Cha. I-Doxycycline ayiyelapha i-bacterial vaginosis. Ibulala amagciwane e-aerobic kanye ne-atypical njenge-Chlamydia trachomatis, hhayi amagciwane e-anaerobe angaphansi kwe-BV. I-CDC incoma i-metronidazole noma i-clindamycin esikhundleni salokho. I-doxycycline esele ku-residi we-prescription yakudala ngeke ikuqede i-BV, futhi ukuyidla kubambezela ukwelashwa okungakwenza.
TL;DR: Izinto Ezibalulekile Okumele Uzikhumbule
- I-Doxycycline ayitholakali ohlwini lwe-CDC lwezindlela zokwelapha i-BV, noma ngabe yimuphi umthamo noma isikhathi.
- Ingabe i-doxycycline ingayelapha i-BV uma uyidla kakhulu, noma uyidla isikhathi eside? Cha. Inkinga iyisibonelo samagciwane, hhayi umthamo.
- Kunolunye ucwaningo oluncane, i-BV yaqhubeka kubantu abangu-95% abathola i-doxycycline eyedwa, kuqhathaniswa nabangu-14% lapho kwengezwa i-metronidazole gel.
- Ukwelashwa okuqala kuwukuthi i-metronidazole noma i-clindamycin, ngemva kokuba udokotela eqinisekise ukuthi i-BV, hhayi i-yeast noma i-trichomoniasis.
- Uma usuvele wadla i-doxycycline esele, yiyeke, futhi wazise udokotela ukuthi yini oyidlayo, ingakanani, futhi nini.
Ingabe i-doxycycline iyayelapha i-BV? Cha, noma ngabe yimuphi umthamo, noma isikhathi esingakanani
Cha. I-CDC's 2021 STI Treatment Guidelines ibalula kuphela i-metronidazole, ethathwa ngomlomo noma njenge-0.75% vaginal gel, kanye ne-clindamycin, njenge-2% cream noma capsule yomlomo, phakathi kwezindlela ezinconywayo nezinye zokwelapha i-bacterial vaginosis. I-Doxycycline ayitholakali kulelo hlu. Umthamo omkhulu, isikhathi eside, noma ukuqedela iphakethe elidala akushintshi lokho.
Imininingwane yezokwelapha icacile. Ku-pilot trial kubantu abanesifo se-cervicitis kanye ne-BV ehambisana nayo, i-bacterial vaginosis yaqhubeka kubantu abangu-95% abelashwa nge-doxycycline eyedwa, kuqhathaniswa nabangu-14% babo abathola i-metronidazole vaginal gel.
Ingabe i-doxycycline ingayelapha i-BV lapho ihlangene nenye into? Ucwaningo olufanayo luphendula lokho: i-metronidazole yenza umsebenzi.
Ukuntuleka kucace kakhulu ezincwadini zocwaningo. Ku-2024 systematic review and network meta-analysis of BV drugs iqhathanise i-metronidazole, i-clindamycin, i-secnidazole, i-tinidazole, i-ornidazole, i-ofloxacin kanye nama-probiotics. I-Doxycycline ayihlolwanga nhlobo, ngoba ayilona ukwelashwa kwe-BV okusemthethweni.
Kungani i-doxycycline yehluleka: i-BV ibangelwa amagciwane ayo angazange enzelwe ukubulala
Ngakho kungani i-doxycycline ingayelapha i-BV, lapho iyikhemisi elisebenza ngempela kwezinye izifo? Ngoba yenziwe ngohlobo lwezinto ezihlukile. I-Doxycycline ihlanganisa amagciwane e-aerobic kanye ne-atypical: i-Chlamydia trachomatis, amagciwane esikhumba abandakanyeka ku-acne, izifo ezibangelwa ama-tick, kanye nezifo eziningi zokuphefumula.
I-BV yinkinga ehlukile. Kuyinto yokwanda kwamagciwane e-anaerobe, amagciwane akhula ngaphandle komoya-mpilo, kuhlanganise ne-Gardnerella vaginalis, izinhlobo ze-Prevotella kanye ne-Fannyhessea vaginae (eyayibizwa ngokuthi i-Atopobium vaginae), kanye nokulahlekelwa yi-Lactobacillus evikelayo.
I-Metronidazole kanye ne-clindamycin zisebenza ngqo kulawo magciwane e-anaerobe. Ama-nitroimidazole afana ne-metronidazole aqala ukusebenza ngaphakathi ezimeni ezinomoya-mpilo ophansi amagciwane e-anaerobe awadala, yingakho eshaya kakhulu amagciwane e-BV futhi ayeke ezinye izinto.
Gcina umthetho, ngoba usebenza kuwo wonke amaphilisi asekhishini lakho: ikhemisi alilona elijwayelekile. Isibonelo samagciwane kufanele sihambisane negciwane, uma kungenjalo ayenzi lutho oluwusizo.
I-doxycycline esele ekhishini lakho ayilona ukwelashwa kwe-BV
Ingabe amakhemisi aseleyo angayelapha i-BV? Cishe akukho, futhi i-doxycycline yisibonelo esicace kakhulu. Lapho abantu bebuzwa ukuthi ingabe i-doxycycline iyayelapha i-BV, bavame ukubheka iphakethe elingasetshenzisiwe kusuka ku-acne yakudala, ukwelashwa kwe-chlamydia yangaphambili, noma i-prescription abayiyekile kusese kusenesikhathi lapho bezizwa bengcono.
Uma usuvele udle okuthile, yiyeke. Ungaqali kabusha isifundo, ungazami ukusiqedela, futhi ungabali lokho oyidlayo njengokwelashwa kwe-BV. Lapho ukhuluma nodokotela, bamtshele ukuthi yini kanye nokuthi kangakanani nokuthi nini okwadlayo, ngoba lokho kuguqula indlela abahumusha ngayo izimpawu zakho kanye ne-swab yakho.
Umbuzo wangempela akuwona ukuthi ngabe amakhemisi aseleyo angayelapha i-BV, kodwa ukuthi ukuwadla kukubiza kangakanani. Izinto ezintathu, ngokuqondile: ukhetha amagciwane azimelayo, uvuza i-vaginal kanye ne-gut microbiome eseyivele ingalingani, futhi ubambezela ukutholwa komfutho wesifo izinsuku noma amaviki. I-Doxycycline ye-BV iphinde yethule nemiphumela yayo engemihle ngaphandle kwenzuzo, kufaka phakathi ukuzwela ekukhanyeni kwelanga, ukucasuka komminzo kanye nesicanucanu.
Okufanayo kusebenza emkhubeni omkhulu wokuzinikezela amakhemisi, yingakho ungeke ukwazi ukuthenga i-doxycycline ngaphandle kweresidi e-United States.
Yini Eqinisweni Ekuqedayo i-BV, Futhi Kungani Kumele Kutholwe Isifo Kuqala
Uma i-doxycycline ye-BV ingekho etafuleni, nansi leyo esetafuleni. Izindlela ezinconywe yi-CDC ziwukuthi i-metronidazole 500 mg ngomlomo kabili ngosuku izinsuku eziyisikhombisa, i-metronidazole 0.75% gel ngaphakathi kwe-vagina izinsuku ezinhlanu, noma i-clindamycin 2% cream ngaphakathi kwe-vagina izinsuku eziyisikhombisa. I-Tinidazole ne-secnidazole ziyi-alternatives ezamukelwayo. Izimo eziningi ziphela ngokwelashwa okukodwa, yize i-Cleveland Clinic igcizelela ukuthi abangu-10% kuya ku-15% abantu badinga okwesibili.
Nansi into emakhasini amaningi ayizokutshela: izimpawu zihambelana kakhulu kangangokuthi ukuqagela akunakwethenjwa. Isifo se-yeast sidinga i-antifungal, hhayi i-antibiotic. I-Trichomoniasis kanye ne-pelvic inflammatory disease zidinga amanye amakhambi futhi. Ukwelapha okungalungile kudla isonto futhi kwenza isimo sibe nzima.
Yileso simo sokuhlolwa ngaphambi kokwelashwa, hhayi ngemuva.
Uma ungayiqiniseki ukuthi ungaqala kuphi, i-August's $39 online urgent care visit ikuxhumanisa nodokotela ogunyazwe yi-US ongabuyekeza izimpawu zakho nomlando wakho futhi anqume ukuthi i-prescription ifanele yini. Yiba sobala ngemikhawulo: ukuvakashelwa okuyimodeli akukwazi ukwenza ukuhlolwa komlomo noma ukuqoqa i-vaginal swab, ngakho-ke uma udokotela wakho edinga lokho, uzothunyelwa mathupha. Kubalulekile futhi ukuqhathanisa izinsizakalo zokwelapha i-BV ku-inthanethi ngaphambi kokuzibophezela.
Leli kanye isikhathi i-doxycycline evela ngaso: kanye nokwelashwa kwe-BV, hhayi esikhundleni sayo
I-Doxycycline ne-metronidazole kumagciwane ahambisana ne-BV avele ekunye ku-prescription esinye isimo: i-pelvic inflammatory disease. I-2021 CDC outpatient PID regimen summarized by the AAFP wukuthi i-ceftriaxone kanye ne-doxycycline 100 mg kabili ngosuku izinsuku eziyi-14 kanye ne-metronidazole 500 mg kabili ngosuku izinsuku eziyi-14.
Qaphela ukuthi yimuphi umuthi owenza umsebenzi. I-doxycycline ihlanganisa i-chlamydia kanye nezinye izinto ezingavamile. Yikho i-metronidazole ehlangene namagciwane e-anaerobe, ahambisana ne-BV.
Ngakho umthetho ulula. I-Doxycycline ingezwa kuphela lapho udokotela eqinisekise i-chlamydia ehambisana nayo noma i-PID. Akukona njengokubuyisela ukwelashwa kwe-BV, futhi akukona nje ukuthi kwenzeke.
Nini Ukuyeka Ukuzelapha Nokubonwa
Shayela ku-911 noma uye esiteshini esiphuthumayo manje uma:
- Unezinga lokushisa eliphezulu kanye nezimpawu ze-vaginal
- Unezinhlungu ezingezansi zesisu noma zesisu ezingezwakali noma ezinzima kakhulu
- Unezinhlungu ezingezwakali noma ezivame kakhulu
- Uneziyalezo ezibukeka kabi noma ezinombala kanye nezinhlungu, umkhuhlane, noma uzizwa ugula ngokujwayelekile
Lawa angase abe izimpawu ze-pelvic inflammatory disease, edinga ukwelashwa ngokushesha, hhayi ikhaya eliyindlela.
Bhukha ukuvakashelwa phakathi nesonto elilandelayo uma:
- Awuzwanga ukuthuthuka ngemva kwezinsuku ezintathu zokwelashwa okulungile, okunconyiwe yi-CDC
- Izimpawu zabuya ngemva kokuqedela isifundo esigcwele
- Ube ne-BV izikhathi ezingaphezu kwezintathu ngonyaka
- Unezimpawu ezintsha noma ezingajwayelekile
Khuluma nodokotela ngaphambi kokuba uqale uma:
- Ukhulelwe noma uzama ukukhulelwa, njengoba i-BV ekuKhulelweni ihlotshaniswa nokubeletha ngaphambi kwesikhathi futhi idinga ukuhlolwa esikhundleni sokuzelapha
- Uvele wadla i-doxycycline esele
- Unayo i-IUD
- Awunaso isiqiniseko ukuthi lokhu kuyi-BV, i-yeast infection, noma i-trichomoniasis
Uma ungayiqiniseki ukuthi isimo sakho sinzima kangakanani, i-August AI Symptom Checker yamahhala ingakusiza ukuthi uhlukanise ukuvakashelwa okujwayelekile nalokho okungamele kulinde. Kuyinto yokuhlunga, hhayi ukuxilonga.
Imibuzo Evame Ukubuzwa
Ingabe i-doxycycline iphephile ukuyidla ukuze kubonakale izimpawu ze-BV ekuKhulelweni?
Cha. I-Doxycycline ayilona ukwelashwa kwe-BV kunoma ngubani, futhi ukukhulelwa kwandisa ubungozi bokuqagela. Amakhemisi e-Tetracycline avame ukugwenywa ekuKhulelweni, futhi i-BV ekuKhulelweni ihlotshaniswa nokubeletha ngaphambi kwesikhathi, okwenza ukuhlolwa okusheshayo kubaluleke kakhulu. Buza udokotela wakho wokubeletha ukuthi yisiphi isifundo esifanele esikhundleni sokufinyelela i-prescription yakudala.
Ingabe ukudla i-doxycycline kunganginika i-yeast infection ngaphezu kwe-BV?
Ngezinye izikhathi. Amakhemisi asetshenziswa kabanzi angavimba amagciwane ajwayelekile e-vaginal futhi avumele i-Candida ukuba yande, okudala ukulunywa kanye nokuphuma okumhlophe okujiyile ngaphezu kwanoma yini oqale ngayo. Lobu ubungozi bangempela bokudla i-antibiotic ongasayidingi, futhi i-yeast infection ehlumela ngalokho idinga i-antifungal, hhayi enye i-antibiotic.
Ngaphandle kokudla utshwala ku-metronidazole ye-BV?
Yebo. Ukulebula komkhiqizo okujwayelekile kubonisa ukugwema utshwala ngesikhathi sokwelashwa nge-metronidazole kanye nezinsuku ezintathu ngemuva komthamo wokugcina, ngoba ukuhlanganiswa kungabangela ukushisa, ukugcwalisa, isicanucanu nokuhlanza kwabanye abantu. Isixwayiso esifanayo sisebenza ku-tinidazole. Hlela isifundo somlomo sezinsuku eziyisikhombisa sibe sezindaweni lapho ungaphuzi khona.
Ingabe umlingani wami udinga ukwelashwa uma ngine-BV?
Hhayi ngavamile. I-Cleveland Clinic igcizelela i-BV ayibhaliswanga njengesifo esidluliselwa ngokocansi, yize ubuhlobo bobulili bungashintsha indawo yamagciwane e-vaginal futhi benyuse ubungozi. Ukwelashwa okujwayelekile kwabalingani besilisa akuyona imikhuba ejwayelekile. Uma unezinguqulo yowesifazane ezinezimpawu, kufanele ahlolwe yena.
Uma ngitholakala ne-BV, ngabe kufanele ngihlale ngihlale ngihlola izifo zocansi?
Yebo. Iziqondiso ze-CDC zithi i-BV yandisa ubungozi bokuthola i-HIV, i-gonorrhea, i-chlamydia, i-trichomoniasis, i-M. genitalium, i-HPV kanye ne-HSV-2. Noma ngubani otholwe ne-BV kufanele ahlolwe i-HIV kanye nezinye izifo zocansi. Lokho kuhlolwa okuhlangene kuyinto eyodwa yezinto eziqondile iphilisi elisele kusuka ekhishini lakho elingakwazi ukukwenzela zona.
Ingabe i-doxycycline iyake isetshenziselwe i-BV ebuyayo ephindelelayo?
Cha. Impendulo kumbuzo wokuthi ingabe i-doxycycline iyayelapha i-BV ayishintshi lapho ibuyela. Kuze kufike ku-66% wabesifazane babuya esikhathini esingu-12 esiphumelele ukwelashwa, okubangelwa i-biofilm yamagciwane esikhundleni sokuqoka uhlobo oluhlukile lwekhambi. Izinketho zokucindezela zihlanganisa i-metronidazole, i-tinidazole, i-boric acid kanye ne-fluconazole.
Isiphetho mayelana ne-doxycycline ne-BV
Kungani i-doxycycline ingayelapha i-BV? Uhlobo olungalungile lwamagciwane, hhayi umthamo ongulungile. I-Doxycycline ihlasela amagciwane e-aerobe kanye ne-atypical, kanti i-BV ingeyo-anaerobe. Ingabe i-doxycycline iyayelapha i-BV kunoma yisiphi isimo? Cha, yize ingahlala kanye ne-metronidazole lapho udokotela eqinisekise i-chlamydia noma i-PID. Okukuqedayo i-BV wukuthi i-metronidazole noma i-clindamycin, ngokwe-CDC, ngemva kokuba udokotela eqinisekise ukuxilongwa.
Isitatimende: Lesi sihloko sizonikeza ulwazi kuphela futhi akusona iseluleko sezokwelapha. Hlala uxhumana nomhlinzeki wezempilo oqeqeshiwe ukuze uthole ukuxilongwa nezinqumo zokwelashwa. Uma ubhekene nesimo esiphuthumayo sezokwelapha, shayela ku-911 noma uye esiteshini esiphuthumayo esiseduze ngokushesha.
