Amokisiline ku ndwara zo mu mazuru siyo igomba guhereza mbere. Impuzwashyirahamwe y’abaganga b’ibihugu by’Abanyamerika (IDSA) ivuga ko amokisiline-clavulanate (Augmentin) ari yo ikwiriye, kuko ingo zikomeye cyane za bakteriya yitwa Haemophilus influenzae zitagira ubwoba kuri amokisiline isanzwe. Amokisiline isanzwe ikomeje kuba mbere ku ndwara zo mu gusara, ku rugero rwa 80 kugeza 90 mg/kg/ku munsi, no ku buhumyi bwo mu mihogo (strep throat) bwemejwe n’ikizamini.

Mbere na mbere: Ibintu by’ingenzi

  • Inshi mu ndwara zo mu mazuru no mu gusara ni iziterwa na virus kandi zigakira zonyine nta antibiyotike.
  • Ku ndwara z’ibisazi ziterwa na bakteriya, amabwiriza agishyira imbere amokisiline-clavulanate kuruta amokisiline isanzwe.
  • Indwara zo mu gusara ni ikindi kintu: amokisiline isanzwe ku rugero rwo hejuru, 80 kugeza 90 mg/kg/ku munsi, iracyari mbere.
  • Ubuvubyi busaba ikizamini cyemejwe mbere, hanyuma iminsi 10 yose yo kuvurwa.
  • Tekereza ko uzoroherwa mu masaha 24 kugeza 48 ku buvubyi, kandi mu minsi 2 kugeza 4 ku ndwara zo mu mazuru no mu gusara.

Amokisiline isanzwe ku ndwara zo mu mazuru akenshi si yo nzira ya mbere ikwiriye

Amokisiline ku ndwara zo mu mazuru itangwa kenshi, ariko si yo amabwiriza agishyira mbere. Amabwiriza ya IDSA yo mu 2012 ku ndwara z’ibisazi zo mu mazuru agaragaza ko amokisiline-clavulanate, atari amokisiline yonyine, ari yo ya mbere mu kuvura abantu bakuru n’abana. Impamvu ni nto kandi yihariye: 27% kugeza 43% by’H. influenzae ntizagira ubwoba kuri amokisiline ariko zikagira ubwoba iyo clavulanate yongeweho.

Clavulanate ntabwo ari antibiyotike ikomeye kurushaho. Ni nk’igihorezo. Ikumira enzyme abakoko bakoresha kugirango bakureho amokisiline mbere yuko iryo doro rigira icyo rikora.

Ibi nibyo benshi batazaguhamiriza: abaganga benshi bafite ubunararibonye bakomeje kwandika amokisiline isanzwe ku ndwara zo mu mazuru, kandi ku kibazo kitari gikomeye ku muntu mukuru utari ufite izindi ndwara kandi utigeze akoresha antibiyotike aherutse, akenshi irakora. Uwanditse avanga ibyo bakteriya bakwirakwiza mu karere, amateka yawe y’uburwayi, n’ibyo wari umaze kuvurirwa uyu mwaka. Kwandikirwa amokisiline isanzwe ntibivuze ko ari ikosa. Ni icyemezo cyo kwifashisha ushobora kwisabira ibisobanuro.

Inshi mu ndwara zo mu mazuru no mu gusara ntizigeze zikeneye antibiyotike na rimwe

CDC irabivuze neza cyane: inshi mu ndwara zo mu mazuru iterwa na virus kandi zigakira zonyine. Abaganga bashobora kwifashisha kwitegereza no gutegereza, cyangwa kwandika resept ya nyuma uzasanga iyo ibintu bidahindutse mu minsi ibiri cyangwa itatu. Kuruhuka, amazi, no gusukura imbere mu mazuru niko bikora muri icyo gihe.

IDSA ivuga imihindagurikire itatu igaragaza ko ari bakteriya kuruta virus:

  • Ibimenyetso bimara iminsi 10 cyangwa bikarenza kandi ntibihinduke.
  • Kwirenza cyane: umuriro wa 39°C (102°F) cyangwa hejuru hamwe n’amazi menshi mabi cyangwa ububabare mu maso, mu gihe cy’iminsi 3 kugeza 4 yikurikiranya.
  • “Kugwara inshuro ebyiri”: wari utangiye kworoherwa, hanyuma ugwa cyane.

Indwara zo mu muhogo zikora mu buryo butandukanye ariko zikagera aho kimwe. CDC ivuga ko isuzuma rikoresheje amaso ridashobora gutandukanya pharyngitis iterwa na virus n’ubuvubyi bw’itsinda A. Ikizamini cyihuse cyemejwe cyangwa culture y’igitsure nibyo bya mbere, kandi ikizamini cyihuse kitameze neza ku mwana kigomba kwemezwa na culture. Ntugategereze cyangwa usabe amokisiline uhereye ku bimenyetso gusa. Kwihutira gusaba kwawe ni uko indwara iterwa na virus ishobora kurangirana n’ibirwara mu nda kandi nta nyungu ibonye. Niba ibimenyetso byawe bidasanzwe, nk’indwara yo mu mazuru idafite umunwa, ubwo bwoba bugomba kwiyongera.

Niba utizera niba wageze ku rwego rwo kwivuza, guhana ikiganiro ku murongo kuri $39 na August bikuganisha kuri muganga wemewe n’amategeko muri Amerika wemeza niba antibiyotike ikwiriye kandi akazayiguha niba koko ikwiriye. Witondere imbibi: ikiganiro kuri videwo ntikishobora kureba mu gusara cyangwa gukoresha icyuma mu buvubyi, bityo indwara y’gusara cyangwa ubuvubyi bishobora gutera kwivuza inyuma y’umuntu.

Kugaburira amokisiline mu mazuru bitandukanya ku myaka: igihe gito ku bantu bakuru, igihe kirekire ku bana

Urugero rwa amokisiline ku ndwara zo mu mazuru si rumwe, kandi igihe cyo kuvurwa gihura n’imyaka kuruta ubukomezi. IDSA ishyiraho iminsi 5 kugeza 7 ku bantu bakuru bashobora kwandura ibisazi mu mazuru kandi iminsi 10 kugeza 14 ku bana. Kuvura ku rugero rwo hejuru (2 g kabiri ku munsi ku bantu bakuru, 90 mg/kg/ku munsi ku bana) byagenewe abafite ibyago: kwakira antibiyotike vuba, kujya mu ishuri ry’abana, cyangwa kuba mu karere kazwiho kurwanya antibiyotike.

Imibare isanzwe ku bantu bakuru iba ari 500 mg buri amasaha 8 cyangwa 875 mg buri amasaha 12. Igisobanuro cyacu cyuzuye kuri urugero rwa amokisiline ku bantu bakuru kivuga uko iyo mibare ihinduka bitewe n’indwara.

Ku bana, urugero rwa amokisiline ku ndwara zo mu mazuru ruhura n’ibiro, kandi icyo ni ikintu ababyeyi bagishyira hasi: urugero rwiza rw’umwana umwe rwahinduka hagati y’indwara uko agenda akura. Imashini yari yararenze umwaka ushize ni imashini yo mu mwaka ushize.

Indwara zo mu gusara ni aho amokisiline yoroheje ikiri mbere

Amokisiline ku ndwara zo mu gusara ni ikintu kimwe n’inkuru y’indwara zo mu mazuru, kuko hano amokisiline isanzwe ari yo igisubizo cy’amabwiriza. Itandukano yihuse mu igenzura ry’ibimenyetso byihuse ry’indwara zo mu gusara ku ngingo ya AAFP yo mu 2013 ishyira amokisiline yoroheje, 80 kugeza 90 mg/kg/ku munsi mu byiciro bibiri, mbere ku bana.

Igihe cyo kuvura gihinduka bitewe n’imyaka n’ubukomezi: iminsi 10 ku bana bari munsi ya 2 cyangwa bafite ibimenyetso bikomeye, kandi iminsi 5 kugeza 7 ku bibazo byoroheje ku bana bafite imyaka 2 kuzamura. Kwitegereza nta antibiyotike ni inzira yemewe mu bibazo bimwe bitari bikomeye iyo igenzura ryizewe, kandi bifite agaciro iyo umwana wawe yavuye mu bikoresho byinshi byo kuvura.

Abakuze na bo bararwara indwara zo mu gusara. Baravurwa bakoresheje imibare isanzwe ya amokisiline ku bantu bakuru aho kugira ngo bagabanye ku bipimo by’ibiro. Niba indwara zikomeje kugaruka, soma uko bikomeza ku ndwara zo mu gusara n’ibibazo byo kumva mbere yuko turara twakiriye.

Kwandikirwa ubuvubyi bifitanye isano no kwirinda rheumati, atari ugukiza ijosi ryawe

Amokisiline ku buvubyi bwo mu muhogo itangwa kubera impamvu benshi batumva bavuga cyane. CDC irabivuze neza ko impamvu yo kuvura ari ugukura ibyago byo kurwara rheumati hamwe n’ibibazo byo kwanduza nko kuba amashyiga ku ngorora n’umutwe, aho kugirango igabanye ububabare bw’ijosi buhoraho ku munsi umwe.

CDC yari mbere y’igihe ni amokisiline 50 mg/kg rimwe ku munsi, kugeza kuri 1000 mg, mu gihe cy’iminsi 10. Penicillin V irahwanye na yo kandi irakoreshwa mu bindi bikoresho byo kwirinda kuko ari nkeya, kandi niyo mpamvu amabwiriza akenshi agenda nk’uko amokisiline ari yo ihagarariwe. Ntabwo ari ko. Ni kimwe mu bishoboka, cyane cyane ku bana.

Gusoza iminsi 10 yose nubwo ijosi ryumva ryoroheje ku munsi wa gatatu. Urarenga ku gihe umara gukira umuriro, warasubira ku ishuri, ku kazi, cyangwa ku ishuri ry’abana amasaha 24 nyuma y’ikigabanywa cya mbere.

Kworoherwa mu minsi ibiri ntibivuze ko wavaho ku rugendo

Amokisiline igihe cyo gukora gitewe n’indwara irimo kuvurwa. Ibimenyetso by’ubuvubyi bikunda kworohera mu gihe cy’amasaha 24 kugeza 48. Indwara zo mu mazuru n’iz’gusara akenshi zifata iminsi 2 kugeza 4 kugirango zihinduke, kuko ibibanza byihagaritse kandi byafunze biroha gahoro nubwo abakoko bari guhunga.

Kutamara ikintu na kimwe mu gihe cy’amasaha 48 kugeza 72 ni ugutanga telefone, aho gutegereza no kureba. Impamvu eshatu ziri ku meza: uwakwirakwiza ataramenyereye, igihe cyo kwemeza ko ari ikindi kintu, cyangwa indwara iterwa na virus itari bugire icyo ikora.

Ibyo bikunze: ntugerageze kwemeza ku kwagira umutwe utuje. Amazi inyuma y’urusare n’ububabare bw’inyuma y’indwara bushobora gukomeza mu byumweru nyuma y’uko indwara ubwayo ivuwe. Iyo kwihanganziza gukomeza ni ugusohora, atari uguhinduka, kandi ntibivuze ko ari impamvu yo guhabwa antibiyotike ya kabiri.

Ingaruka zimwe za amokisiline zigomba guhamagara ibiro; izindi zigomba guhamagara 911

Ingaruka z’ibisanzwe za amokisiline ntabwo zihambaye kandi akenshi ntizihungabanya: kuribwa mu nda, kubabara mu gifu, kuribwa mu ruhu gato, n’ubushye mu gitsina. Ni ibikubabaza, ntibihungabanya, kandi benshi ntibabasaba guhagarika. Urutonde ruto rw’ingaruka rwihariye.

Hamagara 911 cyangwa jya ku cyumba cy’ubutabazi ubu:

Wiyandikishirize gusura mu cyumweru gitaha niba:

  • Ibimenyetso byo mu mazuru bimaze iminsi 10 cyangwa byarenzeho nta gikozwe.
  • Nta kintu na kimwe kibuze nyuma y’iminsi 3 ku antibiyotike.
  • Ufite ibibazo 4 cyangwa byinshi mu mazuru ku mwaka.
  • Indwara zo mu gusara zikomeje kugaruka, cyangwa kumva bikomeye nyuma yo kuvurwa.

Ganira n’umuganga mbere yo gutangira niba:

  • Ufite ububabare kuri penicillin cyangwa cephalosporin, indwara y’impyiko, cyangwa kwandura C. difficile byabayeho.
  • Mono ni indwara ikwiye.
  • Watewe inda cyangwa uriho amashira.
  • Ufata methotrexate cyangwa allopurinol.

Niba utizera icyiciro uriho, August AI Symptom Checker y’ubuntu izagufasha gutandukanya ibihutirwa n’ibisanzwe mbere yo gufata icyemezo aho ujya.

Inshuro nyinshi bibazwa

Amokisiline ivura ubuvubyi bwo mu mihogo?

Yego. Igihe abantu babazaga niba amokisiline ivura ubuvubyi bwo mu mihogo, igisubizo ni uko isukura itsinda A Streptococcus neza iyo ikizamini cyabyemeje. Ikibazo ni mono, indwara isanzwe ikora kimwe n’ubuvubyi. Amokisiline itanzwe ku muntu waba afite mono kenshi itera urubyiriro rwagutse rugaragara nk’uburwayi bw’imiti ariko akenshi si ko bimeze. Impamvu imwe yiyongera ku kwandika mbere yo kwemeza.

Nshobora gufata amokisiline niba mfite ububabare kuri penicillin?

Oya. Amokisiline ni penicillin, bityo ububabare bwa penicillin bukwirukana. Abaganga bakoresha ibindi byiciro bitewe n’indwara, kenshi doxycycline ku ndwara zo mu mazuru na azithromycin cyangwa clindamycin ku buvubyi, hamwe na cephalosporins zimwe zikoreshwa mu kwirinda ku bantu bafite ububabare buke. Benshi mu bana bafite label y’uburwayi bwa “penicillin” bagaragaza ko batari bakwiye ku igenzura rya burundu, kandi bifite agaciro niba bikomeje kugabanya amahitamo yawe.

Nzakora iki niba nakirutse igabanywa rya amokisiline?

Akenshi sibyo. Igabanywa rimwe ryakirutse ntirihindura urugendo. Ifate uko ubyibuka, keretse igihe cy’igabanywa ryawe ritaha rigaragiye, bityo uzihishe igikirutse kandi ugende. Ntiwibone ku gukubiraho ngo uzagere. Niba ukomeje kwirutsa ibigabanywa, tuvugane n’uwanditse, kuko igabanywa ry’inshuro ebyiri ku munsi rishobora kuba rirushijeho kuba ryiza kuruta igabanywa buri saha umunani.

Amokisiline ni ngombwa mu gihe cy’inda?

Rimwe na rimwe. Amokisiline ni kimwe mu bikoresho by’imiti abaganga bakoresha mu gihe cy’inda n’amashira, ariko icyemezo cyihariye ni icy’uwanditse, kivuguruzwa n’indwara irimo kuvurwa. Vuga ko utwite, utegura gutwita, cyangwa uriho amashira mbere yuko resept itangwa, aho kuyikira. Urugero n’igihe bushobora guhinduka aho guhindura imiti.

Amokisiline itwara angahe idafite ubwishingizi?

Akenshi ntibigenda gutyo. Amokisiline ni urugero rwa kera kandi rumwe mu miti y’ibiciro biri hasi cyane ikoreshwa, nubwo ibiciro nyirizina bihinduka bitewe n’isomo, uburyo bwo kuyitunganya, n’ingano, kandi ubusobanuro bw’amazi ku bana bifite ibiciro bitandukanye n’ibifuniko. Twagabanyije imibare y’ubu mu ntambwe yacu kuri ingano ya amokisiline idafite ubwishingizi.

Nshobora gukoresha amokisiline yasizwe kuva kuri resept ya kera?

Oya. Imfungwa zasizwe ziba zifite urugero rubi kandi, nk’uko byemejwe, urugendo rutuzuye, kandi urugero rw’umwana rushingiye ku bipimo by’ibiro rwagiye rugenda ruhinduka kuva icyo gihe. Gukoresha amokisiline ku bimenyetso by’indwara zo mu mazuru nta igenzura ry’ubu bifana nuko nta muntu wagenzuye niba wararenze urwego rw’ibakteriya na gato. Urugendo rutuzuye ni inzira yo kwemerera ibikoresho by’imiti kwiyongera kandi ntivure na kimwe.

Iby’ingenzi ku amokisiline ku ndwara zo mu mazuru, gusara, n’ubuvubyi

Urwego rwo kumenya indwara rugomba kubanza mbere y’ikimenyetso, buri gihe. Ku ndwara zo mu mazuru, amokisiline-clavulanate irashyirwa imbere kuruta amokisiline isanzwe, ku minsi 5 kugeza 7 ku bantu bakuru n’iminsi 10 kugeza 14 ku bana. Ku ndwara zo mu gusara, amokisiline isanzwe ku rugero rwo hejuru 80 kugeza 90 mg/kg/ku munsi iracyari mbere. Ku buvubyi bwemejwe, ni 50 mg/kg rimwe ku munsi, kugeza kuri 1000 mg, mu gihe cy’iminsi 10 yuzuye.

Gusoza urugendo nubwo wiyumva neza, kandi hamagara ubwo nta gikozwe mu gihe cy’amasaha 72.

Inkuru ngufi: iyi nkuru ni iy’amakuru gusa kandi ntibashyira mu mwanya w’inama z’ubuvuzi. Uhora usabwa kuganira n’umukozi w’ubuvuzi wemewe kugira ngo wemeze ibyemezo byo kugena indwara no kuyivura. Niba ufite ikibazo cy’ubuzima gikomeye, hamagara 911 cyangwa jya ku cyumba cy’ubutabazi cyegereye uyu mwanya.