Florfenicol, mushonga wekugadzira we thiamphenicol une monofluorinated derivative, mushonga mutsva we chloramphenicol unorwisa mabhakitiriya une spectrum yakakura wekushandiswa nemhuka, uyo wakagadzirwa zvinobudirira mukupera kwema1980.
Kana paine zvirwere zvinowanzoitika, mapurazi mazhinji enguruve anoshandisa florfenicol kakawanda kudzivirira kana kurapa zvirwere zvenguruve. Pasinei nerudzi rwechirwere, zvisinei neboka kana danho ripi, vamwe varimi vanoshandisa florfenicol yakawanda kurapa kana kudzivirira chirwere. Florfenicol haisi mushonga wekurapa. Inofanira kushandiswa zvine musoro kuti iwane mhedzisiro inodiwa. Inotevera inyaya yakadzama yekushandiswa kweflorfenicol, tichitarisira kubatsira munhu wese:
1. Hunhu hwe florfenicol hune mabhakitiriya
(1) Florfenicol mushonga unorwisa mabhakitiriya une huwandu hwakakura hwemabhakitiriya anorwisa mabhakitiriya akasiyana-siyana eGram-positive neasina kunaka uye mycoplasma. Mabhakitiriya ane hunhu hunosanganisira bovine nenguruve Haemophilus, Shigella dysenteriae, Salmonella, Escherichia coli, Pneumococcus, Influenza bacillus, Streptococcus, Staphylococcus aureus, Chlamydia, Leptospira, Rickettsia, nezvimwewo.
(2) Kuongororwa kwemushonga wekudzivirira muviri kubva muropa (in vitro) uye kubva muropa (in vivo) kunoratidza kuti kushanda kwayo kwemishonga inorwisa mabhakitiriya kuri nani zvikuru kupfuura mishonga inorwisa mabhakitiriya iripo, yakadai sethiamphenicol, oxytetracycline, tetracycline, ampicillin uye quinolones dziri kushandiswa zvakanyanya pari zvino.
(3) Florfenicol inoshanda nekukurumidza, inogona kusvika pahuwandu hwekurapa muropa awa imwe chete mushure mekubaiwa jekiseni remutsinga, uye huwandu hwepamusoro hwemushonga hunogona kusvika mumaawa 1.5-3; huwandu hwemushonga muropa hunoshanda kwenguva refu uye hunoshanda hunogona kuramba huripo kwemaawa anopfuura makumi maviri mushure mekushandisa kamwe chete.
(4) Inogona kupinda muropa-uropi, uye mhedzisiro yayo yekurapa meningitis yemabhakitiriya emhuka haina kufanana neyemimwe mishonga inorwisa mabhakitiriya.
(5) Haina chepfu kana migumisiro yakaipa kana ikashandiswa muhuwandu hunokurudzirwa, inokunda njodzi ye aplastic anemia uye humwe huturu hunokonzerwa ne thiamphenicol, uye haizokuvadzi mhuka nechikafu. Inoshandiswa pazvirwere zvemuviri zvakasiyana-siyana zvinokonzerwa nemabhakitiriya mumhuka. Kurapa nguruve, kusanganisira kudzivirira nekurapa zvirwere zvekufema zvebhakitiriya, meningitis, pleurisy, mastitis, hutachiona hwemudumbu uye postpartum syndrome munguruve.
2. Mabhakitiriya anobatwa ne florfenicol uye chirwere chenguruve chinonzi florfenicol chinofarirwa
(1) Zvirwere zvenguruve uko florfenicol inonyanya kufarirwa
Mushonga uyu unokurudzirwa semushonga unonyanya kusarudzwa we pneumonia yenguruve, porcine infectious pleuropneumonia uye chirwere cheHaemophilus parasuis, kunyanya pakurapa mabhakitiriya asingade fluoroquinolones nemamwe ma antibiotic.
(2) Florfenicol inogona kushandiswawo pakurapa zvirwere zvenguruve zvinotevera
Inogona zvakare kushandiswa kurapa zvirwere zvekufema zvinokonzerwa neStreptococcus (pneumonia), Bordetella bronchiseptica (atrophic rhinitis), Mycoplasma pneumoniae (swine asthma), nezvimwewo; salmonellosis (piglet paratyphoid), colibacillosis (piglet asthma) Zvirwere zvemudumbu zvakaita se enteritis inokonzerwa ne yellow diarrhea, chena diarrhea, piglet edema disease) nezvimwe zvirwere zvinotapukira. Florfenicol inogona kushandiswa kurapa zvirwere izvi zvenguruve, asi haisi mushonga unoshandiswa pakurapa zvirwere izvi zvenguruve, saka inofanira kushandiswa nekungwarira.
3. Kushandiswa zvisina kunaka kwe florfenicol
(1) Dose yacho yakakura zvakanyanya kana kuti diki zvakanyanya. Mimwe mishonga yekudyisa yakasanganiswa inosvika 400 mg/kg, uye mishonga yejekiseni inosvika 40-100 mg/kg, kana kutopfuura. Mimwe midiki kusvika 8~15mg/kg. Mishonga mikuru ine chepfu, uye mishonga midiki haishande.
(2) Nguva yacho yakareba zvakanyanya. Kushandisa mishonga kwenguva refu pasina kurambidzwa.
(3) Kushandiswa kwezvinhu nematanho kwakaipa. Nguruve dzehadzi dzine pamuviri nedzinokora dzinoshandisa mishonga yakadaro zvisina tsarukano, zvichikonzera chepfu kana masara emishonga, zvichikonzera kugadzirwa kwemhuka nechikafu chisina kuchengetedzeka.
(4) Kusashanda zvakanaka kwemishonga iyi. Vamwe vanhu vanowanzo shandisa florfenicol pamwe chete ne sulfonamides ne cephalosporins. Zvakakosha kuongorora kana iri yesainzi uye ine musoro.
(5) Kudyisa nekupiwa kwemishonga zvakasiyana-siyana hazvisanganiswi zvakaenzana, zvichiita kuti pasave nemigumisiro yemishonga kana chepfu yemishonga.
4. Kushandiswa kwemishonga yekudzivirira florfenicol
(1) Chigadzirwa ichi hachifanirwe kusanganiswa nema macrolides (akadai se tylosin, erythromycin, roxithromycin, tilmicosin, guitarmycin, azithromycin, clarithromycin, nezvimwewo), lincosamide (Yakadai se lincomycin, clindamycin) uye diterpenoid semi-synthetic antibiotics - Tiamulin combination, kana ikasanganiswa inogona kukonzera mhedzisiro inopikisa.
(2) Chigadzirwa ichi hachigone kushandiswa pamwe chete ne β-lactone amines (senge penicillins, cephalosporins) uye fluoroquinolones (senge enrofloxacin, ciprofloxacin, nezvimwewo), nekuti chigadzirwa ichi chinodzivisa mapuroteni ebhakitiriya. Synthetic fast-acting bacteriostatic agent, chekupedzisira ibhakitiriya inoshanda nekukurumidza panguva yekubereka. Pasi pebasa rechekutanga, kugadzirwa kwemapuroteni ebhakitiriya kunodziviswa nekukurumidza, mabhakitiriya anomira kukura nekuwanda, uye simba remabhakitiriya rechekupedzisira rinodzikira. Saka, kana kurapwa kuchida kuita nekukurumidza sterilization effect, hakugone kushandiswa pamwe chete.
(3) Mushonga uyu haugone kusanganiswa nesulfadiazine sodium kuti upinzwe mutsinga. Haufanirwe kushandiswa pamwe chete nemishonga yealkaline kana uchipiwa nemuromo kana netsinga, kuitira kudzivirira kuora nekukundikana. Hauna kukodzerawo kubaiwa netsinga ne tetracycline hydrochloride, kanamycin, adenosine triphosphate, coenzyme A, nezvimwewo, kudzivirira kunaya kwemvura uye kudzikira kwekushanda kwayo.
(4) Kuora kwetsandanyama uye kupararira kwemasero etsinga zvinogona kukonzerwa mushure mekubayiwa jekiseni remutsinga. Saka, rinogona kubaiwa netsandanyama dzakadzika dzemutsipa nemagaro, uye hazvikurudzirwi kudzokorora kubaiwa jekiseni panzvimbo imwe chete.
(5) Nekuti mushonga uyu unogona kunge uine chepfu mudumbu, unofanirwa kushandiswa nekungwarira kunguruve dzine pamuviri uye dziri kuyamwisa.
(6) Kana tembiricha yemuviri yenguruve dzinorwara yakakwira, inogona kushandiswa pamwe chete nemishonga inorwisa marwadzo inorwisa pyretic nedexamethasone, uye mhedzisiro yacho inova nani.
(7) Mukudzivirira nekurapa chirwere chekufema chenguruve (PRDC), vamwe vanhu vanokurudzira kushandiswa pamwe chete kwe florfenicol ne amoxicillin, florfenicol ne tylosin, uye florfenicol ne tylosin. Zvakakodzera, nekuti kubva pamaonero emishonga, zviviri izvi hazvigone kushandiswa pamwe chete. Zvisinei, florfenicol inogona kushandiswa pamwe chete ne tetracyclines dzakadai se doxycycline.
(8) Mushonga uyu une chepfu yeropa. Kunyangwe usingazokonzere anemia yemapfupa asina kudzoreka, kudziviswa kwe erythropoiesis kunokonzerwa nawo kwakajairika kupfuura kwe chloramphenicol (yakaremara). Hazvibvumirwi panguva yekubaiwa nhomba kana mhuka dzine immune deficiency yakanyanya.
(9) Kushandiswa kwenguva refu kunogona kukonzera matambudziko ekugaya chikafu uye kushomeka kwemavhitamini kana zviratidzo zve superinfection.
(10) Mukudzivirira nekurapa chirwere chenguruve, kungwarira kunofanira kuitwa, uye mushonga wacho unofanira kupiwa zvichienderana nechiyero chakatarwa uye nzira yekurapa, uye haufanirwe kushandiswa zvisina kunaka kudzivirira migumisiro yakaipa.
(11) Kumhuka dzine dambudziko reitsvo, mushonga unofanira kuderedzwa kana kuti nguva yekushandiswa inofanira kuwedzerwa.
(12) Kana tembiricha yakaderera, zvinoonekwa kuti mwero wekunyungudika unononoka; kana kuti mushonga wakagadzirwa une florfenicol, uye unongoda kupiswa zvishoma (kwete kupfuura 45 ℃) kuti unyungudike nekukurumidza. Mushonga wakagadzirwa unofanirwa kushandiswa mukati memaawa makumi mana nemasere.
Nguva yekutumira: Nyamavhuvhu-09-2022