Amoxicillin clavulanic acid

Clavulanic acid yog ib qho tshuaj tiv thaiv kab mob tua kab mob koom nrog cov pab pawg ntawm semisynthetic penicillins. Cov tshuaj muab cov txiaj ntsig zoo tshaj plaws hauv kev sib xyaw nrog cov tshuaj Amoxicillin, ib qho tshuaj tiv thaiv dav-tshuaj tiv thaiv. Kev sib xyaw ua ke no muaj qhov ua tsis haum rau cov dej num ntawm beta-lactamases thiab siv los kho kab mob ntawm ENT kabmob thiab ua pa, tawv nqaij, urogenital system, pob qij txha thiab pob txha.

Muaj cov tshuaj nyob rau hauv uas amoxicillin, clavulanic acid yog tam sim no. Lawv tau tsim nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, hmoov rau lub chaw tsim khoom ntawm lub qhov ncauj ncua lossis hno tshuaj rau qhov ncauj tswj hwm, hauv daim ntawv ntawm cov kua dej, nrog rau cov tshuaj ua kom haum.

Cov tshuaj "Amoxicillin" thiab clavulanic acid: kev ua thiab thaj chaw

Cov kua qaub nws tus kheej yog cov tshuaj tua kab mob tsis muaj zog, txawm li cas los xij, nws tiv thaiv amoxicillin los ntawm cov kab mob enzymatic degradation, uas tso cai rau cov nyhuv antibacterial ua kom tiav. Cov nyhuv ntawm cov tshuaj txuas ntxiv mus rau ntau tus lej-zoo thiab gram-tsis zoo, anaerobic thiab aerobic pathogens, suav nrog lawv cov kab mob uas tiv taus tshuaj tua kab mob.

Amoxicillin thiab clavulanic acid: kev qhia tau

Cov tshuaj yog siv rau kev kho mob ntawm kev ua pa ntawm lub caj pas, qa, pob ntseg, pob ntseg, uas suav nrog mob ntsws, tonsillitis, otitis media, mob ntsws ntev thiab mob ntsws, mob ntsws, mob khaub thuas, mob ntsws, ntsws ntsws.

Tsis tas li ntawd, cov cuab yeej siv rau kev kis kab mob ntawm cov nqaij mos thiab tawv nqaij (mob qog, rwj, cellulite, mob viav vias, panniculitis, phlegmon). Clavulanic acid yog siv los kho cov kab mob ntawm cov genitourinary huam thiab urogenital huam (suav nrog rau sab hauv), xws li cystitis, pyelonephritis, urethritis, chancre muag, gonorrhea, salpingitis, endometritis, pelvioperitonitis, kab mob vaginitis, salpingo-oophoritis, postpartum sepsis, septic rwj.

Tsis tas li, cov tshuaj siv yog tias muaj kev sib kis ntawm cov pob qij txha thiab pob txha hauv lub cev. Kev tso dej khov yog qhia rau kev tiv thaiv kev kis mob cuam tshuam nrog kev phais mob.

Cov tshuaj "Amoxicillin" thiab clavulanic acid: contraindications

Tsis txhob siv cov tshuaj nrog hypersensitivity rau penicillins thiab lwm yam tshuaj tua kab mob (beta-lactam), kom tshem tawm qhov ua tau ntawm anaphylactic kev poob siab. Contraindicated nyob rau hauv cov neeg mob lymphocytic leukemia thiab mob mononucleosis mob.

Nrog kev ceev faj, kev teem caij yog tsim rau cov neeg mob kev txom nyem los ntawm kub taub hau, ua xua diathesis, urticaria, bronchial hawb pob. Nws raug nquahu kom tsis txhob siv cov tshuaj, zoo li lwm yam tshuaj, thaum cev xeeb tub, txawm hais tias tsis muaj qhov tshwm sim tsis zoo. Hauv kev kho mob ntawm niam mis, kab mob ntawm cov tshuaj tau pom hauv niam mis.

Cov tshuaj "Amoxicillin" thiab clavulanic acid: tus nqi

Vim tias cov ntaub ntawv loj, ntau npaum li cas thiab ntau yam ntawm cov tshuaj, tus nqi tuaj yeem sib txawv.

Pharmacological kev txiav txim

Cov kev sib xyaw tau tsim nyob ib puag ncig xyoo 1977/78. Cov kws tshawb fawb British ua haujlwm ntawm Beecham (tam sim no yog ib feem ntawm GlaxoSmithKline). Tus patent tau tso cai rau xyoo 1984. Augmentin yog lub npe qub thiab yog siv los ntawm nws tus neeg tsim khoom.

Pharmacological kev txiav txim

Nws ua cov kab mob bactericidal, inhibits kev sib txuas ntawm cov kab mob hauv phab ntsa. Amoxicillin ua tau zoo tiv thaiv cov kab mob uas muaj rhiab heev rau nws. Vim tias suav nrog cov beta-lactamase inhibitor (clavulanic acid) hauv cov tshuaj, cov tshuaj kuj tuaj yeem hais txog kev kis kab mob uas tiv taus amoxicillin. Amoxycillin nyob rau hauv ua ke nrog nrog clavulanic acid cuab tam tiv thaiv aerobic gram-zoo kab mob (xws li hom uas khoom beta-lactamase): Staphylococcus aureus, Staphylococcus epidermidis, tus kab mob Streptococcus pyogenes, tus kab mob Streptococcus anthracis, tus kab mob Streptococcus pneumoniae, tus kab mob Streptococcus viridans, Enterococcus faecalis, Corynebacterium spp, Listeria monocytogenes ,. anaerobic gram-cov kab mob zoo: Clostridium spp., Peptococcus spp., Peptostreptococcus spp., kab mob aerobic gram-tsis zoo (suav nrog cov kab mob beta-lactamase uas ua cov noob nqaij): Escherichia coli, Proteus mirabilis, Proteus vulgaris, Klebsiella spp., Salmon. Bordetella pertussis, Yersinia enterocolitica, Gardnerella vaginalis, Neisseria meningitidis, Neisseri a gonoreae, Moraxella catarrhalis, Haemophilus influenzae, Haemophilus ducreyi, Yersinia multocida (yav dhau los Pasteurella), Campylobacter jejuni, kab mob anaerobic gram-tsis zoo (suav nrog rau cov kab mob ua kom muaj cov beta-lactamases): Bacteroides seroilis, suav nrog Bacteroides. Clavulanic acid suppresses hom II, III, IV thiab V hom beta-lactamases, tsis muaj zog tiv thaiv hom I beta-lactamases ua los ntawm Enterobacter spp., Pseudomonas aeruginosa, Serratia spp., Acinetobacter spp.

Clavulanic acid muaj lub siab tropism rau penicillinases, vim tias nws tsim cov chaw ruaj khov nrog cov enzyme, uas tiv thaiv qhov enzymatic degradation ntawm amoxicillin nyob rau hauv kev cuam tshuam ntawm beta-lactamases.

Thaum clavulanic acid ntxiv rau amoxicillin, ntxiv rau qhov nce ntxiv ntawm cov dej num tiv thaiv kab mob ntawm qhov tom kawg, qhov kev nce ntawm cov kab mob sib kis ntawm tib neeg polymorphic nuclear leukocytes tau sau tseg. Cov kev ua ntawm antimicrobial tiv thaiv ntau ntxiv nyob rau hauv kev sib raug zoo nrog cov kab mob ntawm cov kab mob ua thiab tsis tsim cov beta-lactamase. Ua ke nrog amoxicillin, clavulanic acid stimulates chemotaxis thiab kev nplaum ntawm polymorphonuclear leukocytes. Cov kev sib txuam no yuav cuam tshuam rau txoj kev kho mob. Qhov no yog qhov tshwj xeeb tshaj yog cia siab rau kev kho mob ua pa rau kev mob ntsws los ntawm pneumococcus, yog tias peb xav txog polymorphonuclear leukocytes ua ib kab ntawm kev tiv thaiv thawj tus kab mob pneumococcal.

Clavulanic acid ua haujlwm li cas?

Clavulanic acid yog ib feem ntawm ib pawg ntawm cov tshuaj metabolics (enzymes thiab antifermenta). Nws yog ib qho beta-lactamase inhibitor thiab muaj cov nyhuv antimicrobial. Cov txheej txheem ntawm cov khoom zoo li tus qauv ntawm lub pob ntawm lub zog ntawm lub hlwb ntawm penicillin molecule. Txawm li cas los xij, tsis zoo li nws, hloov lub thiazolidine nplhaib, clavulanic acid muaj lub nplhaib oxazolidine.

Tom qab kev tswj hwm ntawm qhov ncauj, clavulanic acid inhibits beta-lactamases, uas ua los ntawm qhov kev txiav txim ntawm gram-tsis zoo thiab qee lwm yam kab mob me. Lub tshuab ntawm kev ua ntawm cov tshuaj muaj raws li hauv qab no: clavulanic acid nkag mus los ntawm daim nyias nyias ntawm cov kab mob hlwb thiab inactivates cov enzymes nyob hauv cov hlwb thiab ntawm lawv cov ciam teb. Cov txheej txheem ntawm inhibiting beta-lactamase feem ntau yog tsis hloov. Yog li ntawd, cov kab mob me me tsis tuaj yeem txhim kho cov tshuaj tiv thaiv uas siv cov tshuaj tua kab mob.

Kev siv cov tshuaj nrog clavulanic acid

Clavulanic acid tau raug txiav txim ib txhij nrog Amoxicillin lossis Ticarcillin rau kev kho mob kis thiab mob los ntawm kev sib xyaw ua ke ntawm cov kab mob me me. Qhov ntau npaum li cas ntawm cov tshuaj yog ib leeg thiab txiav txim los ntawm tus kws kho mob nyob ntawm lub hnub nyoog ntawm tus neeg mob, cim thiab ntau npaum li cas ntawm daim ntawv tshuaj. Clavulanic acid npaj tau siv rau hauv lub cev nrog kev ceev faj rau cov neeg mob uas lub siab tsis ua haujlwm hnyav. Yog tias ua xua lossis xoo pob liab vog tshwm sim, yuav tsum tau noj tshuaj.

Clavulanic acid yog sib kis nyob rau hauv cov ntaub ntawv ntawm ib tug neeg intolerance. Thaum cev xeeb tub, kev siv cov tshuaj no nrog Amoxicillin lossis Ticarcillin raug tso cai tsuas yog rau kev noj qab haus huv. Thaum lub sijhawm lactation, nws tsis pom zoo siv cov tshuaj. Cov kev mob tshwm sim ntawm clavulanic acid muaj xws li: dyspepsia, cholestatic jaundice, kev ua haujlwm ntawm lub siab ua haujlwm, mob siab, pseudomembranous colitis, candidiasis, kev tsis haum (erythema multiforme, Quincke's edema, exfoliative dermatitis, urticaria, anaphylactic shock).

Lub npe lag luam rau cov tshuaj nrog clavulanic acid yog "Potassium Clavulanate + Microcrystalline Cellulose". Cov tshuaj sib xyaw uas muaj clavulanic acid: Amovicomb, Amoxiclav, Amoxiclav Quiktab, Arlet, Augmentin, Bactoclav, Verclave, Clamosar, Liclav, Panclave, Ranklav ”,“ Taromentin ”,“ Flemoklav Solyutab ”,“ Ecoclave ”,“ Timentin ”.

Kev piav qhia ntawm clavulanic acid

Clavulanic acid yog beta-lactamase inhibitor vim nws cov qauv beta-lactam, uas ua rau nws zoo sib xws hauv cov qauv tsim tshuaj tua kab mob.

Cov yam ntxwv no tso cai rau cov khoom sib txuas ua ke nrog penicillin-khi cov protein ntau nyob rau ntawm cov phab ntsa ntawm cov kab mob gram-positive lossis gram-tsis zoo, uas ua rau lawv rhuav tshem.

Cov kua qaub ua haujlwm li cas

Clavulanic acid muaj peev xwm nthuav tawm cov haujlwm qis qis tawm tsam Pseudomonas aeruginosa, enterococci, hauv nruab nrab nrog kev hwm ntawm enterobacteria thiab hemophilus bacillus, thiab muaj zog nrog bacteroids, moraxella, staphylococci thiab streptococci. Qhov beta-lactam compound no cuam tshuam rau gonococci thiab atypical chlamydia thiab legionella cov kab mob hauv chav kawm.

Clavulanic acid-based npaj

Cov tshuaj tua kab mob Beta-lactam ua ke zoo nrog cov tshuaj no, uas tso cai rau koj los tsim cov tshuaj tua kab mob sib xyaw nrog cov npe lag luam sib txawv, piv txwv li, Amoxil-K, Augmentin, Amoxiclav.

Cov tshuaj tseem ceeb yog cov tshuaj "Amoxicillin + clavulanic acid." Muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, hmoov rau qhov kev npaj tawm (nrog nrog kev siv li qub thiab "forte"), hmoov rau kua thiab txhaj tshuaj. Cov tshuaj muaj pes tsawg leeg xws li amoxicillin trihydrate thiab clavulanic acid nyob rau hauv daim ntawv ntawm poov tshuaj ntsev nyob rau hauv ntau yam. Cov tshuaj muaj 500 lossis 250 mg tshuaj tua kab mob thiab ntsev ntawm 125 mg, thaum lub sij hawm tag nrho cov ntsiab lus ntawm cov khoom siv nquag tuaj yeem yog 625 mg, 1 g, 375 mg.

Mechanism ntawm kev ua

Cov tshuaj nquag hu ua Amoxicillin yog tshuaj tua hluavtaws ib nrab nrog cov kev pom tseeb ntawm kev ua kom muaj cov kab mob gram-zoo thiab gram-tsis zoo. Lub chaw pov tseg tuaj yeem rhuav tshem nrog kev koom tes ntawm β-lactamases, yog li ntawd, nws tsis cuam tshuam cov kab mob me me uas tsim cov enzymes no.

Clavulanic acid yog hais txog β-lactam tebchaw uas thaiv qhov ntau ntawm cov enzymes vim yog qhov tsim kev ruaj khov nyob hauv kev ua haujlwm. Qhov kev ua no tiv thaiv qhov kev rhuav tshem ntawm amoxicillin cov tshuaj tua kab mob thiab pab txhawb kom nthuav dav nws cov haujlwm ntawm cov kab mob me me, uas feem ntau tiv taus nws cov cawv.

Cov tshuaj "Amoxicillin + clavulanic acid" tuaj yeem kho cov kab mob ntawm cov kab mob sab sauv thiab qis, daim tawv nqaij thiab cov leeg mob.

Tus neeg sawv cev yog tawm tsam los tua tus kab mob hauv cov genitourinary huam hauv daim ntawv ntawm cystitis, urethritis, pyelonephritis, sepsis, uas tsim kho tom qab rho menyuam lossis yug menyuam, thiab kab mob ntawm lub plab hauv plab. Cov tshuaj yog siv rau osteomyelitis, ntshav lom, ua mob rau peritoneum, kab mob tom qab, tsiaj kis.

Yuav noj tshuaj li cas

Rau txhua tus neeg mob, ib koob tshuaj tau xaiv ib tus zuj zus, rau qhov mob hnyav ntawm tus kabmob, nws qhov chaw nyob thiab qhov mob rhiab ntawm cov kab mob uas raug cuam tshuam los ntawm clavulanic acid tau coj mus rau hauv tus lej. Cov ntsiav tshuaj uas muaj tag nrho cov ntsiab lus ntawm cov tshuaj lom neeg tseem ceeb ntawm 0.375 g rau cov neeg laus thiab menyuam yaus tom qab 12 xyoo, suav txog qhov mob me lossis mob nrab ntawm tus kabmob, raug kho 1 chav 3 zaug nyob rau ib hnub. Yog tias nyob rau hauv ib ntsiav tshuaj tag nrho cov ntsiab lus ntawm cov khoom xyaw nquag yog 1 g, lawv tau noj 1 daim 2 zaug hauv ib hnub.

Cov mob sib kis mob hnyav tau kho nrog ib koob tshuaj 1 ntsiav tshuaj nrog qhov ntau ntxiv ntawm 0.625 g lossis 2 ntsiav tshuaj ntawm 0.375 g, noj 3 zaug hauv ib hnub.

Kev npaj uas muaj clavulanic acid, cov lus qhia rau kev siv pom zoo kom noj nkaus xwb raws li koj tus kws kho mob tau qhia.

Kev siv lwm cov tshuaj ntawm cov tshuaj

Cov koob tshuaj ntawm cov tshuaj yog muab rau lub hauv paus ntawm kev rov ua dua tshiab ntawm cov ntsiab lus ntawm cov tshuaj tua kab mob hauv nws. Rau cov menyuam yaus hnub nyoog qis dua 12 xyoos, cov tshuaj "Amoxicillin + clavulanic acid" cov lus qhia tsis pom zoo kom ua daim ntawv noj tshuaj. Nws yog qhov zoo dua yog siv ncua kev kawm, phoov lossis dej rau siv rau sab hauv.

Cov koob tshuaj amoxicillin ib zaug thiab txhua hnub yog xaiv raws li cov hnub nyoog:

• cov menyuam uas tsis tau muaj peb hlis, yog 0.03 g rau 1 kg ntawm ib hnub twg hnyav 2 zaug,
• los ntawm 3 lub hlis ntawm lub neej thiab nrog mob sib kis me, siv ib hnub 0.025 g rau 1 kg ntawm qhov hnyav rau 2 zaug lossis 0.02 g ib 1 kg ntawm qhov hnyav rau 3 zaug,
• cov mob hnyav yuav tsum tau 0.045 g rau 1 kg ntawm lub cev qhov hnyav ib hnub rau 2 zaug lossis 0.04 g rau 1 kg ntawm lub cev hnyav hauv ib hnub rau 3 zaug,
• cov neeg laus thiab menyuam yaus txij li 12 xyoo, uas nws qhov hnyav los ntawm 40 kg thiab siab dua, tuaj yeem siv ib koob tshuaj 0.5 g 2 zaug lossis 0.25 g 3 zaug,
• rau kev kis mob hnyav lossis kab mob ntawm cov kab mob ua pa, 0.875 g 2 zaug hauv ib hnub yog tshuaj, lossis 0.5 g 3 zaug ib hnub.

Kev noj tshuaj ntau kawg txhua hnub ntawm amoxicillin rau cov neeg laus thiab menyuam yaus tom qab 12 xyoos yog 6 g, thiab rau cov menyuam hnub nyoog qis dua 12 xyoos - tsis pub ntau dua 0.045 g ib 1 kg ntawm lub cev qhov hnyav.

Qhov siab tshaj plaws tau tso cai tau noj txhua hnub ntawm clavulanic acid kuj tau tsim: rau cov neeg laus thiab menyuam yaus tom qab 12 xyoos - 600 mg, rau cov menyuam yaus hnub nyoog qis dua 12 xyoos - 0.01 g ib 1 kg ntawm lub cev qhov hnyav.

Yog tias nqos tsis yooj yim, yuav tsum tau muab tshem tawm rau cov laus. Txog kev npaj cov ntawv ua kua, cov kuab tshuaj yog dej ntshiab.

Kev tswj hwm cov quav rau cov neeg laus thiab cov hluas tom qab 12 xyoo tso cai muab tshuaj ntau ntawm 1 g ntawm amoxicillin 4 zaug ib hnub. Qhov nyiaj ntau tshaj hauv ib hnub twg tsis ntau tshaj 6 g. Cov menyuam yaus hnub nyoog qis dua 3 hlis txog 12 xyoos raug tswj hwm 0.025 g ib 1 kg hauv 3 koob tshuaj; rau qhov mob txhab ntxiv, txhaj 4 ib hnub.

Cov menyuam mos hnub nyoog qis dua 3 hlis, cov menyuam mos thaum ntxov tau txhaj nrog 0,025 g rau 1 kg hauv 2 faib koob tshuaj ib hnub, nyob rau lub sijhawm postperinatal ntawm kev txhim kho, 0.025 mg rau 1 kg hauv 3 koob tau faib tawm.

Lub sijhawm ntawm kev kho yog ob lub lis piam, nrog mob otitis media - ntev txog 10 hnub.

Kev tiv thaiv kev kis kab mob tom qab kev phais mob thaum lub sijhawm ua haujlwm tsis ntev tshaj 60 feeb nyob rau lub sijhawm yog coj los ntawm cov tshuaj tso ntshav ntawm 1 g ntawm cov tshuaj thaum lub sijhawm ua kom tsis nco qab. Kev ua haujlwm ntev ntev xav tau siv 1000 mg tom qab 6 teev thoob plaws ib hnub. Yog tias qhov tshwm sim ntawm kev kis tus mob siab, kev siv tshuaj yog txuas ntxiv rau ob lossis peb hnub tom ntej.

Cov neeg mob uas mob hemodialysis yog noj tshuaj 0.25 g lossis 0.5 g ib daim ntawv thov lossis 500 mg yog tso tshuaj rau hauv lub cev. Qhov kev txiav txim siab ntxiv yog siv 1 koob tshuaj thaum lub sijhawm lim ntshav thiab 1 koob tshuaj nyob rau thaum xaus ntawm kev tswj hwm.