv, nws muaj qee yam haujlwm tiv thaiv Treponema pallidum, Mycobacterium avium thiab Toxoplasma murine, thiab lawv feem ntau zoo dua lwm hom. Ntxiv rau qhov muaj cov tshuaj tua kab mob muaj zog ntawm anaerobic cocci, cov txiaj ntsig ntawm Bacteroides fragilis zoo dua li ntawm erythromycin. Cov nyhuv ntawm Clarithromycin ntawm Staphylococcus aureus, Streptococcus pyogenes, Influenza bacillus thiab lwm yam tshuaj tua kab mob muaj zog dua li erythromycin.
Cov tshuaj no yog cov tshuaj tua kab mob macrolide, thiab nws cov txheej txheem yog txhawm rau txhawm rau ua kom muaj protein ntau los ntawm kev thaiv qhov kev sib txuas ntawm 50S subunit ntawm nucleoprotein los tsim cov tshuaj tua kab mob. Cov tshuaj no muaj qhov cuam tshuam rau cov kab mob Gram-positive xws li Staphylococcus aureus, Streptococcus, pneumococcus, thiab lwm yam, thiab tiv thaiv qee cov kab mob Gram tsis zoo xws li Haemophilus influenzae, Bacillus pertussis, Gonorrhoeae, Legionella pneumophila thiab qee cov kab mob Anaerobic xws li Bacteroides fragilis , Peptostreptococcus, thiab Propionibacterium acnes.
Ib qho ntxiv, nws kuj muaj qhov cuam tshuam rau ntawm mycoplasma. Cov yam ntxwv ntawm cov tshuaj no yog nws cov tshuaj tua kab mob zoo ib yam li erythromycin hauv vitro, tab sis nws cov tshuaj tua kab mob tiv thaiv qee yam kab mob xws li Staphylococcus aureus, Streptococcus, Haemophilus influenzae thiab lwm yam muaj zog dua li ntawm erythromycin. Muaj kev tiv thaiv khaub thuas nrog erythromycin.
Vim tias cov kab mob tua kab mob ntawm clarithromycin zoo ib yam li erythromycin, ob qho tuaj yeem siv sib pauv tau hauv qee txoj hauv kev. Tab sis sib txawv los ntawm erythromycin, clarithromycin muaj qhov ua tau zoo dua ntawm Streptococcus, Legionella, thiab Chlamydia trachomatis tshaj li erythromycin, tshwj xeeb tshaj yog Helicobacter pylori, uas tsuas yog siv los tshem tawm nws. Clarithromycin kuj txawv ntawm erythromycin. Nws tuaj yeem noj qhov ncauj ncaj qha. Tom qab noj nws, qhov tsis txaus ntseeg tuaj yeem ncav cuag li tsib caug. Tom qab noj nws, qhov concentration ntawm txhua lub cev kuj txawv. Feem ntau hais lus, cov concentration hauv cov tonsils siab dua li cov ntshav hauv cov ntshav.
Feem ntau, clarithromycin tuaj yeem kho thiab tshem tawm cov kab mob sib kis tau yooj yim ntawm pob ntseg, qhov ntswg, caj pas, qis ua pa, tawv nqaij thiab cov nqaij mos. Piv txwv li, yog tias muaj mob otitis media, lossis mob urethritis, thiab lwm yam, cov tshuaj no tuaj yeem siv tau.
Nws feem ntau yog siv rau kev ua pa sab saud thiab qis los ntawm cov kab mob rhiab, suav nrog tonsillitis, pharyngitis, sinusitis, bronchitis, mob ntsws, thiab lwm yam, tawv nqaij thiab cov nqaij mos kis mob, purulent furuncle, erysipelas, folliculitis, mob qhov txhab, thiab lwm yam. yog piv rau lwm yam cov macrolides. Clarithromycin kuj tseem tuaj yeem siv rau kev kis kab mob ntawm cov kab mob genitourinary los ntawm Chlamydia trachomatis lossis Ureaplasma urealyticum, thiab atypical mycobacterial infections hauv cov neeg mob AIDS.
Cov tshuaj tua kab mob zoo ib yam li erythromycin tshuaj. Nws ruaj khov rau cov kua qaub hauv lub plab thiab muaj qhov ua kom muaj zog ntawm cov kab mob Gram-positive. Nws muaj cov tshuaj tua kab mob tiv thaiv kab mob Gram-negative, Streptococcus, Mycoplasma thiab Chlamydia. Nws muaj txiaj ntsig zoo tiv thaiv Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, Moraxella catarrhalis, Haemophilus influenzae thiab Mycoplasma pneumoniae. Clinically, nws feem ntau yog siv rau mob ntsws, mob ntsws, pharyngitis, tonsillitis, mycoplasma pneumonia, tawv nqaij thiab cov nqaij mos kis, otitis media, periodontitis, hnoos qeev, ua npaws liab.
Clarithromycin yog tshuaj tua kab mob biochemical, uas ua lub luag haujlwm tiv thaiv kev kis kab mob microbial thiab tshuaj tiv thaiv kab mob hauv cov nqaij mos. Ib qho ntxiv, clarithromycin yog 14-membered ring macrolide tshuaj tua kab mob hauv kev kho. Cov kab mob tua kab mob zoo ib yam li erythromycin thiab roxithromycin tshuaj, tab sis cov kab mob tua kab mob ntawm cov kab mob Gram-positive xws li Streptococcus, pneumococcus, thiab staphylococcus zoo dua me ntsis, thiab nws kuj tseem muaj qee yam cuam tshuam rau qhov ua rau erythromycin tiv taus kab mob ua haujlwm tua kab mob.
Clarithromycin thiab nws cov metabolites hauv lub cev tau txhim kho cov kab mob tiv thaiv kab mob khaub thuas bacilli. Clarithromycin kuj muaj qee qhov cuam tshuam rau Neisseria gonorrhoeae, Listeria, Campylobacter jejuni, thiab Legionella pneumophila, Mycoplasma pneumoniae, Chlamydia trachomatis, Ureaplasma urealyticum, thiab lwm yam.
Cov neeg laus noj 250 mg txhua 12h, thiab koob tshuaj rau cov neeg mob hnyav tuaj yeem nce ntxiv rau 500 mg txhua 12h; chav kawm ntawm kev kho mob yog nyob ntawm qib kev kis mob, feem ntau 7 txog 14 hnub. Yog tias qhov kev tshem tawm creatinine tsawg dua 0.501ml/1.73 square metres, koob tshuaj yog ib nrab.
Cov menyuam yaus koob tshuaj: 7.5 mg/kg txhua lub sijhawm, 2 zaug hauv ib hnub, qhov siab tshaj plaws tsis tshaj 500 mg ib hnub. Mob me: 250 mg txhua lub sijhawm, 500 mg txhua lub sijhawm rau mob hnyav, ib zaug txhua 12 teev, thiab kev kho yog 7-14 hnub. Cov menyuam hnub nyoog tshaj 12 xyoos raug suav ua cov neeg laus. Cov menyuam yaus hnub nyoog qis dua 12 xyoos yuav tsum tsis txhob siv cov tshuaj no.
Tsuas yog tias nws tshem tawm qhov mob, clarithromycin kuj tseem muaj nws tus kheej cov kev mob tshwm sim. Cov uas ib txwm muaj yog raws plab, xeev siab, hloov pauv saj, tsis hnov tsw, mob plab, thiab lwm yam. leukopenia, nce alkaline phosphatase, thiab nce bilirubin ntau zaus thaum noj tshuaj; Qee zaum pseudomembranous enteritis thiab Pancreatitis tuaj yeem pom; qee qhov xwm txheej, clarithromycin kuj tseem tuaj yeem ua rau lub plawv tsis ua haujlwm thiab QT ncua sijhawm.
Cov neeg uas ua xua rau cov macrolides, poj niam cev xeeb tub, poj niam pub niam mis, cov neeg muaj lub siab thiab lub raum tsis ua haujlwm, lub plawv dhia tsis zoo, bradycardia, QT ncua ntev, hlau tsis muaj kab mob hauv lub plawv, mob plawv tsis ua haujlwm thiab dej thiab cov dej tsis zoo yuav tsum siv nws nrog ceev faj. Cov khoom lag luam feem ntau yog metabolized thiab tso tawm hauv lub siab, yog li cov neeg mob lub siab tsis txaus, lub raum tsis txaus, thiab cov neeg laus hnub nyoog tshaj 65 xyoos yuav tsum tau ua tib zoo saib xyuas tshwj xeeb rau cov kev phiv thaum siv cov tshuaj.
Txoj hnyuv ua haujlwm tsis zoo thiab cov tsos mob tshwm sim tuaj yeem tshwm sim los ntawm kev noj ntau dhau, thiab lub plab lavage thiab kev kho mob tuaj yeem muab tau. Tsis yog hemodialysis los yog peritoneal dialysis tsis tuaj yeem tshem tawm cov khoom lag luam, yog li kev ntxuav lub plab yuav tsum tau ua sai li sai tau, thiab yuav tsum tau kho qhov sib xws. Nws tau txwv tsis pub poj niam cev xeeb tub (qhov siab ntawm Clarithromycin hauv cov tsiaj me yog 2-17 npaug ntawm tib neeg cov ntshav). Cov poj niam pub niam mis yuav tsum siv nws nrog ceev faj (pub niam mis yuav tsum raug ncua).
Clarithromycin yog derivative ntawm erythromycin tshuaj. Nws muaj txiaj ntsig zoo, yooj yim nqus tau ntawm qhov ncauj, thiab muaj cov kua qaub zoo. Feem ntau, clarithromycin tuaj yeem hloov pauv erythromycin. Tab sis cov kws kho mob tseem yuav tsum tau them sai sai rau qhov ntau npaum li cas thiab ua ke ntawm clarithromycin, vim tias yog nws siv tsis raug, nws yuav ua rau tus neeg mob muaj kev phom sij.
BALLYA muab rau clarithromycin-nrawm-kuaj-dipsticks qhia rau koj yog tias muaj clarithromycin cov khoom seem hauv cov dej uas koj noj.
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