Cha. I-Nitrofurantoin (iMacrobid) ivunyelwe kuphela izifo zamagciwane esinqeni. Ikozigxilisa emchameni, hhayi ezicutini zesitho sangasese sowesifazane, ngakho-ke ayilufiki nhlobo amagciwane abangela i-bacterial vaginosis. Ukuyisebenzisa akubanga yingozi; ayisebenzi nje kuphela. Ungakwazi yini iNitrofurantoin ukwelapha iBV ngomthamo omkhulu noma isikhathi eside? Kusengokuthi cha. I-BV idinga i-metronidazole noma i-clindamycin.

TL;DR: Izinto ezibalulekile okumele uzikhumbule

  • Isimemezelo se-FDA seNitrofurantoin sithinta kuphela izifo zamagciwane ezimbi zomgudu wokuchama. Akukho ukutheleleka kwesitho sangasese sowesifazane okukhulunywa ngakho kuso.
  • Imithi ibulala amagciwane ahambisana ne-BV esidlalweni, kodwa isheshiswa kakhulu izinsizwa ngenxa yalo igagasi ngakho ayilufiki ezingeni eliwusizo ezicutini zesitho sangasese sowesifazane.
  • Lokhu akuyona inkinga yokuphepha. Kuyinkinga yokulibazisa: iviki elichithwe kumuthi wokulwa namagciwane ongulungile yiviki lapho isifo siqhubeka khona.
  • Ukwelashwa kokuqala kwe-BV ukudla i-metronidazole, i-metronidazole gel yesitho sangasese sowesifazane, noma i-clindamycin cream yesitho sangasese sowesifazane.
  • Uma ukukhishwa kanye nephunga kungashintshanga ngemuva kwezinsuku ezingu-2 kuye kwezingu-3 kumuthi wokulwa namagciwane we-UTI, udinga ukutholwa komgomo, hhayi isikhathi eside.

I-Nitrofurantoin iyimithi yokulwa namagciwane yesinqena kuphela, futhi i-BV ayiyona isifo sesinqena

Cha, i-nitrofurantoin ayilwelwa i-bacterial vaginosis, futhi lokhu akulona ubalazwe. Isimemezelo se-FDA esigunyaziwe se-nitrofurantoin capsules sigudla into eyodwa: isifo esibuhlungu nesingezona kabi somgudu wokuchama, okusho ukuthi i-acute cystitis ebangelwa yi-E. coli noma i-Staphylococcus saprophyticus evumelana nayo. Isimemezelo esifanayo sisho ukuthi umuthi awuphathisi i-pyelonephritis noma i-perinephric abscess. Ukutheleleka kwesitho sangasese sowesifazane akukhulunywa ngakho kuyo yonke indawo.

Izinga likazwelonke lokwelashwa lithi into efanayo ngokungakhulumi ngakho. I-Nitrofurantoin ayiveli ndawo kwisehlandla se-CDC's 2021 STI Treatment Guidelines mayelana ne-bacterial vaginosis. Qonda ukuthi lokhu kusho ukuthini. Lokhu akulona ukuphikisana. I-Nitrofurantoin ayiyona ingozi kumuntu onayo i-BV. Ayikwazi ukwenza lutho ngayo.

Ukubulala i-Gardnerella esidlalweni akufani nokwelapha i-BV

Ngabe i-nitrofurantoin iyayelapha yini i-BV ngomqondo ongajulile welebhu? Ingxenye, futhi yilapho khona ukudideka kuqala khona. I-Nitrofurantoin ibonisa ukusebenza okungokoqobo ku-Gardnerella vaginalis kanye ne-Atopobium vaginae, ezimbili zezinhlamvu eziphuma ngaphandle ku-BV. Emagqolweni, lokho kubukeka kuthembisa.

Nansi into amakhasi amaningi angayitsheli: ukusebenza ngaphandle kusho isitatimende mayelana ne-petri dish, hhayi mayelana nomzimba wakho. I-Nitrofurantoin iyathathwa bese igobhokwa izinsizwa cishe ngokushesha. Ikozigxilisa emchameni nasezicutini zesinqena, okwenza kube umuthi omuhle kakhulu we-cystitis, futhi okubuye kubangela ukuthi ungabi namandla kuyo yonke indawo. Izicubu zesitho sangasese sowesifazane aziluboni nini ubuqeqeshi obanele.

Ibhayoloji eyisisekelo nayo ihlukile. I-BV iyisiphutha sokulahlekelwa i-Lactobacillus evikelayo ngokukhula okuningi kwe-anaerobes njenge-Gardnerella vaginalis kanye ne-Atopobium vaginae, hhayi ukuhlasela kwe-E. coli odongeni lwesinqena. Umuthi osebenza kuphela lapho uchama khona awukwazi ukulungisa ukungalingani esithweni sangasese sowesifazane.

Ukuthatha i-Macrobid esele ye-BV akugcini nje ngokuhluleka, kukubiza iviki

Ukufuna i-Macrobid esele ye-BV kuyindlela enengqondo ngokuphelele: unengxenye yebhodlela, uyakuqonda umuzwa, futhi isikhathi ngu-11 ebusuku. Inkinga ayikona ukuthi leli pilisi likulimaza. Inkinga yilezi zingqinamba eziyisikhombisa echitha ucabanga ukuthi isifo siyaphathwa lapho singaphathwa.

Lokho kubalulekile ngoba i-BV engelapheki noma elashwe ngokungalungile ixhumene nengozi enkulu yokuzalwa ngaphambi kwesikhathi, ukutheleleka kakhulu ngezifo ezidluliselwa ngocansi okubalwa kuzo i-HIV, nesifo sokupheluka kwamalungu. Lezi akuzona izizathu zokwesaba. Ziyizizathu zokungadlali iviki kumuthi obungayi kusebenza.

Sebenzisa lokhu njengokuzihlola kwakho: uma ukukhishwa okunomqondo we-BV kanye nephunga kungathuthukanga kungakapheli izinsuku ezingu-2 kuye kwezingu-3 kumjikelezo we-nitrofurantoin, umuthi awuthinti isifo esiyisisekelo, futhi impendulo iyokubuyekezwa kunokuba uchithe izinsuku ezengeziwe zepilisi elifanayo. Kufanele ukwazi futhi, i-BV iphindeka kubantu abangama-50% kuye kwabangu-80% kungakapheli unyaka ngisho nangemuva kokwelashwa okulungile. Esinye isizathu esengeziwe sokuqala ngomuthi olungile kanye nokutholwa kweqiniso kunokuba kube ngumlando.

Imithi eyenza ngempela ikhulule i-BV nge-metronidazole ne-clindamycin

Okwe ngempela kuwelapha i-bacterial vaginosis ngumjikelezo omfushane we-metronidazole noma i-clindamycin, unikezwe ngomlomo noma nge-vaginal. I-CDC's 2021 STI Treatment Guidelines ibeka izinketho ezintathu zokuqala: i-metronidazole yomlomo 500 mg kabili ngosuku izinsuku ezingu-7, i-metronidazole 0.75% vaginal gel kanye ngosuku izinsuku ezingu-5, noma i-clindamycin 2% vaginal cream ngaphambi kokulala izinsuku ezingu-7.

Kunezindlela ezinye, kufaka phakathi i-tinidazole ne-secnidazole, futhi ukukhetha phakathi kwalezi zonke kuyisinqumo sobuchwepheshe. Isimo sokukhulelwa, ukuthi zingaki izikhathi ozibonile, nokuthi ungabekezelela kangakanani i-metronidazole yomlomo konke kuguqula isinqumo, yingakho umelaphi kufanele asenze kunokuba kube umphumela wokufuna. I-MedlinePlus iphawula ukuthi i-BV yiyona nto eyenzeka kakhulu yokutheleleka kwesitho sangasese sowesifazane kwabesifazane abaneminyaka ephakathi kuka-15 no-44 futhi iyaphathwa ngamaphilisi okulwa namagciwane noma i-cream yomlomo noma i-gel, hhayi ngemithi enzelwe umgudu wokuchama.

Qedela umjikelezo wonke. Uphunga kanye nokukhishwa kuvame ukuzola ngaphambi kokuba amagciwane abuyele esimweni esilinganisiwe, futhi ukuqeda ngaphambi kwesikhathi kungenye yezizathu ezivamile zokuthi isifo eselaphiwe sibuye.

Uma udinga ukubonwa namuhla, i-August's $39 online urgent care visit ikuxhumanisa nomelaphi onelayisense lase-US ongahlola izimpawu zakho futhi ubhale imiyalelo lapho kufanele khona; umelaphi uyenquma, futhi ukubhalwa kuhlale kungaqiniseki. Zibekezele mayelana nemingcele: ukuvakashelwa kwevidiyo akukwazi ukwenza ukuhlolwa kwamathambo noma ukuqoqa isampula lesitho sangasese sowesifazane noma isiko, ngakho-ke isimo sokuqala, ukukhulelwa, noma ubuhlungu bamathambo kudinga ukunakekelwa ngqo. Ukuqhathanisa izinsizakalo zokwelapha i-BV online kungakusiza uma ungakhetha ukuthenga izinketho kuqala.

Izimpawu ziyafana kancane kunalokho ocabanga ngakho, i-BV kanye ne-UTI azizwa ngendlela efanayo

I-BV vs izimpawu ze-UTI zihlukanisa kucace kunalokho abantu abaningi abakujabulelayo, okufanele ukwazi uma uzama ukuthola ukuthi umuthi ongulungile wawuphume kanjani. I-BV ikhiqiza ukukhishwa okuncane okumhlophe, okumpunga, noma okuhlaza okotshani okunukusa kwezinhlanzi okujwayele ukuba namandla ngemuva kocansi, ngokuvamile ngaphandle kokushiswa lapho uchama. I-UTI ikhiqiza ukushisa noma ukuluma lapho uchama, ukufisa nokuvama, ingcindezi ephansi yesisu noma yamathambo, nomchamo ongacacile noma onukayo, ngaphandle kokushintsha ekukhishweni kwesitho sangasese sowesifazane. I-Macrobid ingeyekholamu yesibili, okuyiyona nesimo lapho ukufaniswa kwe-Macrobid ne-Bactrim ye-UTI kusho khona kakhulu.

Izinkinga ezimbili. Kufika ku-84% abantu abane-BV abanazo nhlobo izimpawu, ngakho-ke ukungabikho kwezimpawu akufakazeli lutho. Futhi ukuhlola i-UTI esekelwe emchameni akutholisi i-BV. Lokho kudinga isampula lesitho sangasese sowesifazane noma izinkambiso ezisekelwe ekuhloleni.

Uma umelaphi wakho ekubhalela imithi yomibili ngasikhathi sinye, lokho akuyona iphutha

Ungakwazi yini ukuba ne-BV kanye ne-UTI ngasikhathi sinye? Yebo, futhi inhlanganisela yinto eyenzeka njalo kangangokuthi odokotela bayilindele. I-Nitrofurantoin kanye ne-metronidazole yindlela efanele yokwelashwa okukabili: umuthi owodwa usebenza esinqeneni, omunye esithweni sangasese sowesifazane, futhi akekho ongathatha indawo omunye.

Ngakho-ke ungayeki i-metronidazole ngoba ukushisa emgudu wokuchama kuye kwaphela kuqala. Lezi yizifo ezihlukene ngezigqi ezihlukene, futhi umjikelezo we-BV usudinga ukuqedwa. Uma unikezwe imiyalelo eyodwa kuphela naphezu kwezimpawu ezindaweni zombili, buza ukuthi ngabe isifo sesibili sahlolwa yini.

Ezinye izimpawu ze-BV akumele zilinde umbono wesibili

Shayela ku-911 noma uye egumbini lezimo eziphuthumayo manje uma:

  • Unomkhuhla noma ukujuluka kokuza nokuhamba kanye nobuhlungu bamathambo noma besisu esingaphansi.
  • Ukuphatheka kwezicubu kubuhlungu kakhulu noma kuyanda, ikakhulukazi ngokuhlaza noma ukuhlanza.
  • Unokukhishwa okunukusa kabi kanye nomkhuhla noma uzizwa ugula kakhulu.
  • Unokuphuma kwegazi okukhulu esithweni sangasese sowesifazane okungahlobene nesikhathi sakho.
  • Ukhulelwe futhi unezinkontileka, ingcindezi yamathambo, ukuphuma koketshezi, noma ukuphuma kwegazi esithweni sangasese sowesifazane. Hamba emisebenzini yokubeletha.

Bhukha ukuvakashelwa kungakapheli isonto uma:

  • Uqede umjikelezo ogcwele wokulwa namagciwane bese ukukhishwa noma iphunga kuyaqhubeka.
  • Izimpawu zibuyele ngaphakathi kwamaviki ngemuva kokuqeda ukwelashwa.
  • Ube nezigameko ezintathu noma ngaphezulu ngonyaka.
  • Wathatha umuthi wokulwa namagciwane we-UTI ngezimpawu zesitho sangasese sowesifazane futhi akukho lutho olwashintsha.

Khuluma nomelaphi ngaphambi kokuba uqale uma:

  • Ukhulelwe noma uzama ukukhulelwa.
  • Uthatha imithi yokulwa namagciwane esele yanoma yiluphi uhlobo.
  • Wake wasabela kabi nge-metronidazole noma i-clindamycin ngaphambili.
  • Awuzange uhlolwe futhi lokhu kuyisimo sokuqala.

Imibuzo ejwayele ukubuzwa

Ngabe i-nitrofurantoin izwelapha yini i-yeast infection noma i-trichomoniasis esikhundleni sayo?

Cha. I-Nitrofurantoin i-antibacterial, ngakho ayinayo umthelela ku-yeast infection, okuyigciwane futhi ludinga ukwelashwa kwama-antifungal. I-Trichomoniasis yisifo samagciwane eselashwa ngemithi ye-nitroimidazole njenge-metronidazole noma i-tinidazole, umndeni ofanayo osetshenziselwa i-BV. Izimbangela ezintathu ezihlukene, izinhlobo zemithi ezintathu, futhi imithi yokulwa namagciwane yomgudu wokuchama ayizimbozi nanoma iyiphi kuzo.

Kubaba yini sengithathe i-Macrobid lapho empeleni bengine-BV?

Ngokuvamile cha. Ukuthatha umjikelezo we-nitrofurantoin lapho une-BV akubhebhetheki i-BV noma kulimaze imvelo yesitho sangasese sowesifazane ngendlela ehlala njalo. Ungase uthole imiphumela evamile yomuthi: isicanucanu, ubuhlungu bekhanda, noma umchamo onsundu-ophuzi, okuyinto engalungile. Intengo yangempela yisikhathi. Tshela umelaphi okubhalela lokho owakuthatha nokuthi nini, bese uhlolwa kahle.

Ngabe ukuhlolwa komchamo noma ukuhlolwa komchamo kungathola i-BV?

Cha. Ukuhlolwa komchamo kwenzelwe ukukhulisa izifo zomgudu wokuchama, futhi izinhlamvu ze-BV azizona lezo ezibika ngazo. Ukutholwa kwenziwa kusuka esithweni sangasese sowesifazane, kusetshenziswa isampula nge-microscopy yamahlamvu okhiye, i-pH yesitho sangasese sowesifazane, kanye novivinyo lwe-whiff, noma iphaneli lezindlela ezamukelwe zokubona amagciwane. Ukuhlolwa komchamo okuhlanzekile kanye nezimpawu zesitho sangasese sowesifazane kuvame kusho ukuthi isampula elingalungile laqoqwa.

Ngingaphuzwa utshwala ngenkathi ngithatha i-metronidazole ye-BV?

Cha. I-CDC incoma ukugwema utshwala ngesikhathi sokwelashwa nge-metronidazole kanye nangezinsuku ezingu-24 ngemuva komthamo wokugcina, ngoba inhlanganisela ingabangela ukujulukisa, isicanucanu, ukuhlanza, kanye nobuhlungu bekhanda. Lokhu kusebenza ku-metronidazole yomlomo ngokukhethekile. Uma usebenzisa indlela ehlukile, qinisekisa isikhathi sokuqeda ngqo nomdodisi wakho.

Ingabe i-BV ingaphela yodwa ngaphandle kwemithi yokulwa namagciwane?

Ngezinye izikhathi. Ezinye izimo ziphela ngaphandle kokwelashwa njengoba i-Lactobacillus ibuyela emuva, kodwa akukho ndlela eqinisekile yokubikezela ukuthi lokhu kuzokwenzeka kubani, futhi ukulinda akuyona inketho enhle ngesikhathi sokukhulelwa noma lapho unezinhlungu zamathambo. Uma kucatshangelwa isilinganiso sokuphindeka ngisho nangemva kokwelashwa, i-BV enezimpawu kufanele ilashwe kahle kunokuba ibukelwe.

Isiphetho nge-nitrofurantoin ne-BV

Ungakwazi yini iNitrofurantoin ukwelapha iBV? Cha. I-Macrobid iphathelene nezifo zesinqena ngoba ikogoza emchameni kunokuba ezicutini zesitho sangasese sowesifazane, okuyinto enqekayo okungakwazi ukulungisa i-bacterial vaginosis. I-Metronidazole noma i-clindamycin izokwenza. Uma izinsuku ezimbili kuya kwezintathu emgqonyeni ongulungile kungashintshanga lutho, hlolwa esikhundleni sokuphinda ugcwalise lokho okusele ebhodleleni.

Isitatimende: Lesi sihloko senzelwe izinjongo zolwazi kuphela futhi akusona iseluleko sezokwelapha. Hlala udadlana nodokotela oqeqeshiwe ukuze uthole izinqumo zokuthola kanye nokwelashwa. Uma uhlangabezana nesimo esiphuthumayo sezokwelapha, shayela ku-911 noma uye egumbini lezimo eziphuthumayo eliseduze ngokushesha.