Azithromycin yog ib tug macrolide hmoov tshuaj tua kab mob. Nws tau tshawb pom xyoo 1980 thiab tau tsim tawm xyoo 1981. Nws cov npe lag luam yog Tellite, Xishumei, thiab Shumei Te. Azithromycin yog ib nrab hluavtaws 15-membered macrolide tshuaj tua kab mob. Azithromycin tau siv dav, tab sis koj yuav tsum tau them sai sai rau azithromycin ntau npaum li cas, kev siv thiab cov kev mob tshwm sim. BALLYAtuaj yeem ua tau macrolides kuaj qhia rau koj paub yog tias muaj macrolides seem hauv cov mis koj haus hauv 10 feeb.
Nws tsim nyog rau cov kab mob hauv qab no tshwm sim los ntawm cov kab mob rhiab: mob ntsws, mob ntsws thiab lwm yam kab mob hauv lub ntsws ua pa; kab mob ntawm daim tawv nqaij thiab cov nqaij mos; mob otitis media; kab mob ua pa rau sab sauv xws li sinusitis, pharyngitis, tonsillitis, thiab lwm yam (tshuaj penicillin yog ib qho tshuaj nquag siv rau kev kho mob Streptococcus pyogenes pharyngitis, thiab tseem yog cov tshuaj nquag siv los tiv thaiv kub cev. Azithromycin tuaj yeem tshem tawm oropharyngeal streptococci tau zoo, tab sis tsis muaj cov ntaub ntawv qhia txog kev ua tau zoo ntawm azithromycin hauv kev kho thiab tiv thaiv mob rheumatic).
Azithromycin yog siv rau kab mob kis tau yooj yim los ntawm Chlamydia trachomatis hauv kev sib deev kis kab mob ntawm txiv neej thiab poj niam. Azithromycin kuj tseem tuaj yeem siv rau kev kis kab mob yooj yim los ntawm kev tsis muaj tshuaj ntau yam tiv thaiv Neisseria gonorrhoeae thiab chancroid tshwm sim los ntawm Haemophilus duke (xav kom txiav tawm kev sib kis ntawm Treponema pallidum).
Azithromycin yog qhov tsim nyog tau txais kev mob ntsws hauv zej zog los ntawm Chlamydia pneumoniae, Haemophilus influenzae, Legionella pneumophila, Moraxella catarrhalis, Staphylococcus aureus lossis Streptococcus pneumoniae, uas yuav tsum tau txhaj tshuaj tso ntshav ua ntej, thiab mob pelvic inflammatory tshwm sim los ntawm Chlamydia trachomatis, kev tso dej tawm ua ntej ua ntej. Yog tias xav tias muaj kab mob anaerobic, tshuaj tua kab mob tiv thaiv kab mob anaerobic yuav tsum siv ua ke.
Cov khoom no ruaj khov rau cov kua qaub. Txawm hais tias qhov ncauj nqus tau yooj yim tsuas yog 37% thiab qhov siab tshaj plaws ntawm cov ntshav ntshav yog li 0.4μg/ml tom qab txhaj ib zaug ntawm 0.5g hauv 2 txog 3 teev, cov ntaub so ntswg faib tau zoo thiab cov protein sib khi tau qis (7% txog 23%) ), tshem tawm ib nrab-lub neej yog 12 txog 14 teev, thiab qhov ntau ntawm cov prostate, tonsils, cov nqaij hauv ntsws, cov nqaij hauv plab, thiab poj niam cov ntaub so ntswg tau nce mus txog 2.6 μg/g, 4.5 μg/g, 3.6 μg/g, 6.1 μg/ g thiab 2.7 ～ 3.5μg/g feem hauv 12 txog 30 teev tom qab noj tshuaj.
Ntau dua 50% ntawm cov tshuaj raug tso tawm los ntawm cov kua tsib hauv lawv daim ntawv qub, thiab qee qhov yog cov tshuaj metabolite demethylated. Cov tshuaj nyob hauv cov ntaub so ntswg ntev thiab tso tawm qeeb. Tom qab txhaj tshuaj ib zaug 14 hnub, thawj cov tshuaj tseem tuaj yeem kuaj pom hauv cov zis. Cov zis tso zis tsis pub dhau 1 lub lis piam tsawg dua 6%, thiab lub raum tshem tawm tus nqi yog 1.67 ～ 3.156ml/s. Qhov laj thawj yog vim li cas qhov concentration ntawm cov khoom no hauv cov ntaub so ntswg yog qhov siab dua li cov ntshav cov tshuaj feem ntau yog los ntawm kev txav mus los ntawm cov tshuaj los ntawm cov ntaub so ntswg hauv zos mus rau cov cell saum toj no los ntawm neutrophils thiab phagocytes. Neutrophils uas khaws cov tshuaj nyob rau ntawm qhov chaw kis kab mob tau txhawb los ntawm cov kab mob kom tso tshuaj thiab ua cov tshuaj tua kab mob.
Nws tau hais lus ib hnub ib hnub, nqos tag nrho, thiab tuaj yeem noj nrog zaub mov. Azithromycin ntsiav tshuaj tau siv los kho ntau yam kab mob sib kis. Hoob kho thiab txoj kev siv yog raws li hauv qab no: Rau kev sib deev kis kab mob tshwm sim los ntawm Tus mob chlamydia trachomatis, Haemophilus duke lossis Neisseria gonorrhoeae, tsuas yog siv qhov ncauj ntawm 1000 mg ntawm cov khoom no. Kho lwm yam kab mob: Qhov koob tshuaj tag nrho yog 1500 mg, 500 mg ntawm cov khoom no tau noj ib hnub ib zaug rau peb hnub. Los yog tag nrho cov tshuaj yog tib yam, 500 mg ntawm thawj hnub, 250 mg hais lus ib hnub ib hnub nyob rau hnub thib ob txog rau hnub 2.
Noj cov khoom no yam tsawg 1 teev ua ntej noj mov, lossis 2 teev tom qab noj mov. Cov neeg laus noj 0.3g ib hnub, 1 pluas noj rau 3 hnub; lossis 0.5g rau thawj koob tshuaj, 0.1g txhua hnub rau 5 hnub tom ntej. Cov kab mob sib kis los ntawm kev sib deev tuaj yeem kho nrog ib koob tshuaj 1g. Cov laus tuaj yeem ua tus neeg laus. Rau menyuam yaus hnub nyoog tshaj 6 hli (qis dua 45 kg), koob tshuaj txhua hnub yog 10 mg/kg, thiab qhov ntau npaum li cas thiab kev kho yog tib yam li cov neeg laus. Yog tias noj azithromycin ncua, noj 5ml (200 mg) rau 3 ～ 7 xyoo (15 ～ 25 kg), noj 7.5ml (300 mg) rau 8 ～ 11 xyoos (26 ～ 35 kg), thiab noj 10ml rau 12 ～ 14 xyoos (36 ～ 45 kg).
Tom qab cov npe, lwm yam xwm txheej tsis zoo qhia thaum siv cov khoom no suav nrog:
Cov khoom no tsis muaj kev cuam tshuam nrog theophylline, warfarin, carbamazepine, prednisone methyl, thiab lwm yam. Siv cov khoom no 1h ua ntej lossis 2h tom qab noj tshuaj antacid. Ob teev ua ntej noj cov khoom no, ib koob tshuaj cimetidine tsis cuam tshuam rau cov ntshav siab ntawm cov khoom no. Ib txhia cov macrolides tuaj yeem cuam tshuam cov metabolism hauv digoxin. Yog li ntawd, daim ntawv thov txuas ntxiv ntawm cov khoom no tuaj yeem ua rau kom ntshav siab ntau ntxiv digoxin, yog li yuav tsum tau them nyiaj mloog.
Cov khoom no yuav tsum tsis txhob siv ua ke nrog cov tshuaj ergot, vim nws tuaj yeem ua rau cov tshuaj lom ergot hauv cov neeg mob; ntxiv rau, cov macrolides tau tshaj tawm kom nce digoxin (hloov pauv cov hnyuv hauv lub cev), cyclosporine thiab carmidazine (Txwv tsis pub cov metabolism) ntshav siab, yog li thaum AM thiab cov tshuaj peb tau noj tib lub sijhawm, nws kuj tseem tuaj yeem ua rau cov ntshav siab ntawm cov tshuaj no. Cov ntshav ntshav ntawm qhov kawg yuav tsum tau saib xyuas thaum cov tshuaj no ua ke.
Raws li cov ntaub ntawv hauv tsev, ntawm 19 tus neeg mob uas muaj kev phiv tsis zoo los ntawm qhov ncauj azithromycin, 3 tau nce tus naj npawb ntawm cov tshuaj niaj hnub lawv tus kheej, thiab 5 txuas ntxiv noj tshuaj ntau dua 5 hnub, ua rau muaj kev phiv tshuaj ntau ntxiv vim siv tshuaj tsis xwm yeem. Qhov kev pheej hmoo nce mus txog ntau dua 40%. Qhov tseeb, raws li cov tshuaj ua yeeb yam ntev, azithromycin tsuas yog yuav tsum tau noj ib zaug ib hnub.
Azithromycin yog ib tiam neeg tshiab macrolide tshuaj tua kab mob. Piv nrog erythromycin tshuaj, nws muaj cov tshuaj tiv thaiv kab mob muaj zog, dav dua cov kab mob tua kab mob thiab tsawg dua qhov tsis zoo. Lwm qhov tseem ceeb tshaj plaws yog qhov ntawd azithromycin muaj cov txiaj ntsig zoo tom qab tshuaj tua kab mob, uas cuam tshuam nrog nws cov ntshav ntev ib nrab ntawm lub neej.
Cov ntaub ntawv tseem ceeb qhia tias tom qab qhov ncauj los yog txhaj tshuaj ntawm azithromycin, nws cov ntshav ib nrab-lub neej tuaj yeem ntev li 35 txog 48 teev, yog li azithromycin tseem tuaj yeem tswj hwm qhov ua kom muaj zog tsawg tshaj plaws nyob rau hauv 72 teev tom qab siv tshuaj. Cov yam ntxwv no, ntawm ib sab tes, ua rau nws muaj qhov ua haujlwm ntev. Nws tsuas yog yuav tsum tau noj ib zaug ib hnub kom ua tiav cov txiaj ntsig kho tib yam li erythromycin tshuaj noj ntau zaus ib hnub.
Ntawm qhov tod tes, nws tsis tas yuav tsum tau tswj hwm tas li. Thaum ua ntawv thov azithromycin los kho tus mob mycoplasma mob ntsws thiab mob mycoplasma ntawm cov kab mob urogenital, kev kho ua ntu zus feem ntau tau txais, uas yog, cov tshuaj tau siv rau 3 hnub thiab tom qab ntawd nres rau 4 hnub, thiab lub voj voog txuas ntxiv mus. Ua li no, noj tshuaj ib hnub ib hnub thiab noj tshuaj rau lub sijhawm luv luv tuaj yeem ua rau tus neeg mob ua raws li qhov ua tau zoo thiab txo qis qhov tsis zoo.
Txawm li cas los xij, qee tus neeg mob tseem tsis tau paub txog tus yam ntxwv ntawm azithromycin, lossis lawv tau ua raws tus cwj pwm ntawm kev siv tshuaj 3 zaug hauv ib hnub, lossis lawv xav tias tsis nyab xeeb rau kev siv tshuaj ib hnub ib zaug thiab "ua haujlwm 3 thiab siv 4", yog li lawv nce tus naj npawb ntawm cov tshuaj ntawm yuav, noj azithromycin ob peb zaug hauv ib hnub, lossis txiav txim siab txuas ntxiv tshuaj los ntawm lawv tus kheej. Cov txiaj ntsig tsis muaj txiaj ntsig los txhim kho tus mob, tsuas yog ua rau muaj kev phom sij ntau ntxiv.
Yog li ntawd, cov neeg mob yuav tsum nruj me ntsis ua raws li kws kho mob cov lus qhia, coj azithromycin tsuas yog ib zaug ib hnub, thiab tiv thaiv ntau yam tshuaj rau ib hnub thiab siv tshuaj ntev.
Azithromycin muaj cov txiaj ntsig zoo ntawm ntau tus kab mob, tab sis cov kev mob tshwm sim thiab tshuaj tiv thaiv ntawm Azithromycin tau pom tseeb. Peb yuav tsum ua raws tus kws kho mob cov lus qhia kom tswj hwm azithromycin ntau npaum li cas.
References