Ngokuvamile akukona ukungezwani komzimba. Umkhuhlane owavela ezinsukwini ezimbalwa ngemva kokuqala ukuthatha i-amoxicillin uvame ukuba umkhuhlane ongajwayelekile wemithi, uvamise ukubangelwa yi-virus owayenayo wena noma umntanakho. Esinye isifundo esingokuhlolwa kabusha, kungu-6.8% kuphela wezingane ezazibhalwe ukuthi azibekezeleli i-amoxicillin ezaziphendula ngempela lapho zihlolwa futhi. Isikhathi nezibonakaliso zengozi kusho umehluko.

Okubalulekile okumele ukwazi:

  • Imikhuhlane eqala ezinsukwini ngemva kokuqala ukuphuza umuthi ivame ukuba ingezwani nomzimba; ukusabela okusheshayo kuqala cishe ngehora.
  • Izindawo ezizacile, ezibomvu, ezihlangene, ezibuye zihlabele kancane emzimbeni yizo ezingajwayelekile.
  • Ukubhakabhaka, ukuqhwetshuka, izilonda emlonyeni noma emehlweni, ukuqunjelwa ubuso nomkhuhlane, noma ubunzima bokuphefumula yizimo eziphuthumayo.
  • Imikhuhlane eminingi eyajwayelekile iyanyamalala cishe ngesonto.
  • Ungazibandakanyi ngokwakho njengomuntu ongelakho i-penicillin. Hlola ukusabela esikhundleni salokho.

Imikhuhlane eminingi ye-amoxicillin iyimiphumela eseceleni, hhayi ukungezwani komzimba

Umkhuhlane owavela ezinsukwini ezimbalwa ngemva kokuqala ukuphuza i-amoxicillin uvame ukuba umkhuhlane ongajwayelekile ongabangelwa ukungezwani komzimba kunokuba kube ukungezwani komzimba kwangempela. Ngokuvamile uwuphaphathekile, ubomvu, uhlangene, futhi uvame ukuvela ngosuku lwesine noma lwesihlanu, kaningi ngenkathi i-virus isivele isebenza. Ukungezwani komzimba kwangempela kuchazwa ngesikhathi nezimpawu ngaphezu kwesikhumba.

Ubufakazi obuqinile kulokho buvela ekuhlolweni kabusha. Esikhundleni sako, ezingane eziyi-88 ezazibhalwe ukuthi azibekezeleli i-penicillin noma i-amoxicillin ngemva komkhuhlane, kungu-6.8% kuphela (ezingane eziyisithupha) ezaziphendula lapho umuthi ubuyiselwa ngokuqondiswa ngaphansi kokuqondiswa. Ukuvela komkhuhlane wokuqala kwakungamaviki angu-4.9 ngemuva komthamo wokuqala, futhi u-65.9% wezingane eziphumelele ukuhlolwa kwazithola zinog viroshini oluqinisekisiwe oluqhubekayo ngesikhathi esifanayo.

Lona lona ubuchopho busetshenziswa nabantu abadala. Cishe u-8% kuya ku-10% wabantu e-United States banomlando wokungezwani komzimba kwe-penicillin, kodwa ngaphezu kuka-90% wabo bayakwazi ukubekezelela i-penicillin ekuhlolweni okuqondile. Umlando, kunokuba kaningi, ungamanga.

Isikhathi sikunikeza okuningi kunomkhuhlane ngokwawo

Uma umuntu ebiza umkhuhlane we-maculopapular, ukusabela okujwayelekile kwesikhumba kwe-amoxicillin, ukuhumusha okulula ukuthi izindawo ezibomvu ezizacile kuya phezulu ezingase zihlanganiswe, ngokuvamile ziqala emzimbeni zisakazeke ngaphandle.

Okwenza umehluko phakathi kokujwayelekile nokukhathazayo ukuthi laqala nini, hhayi ukuthi libukeka kanjani. Ukusabela kwangempela kwe-IgE-mediated, uhlobo olusheshayo, ngokuvamile luqala cishe ngehora ngemva komthamo. Umkhuhlane obambezelekile, owenziwa yi-T-cell, ufika ezinsukwini futhi uthinta abantu abangu-7% abathatha ama-aminopenicillin. Izimungumungwane ziyizindawo eziphakeme ezihlabayo kakhulu, ezithutha emzimbeni, futhi zinyamalala endaweni eyodwa ngehora. Umkhuhlane obambezelekile uhlala, usakazeka ngendlela efanayo, futhi ubabaza kancane noma ungabhabhazi nhlobo. Ukuhlolwa kwesikhumba akudingeki ngakho.

Nansi into abaningi abayisho: akukho umthetho we-inthanethi ongatshelwa ukuba umuntu odokotela abuka isikhumba. Izinto eziningi zibangela umkhuhlane obabazayo esiswini, futhi isikhathi ongasinikeza wena noma umntanakho sibaluleke kakhulu kunanoma yikuphi uchwepheshe obukayo.

Ukusabela kwe-Amoxicillin kufika ngezindlela ezintathu, hhayi ezimbili

Izimpawu zokungezwani komzimba kwe-amoxicillin ngokuvamile ziboniswa njengezinketho ezimbili, umkhuhlane ongaboni noma i-anaphylaxis, futhi lokho kuhlukaniswa kushiya isigaba esiphakathi esithumela abantu ezindaweni eziphuthumayo bedidekile. Izindlela ezintathu ezibalulekile ukuzazi.

  • Okusheshayo, okwenziwa yi-IgE-mediated: izimungumungwane, i-angioedema (ukuqunjelwa kwezindebe, ulimi, noma ubuso), ukugquma, noma i-anaphylaxis, ngaphakathi kwehora ngemva komthamo.
  • Ukusabela okufana nesifo sokuqina: umkhuhlane kanye nobuhlungu bamalunga noma ukuqunjelwa kanye nomkhuhlane, okuvela cishe isonto kuya kwamathathu ngemva kokuqala. Lokhu akulona umkhuhlane ojwayelekile wosuku lwesihlanu noma izimungumungwane ezisheshayo.
  • Izimo ezingajwayelekile ezimbi ezibambezelekile: i-Stevens-Johnson syndrome kanye ne-toxic epidermal necrolysis (ubuhlungu besikhumba, ukuqunjelwa, ukuqhwetshuka, izilonda emlonyeni, emehlweni, noma ezithweni zangasese), kanye ne-DRESS syndrome (umkhuhlane, ukuqunjelwa ubuso, amalunga akhandiwe, ngokuvamile amasonto amabili kuya kwamathathu).

I-Stevens-Johnson syndrome ngokuvamile izibonakalisa izinsuku ezimbalwa ngaphambi komkhuhlane ngezigulo ezifana ne-flu: umkhuhlane, amehlo avuthayo, umphimbo noma umlomo obuhlungu. Uma wena noma umntanakho nazo lezi zimpawu kanye nomkhuhlane omusha, leyo nhlanganisela idlula konke okunye kuleli khasi.

Ingabe umkhuhlane we-amoxicillin uyingozi? Ngokungajwayelekile, kodwa izibonakaliso ezine yizona ezingezinhle

Umkhuhlane we-amoxicillin cishe awulona uyingozi. Izimo ezingezinhle ziyachazeka, futhi ziyabonakala ngaphandle kwesiqu esiqeqeshiwe.

Shayela u-911 noma uye esibhedlela esiphuthumayo manje uma:

  • Izindebe, ulimi, ubuso, noma umphimbo kuqunjela, noma ukuphefumula noma ukugwinya kunzima, ngemizuzu noma amahora ngemva komthamo.
  • Izimungumungwane zisaksazeka ngokushesha ngeziyobisi, ukushoda, noma isivinini, ukushaya kwenhliziyo okubuthakathaka.
  • Isikhumba sibuhlungu, sibhakabhaka, noma siqhwetshuka, noma kunezilonda emlonyeni, emehlweni, noma ezithweni zangasese, ikakhulukazi nomkhuhlane. I-Mayo Clinic ikhuluma ngokuphuthumisa u-911 ngokushesha ngezigulo ezinjalo.
  • Kukhona ukugquma noma ubunzima bokuphefumula nomkhuhlane.

Bhuka ukuvakashela ngaphakathi nesonto elizayo uma: umkhuhlane usasazeka noma ungashintshi ngemva kweviki; umkhuhlane kanye nobuhlungu bamalunga kuvela ngesonto kuya kwamathathu; amalunga akhandiwe kanye nokuvuvukala kobuso; noma umane ufuna ukuthi ukusabela kudokhiswe kahle eshadini.

Khuluma nodokotela ngaphambi kokuthi uqale uma: wena noma umntanakho nanolunye uhlobo lomkhuhlane ku-penicillin ngaphambi kwalokho; umlando wokungezwani komzimba awuzange uhlolwe; kunezigulo ze-mono manje; noma omunye umuthi omusha waqala ngesikhathi esifanayo.

Isizathu sokuthi kungani ibhakabhaka libe phezulu: i-toxic epidermal necrolysis ihlanganisa ukuqhwetshuka nokwakha esikhundleni esingaphezu kuka-30% womzimba ngeziqhwamu zamehlo, umlomo, umgudu wokuphefumula, nezitho zangasese, idinga ukunakekelwa kwe-ICU noma izindawo zokusha, futhi inezinkulu ezingaba ngu-25% zokubulala. Uma unganaso isiqiniseko ukuthi yikuphi ukwelashwa osukwini lwakho, i-August AI Symptom Checker yamahhala ingakusiza ukuthi uhlukanise izimo eziphuthumayo ngemizuzu embalwa. Akufanele ithathe indawo yokushayela u-911 lapho izibonakaliso ezingenhla zisebenza.

Izingane ezincane zithola lo mkhuhlane kakhulu, futhi i-mono yikho izinombolo ezibukeka ziyinqaba

Umkhuhlane we-amoxicillin enganeni encane iyona inganekwane ejwayeleke kakhulu yale ndaba, ngoba izingane ezincane zithola izifo zendlebe nomgogodla ezilashwa nge-amoxicillin ngenkathi zidlula kuma-virus kakhulu. Izimbangela ezimbili, isikhumba esisodwa.

Lokho kuhlangana kuchaza izinombolo ezididiyelayo. Amanani emikhuhlane yemithi ayelula afika ku-5% kuya ku-10%, kodwa umkhuhlane ngemva kwe-amoxicillin ku-infectious mononucleosis kwakubalwa ngokomlando ku-80% kuya ku-100% wezigameko, nakuba izifundo zakamuva zibeka isibalo sangempela sibe ngaphansi kakhulu. Amathuba akho omntanakho ancike kakhulu ekutheni kune-virus esebenza. Ubufakazi obubuyayo futhi bubonisa ukuthi imikhuhlane ethile ehlobene ne-mono ingukusabela okubambezelekile okwangempela komuthi, yingakho ukuqhubeka kokulandelwa okuqeqeshiwe kungcono kunezikhathi zokucabanga ukuthi yayingelona ingozi.

Enganeni encane kakhulu ukuthi ingachaza izimpawu, buka izilonda zomlomo, ukwenqaba ukuphuza, ukudlulisa noma ubunzima bokugwinya, ukulala okungajwayelekile, kanye nomkhuhlane okhulayo kunokuba ubuyele emuva.

Umkhuhlane uyanyamalala ngokwawo; ukuyeka i-antibiotic kungabiza kakhulu kunokulondoloza

Imikhuhlane eminingi ihlala cishe izinsuku ezimbili kuya kweyisithupha, ngokwesilinganiso izinsuku ezingu-3.8 esifundweni sokuhlolwa kabusha sezingane eziyi-88. Ivame ukubukeka ibi kakhulu ngaphambi kokuba iphume, futhi ingase ibe mnyama noma ibe nzima njengoba iyanyamalala.

Ukufuna ukuyeka i-antibiotic ngokushesha kuyavumeleka futhi kaningi kube yiphutha. Ukuyeka ukuqedela umuthi ngokusekelwe kumkhuhlane kuphela kubeka engozini ukungaphuthumisi isifo, ukushintshela okungadingekile kumuthi obanzi futhi obiza kakhulu, kanye nomlando wokungezwani komzimba ongahlala njalo okuhamba wena noma umntanakho iminyaka. Lona umsebenzi odokotela oye wabona umkhuhlane, hhayi esikhundleni sesiphumo sokusesha.

Uma udinga lesi sicelo ngokushesha, ukuvakashelwa kwe-online urgent care kubiza u-$39 futhi udokotela ogunyaziwe e-US ubuyekeza isikhathi futhi anqume ukuthi incwadi kadokotela noma ukushintsha kuyafaneleka yini. Lokho i-telehealth ingakwazi ukukwenza ukuhlola isikhumba esibhakabhakayo, izilonda zemithambo, noma inkinga yomgudu wokuphefumula, zonke lezi zidinga ukunakekelwa esibhedlela. Kumkhuhlane odlula isikhathi esilindelekile noma uhlangana nohlobo lwemikhuhlane kanye nezinye izimila ezibuyayo, cela ukuthi kuhloliswe.

Umkhuhlane owodwa akumele ube umlando wokungezwani komzimba kwe-penicillin impilo yonke

Ukuzinqumela wena ukuthi lokhu kwakungukusabela komzimba kwe-amoxicillin ngokuvamile kuyabiza kakhulu kunomkhuhlane ngokwawo, ngoba ngaphezu kuka-90% wabantu abane-penicillin allergy label babekezelela ama-penicillin ekuhlolweni okuqondile. Umlando kukukhuthaza noma umntanakho ukuba usebenzise izinto ezibanzi lapho i-amoxicillin elula, ebizwa ngaphansi kuka-$20 ngaphandle komshwalense, yayiyosebenza.

Rekhoda imininingwane ngenkathi isekhona: igama lemithi, usuku, zingaki amahora noma izinsuku ngemva komthamo umkhuhlane waqala, wawubukeka kanjani, kwakukhona yini umkhuhlane, ukuqunjelwa, noma ubunzima bokuphefumula, nokwenzeka ngemva kokuthi uyekile. Nikeza lokho kulo lonke udokotela ozohlola esikhathini esizayo.

Ukuhlolwa kokungezwani komzimba noma ukuvivinya ngomlomo okuqondiswe kungasusa umbhalo ongagunyaziwe ungakhohlisiwe. Ithuluzi eliqinisekisiwe le-PEN-FAST line-96.3% negative predictive value, futhi iziguli ezingezona ingozi zingase zinikezwe i-carbapenem ngaphandle kokuhlolwa kwangaphambili. Cela ngalokho ekuvakasheni okujwayelekile okulandelayo.

Imibuzo evame ukubuzwa

Ngabe umkhuhlane we-amoxicillin usho ukuthi ingane yami ayibekezeleli ne-cephalosporins nezinye izidakamizwa?

Ngokuvamile akunjalo. Umkhuhlane obambezelekile ku-amoxicillin uthi kancane kakhulu mayelana nokubekezelela izigaba zezinye izidakamizwa. Ukuhlangana phakathi kwama-penicillins nama-cephalosporins kungaphansi kakhulu kunalokho okwafundiswa isizukulwane esedlule, futhi abantu abaningi abaphendula komunye bayakwazi ukubekezelela omunye. Ngenisa umlando obhalisiwe kunoma yimuphi udokotela esikhundleni sokugwema izigaba ezibanzi ngokucabanga.

Ingabe umkhuhlane we-amoxicillin ungozini kwezinye izindlu emzini?

Cha. Umkhuhlane wemithi awusakazeki kumuntu komunye. Okungasakazeka yisifo esifihlekile esasidinga i-antibiotic, kanye ne-virus engase yandise umkhuhlane. Uma umzalwane ethola umkhuhlane ofanayo ngaphandle kokuthatha umuthi, lokho kubonisa uhlobo olufanayo lwe-viral illness kunokuba lubonise umuthi.

Ingabe umkhuhlane we-amoxicillin ungase uqale ngemva kokuthi umthamo wokugcina usuphelile?

Yebo. Izimo ezingezinhle ezibambezelekile zenziwa yi-T cells, ezidinga izinsuku ukuba ziqale, ngakho-ke umkhuhlane ungavela ezinsukwini ezimbalwa ngemva komthamo wokugcina. Lokho kusavunyelaniswa nohlobo olujwayelekile. Qaphela isikhala esiqondile phakathi komthamo wokugcina namachashaza okuqala, ngoba yilokho udokotela wezindaba zomzimba oyobuzwa kuqala.

Abantu abadala bathola umkhuhlane we-amoxicillin ngendlela ehlukile kunezingane?

Kwesinye isikhathi. Abantu abadala babika ukulunywa okuningi futhi banokwenzeka kakhulu ukuthi bathathe imithi eyengeziwe, okwenza kube nzima ukuthi yimiphi imithi enesibopho. Abantu abadala futhi banezibonakaliso zokungezwani komzimba ezivela ebuncaneni ezingazange ziqinisekiswe. Imithetho yesikhathi iyalingana, kodwa abantu abadala kufanele babhale zonke izithako nemiyalelo yezidakamizwa eyayiqalisiwe ngenyanga edlule.

Ingabe ukuqhwetshuka kwesikhumba njengoba umkhuhlane uyanyamalala kuyisibonakaliso esibi?

Ngokuvamile akunjalo. Ukuhlaba okulula, okuyizici njengoba umkhuhlane ophuma uhlanzekile kulula futhi akubuhlungu, kakhulu njengesikhumba ngemuva kokushiswa yilanga. Okubalulekile umehluko kusuka ekuphumuleni okubuhlungu, okufana nezingubo, lapho isikhumba siyeka kancane izingxenye ezinkulu, indawo engaphezulu iyavuthisa uma kuyathintwa, noma izitho zomzimba ziyabonakala. Lona uhlobo uyiphuthumisi, hhayi isigaba sokuphulukisa.

Umlayezo wokugcina

Ngezikhathi eziningi, umkhuhlane we-amoxicillin uyinto ejwayelekile, eyaziwa ukuthi iyanyamalala ngaphakathi kweviki futhi ayisho lutho ngezinketho zezidakamizwa zesikhathi esizayo. Isikhathi siyahlukanisa kusukela ekungezwani komzimba kwangempela: ngaphakathi kwehora kukhathazekile, izinsuku ngamakhambi ngokuvamile akunjalo. Thola ukusabela kuhlolwe, futhi wenqabe umbhalo ongahlala njalo kuze kube yilapho othile ehlole.

Ukuzihlangula: Lesi sihloko sinemibono yokwazisa kuphela futhi asisho ukuthi siyisidingo sezokwelapha. Njalo xhumana nodokotela ofanelekayo ukuze uthole isiphetho nezimiso zokwelapha. Uma ubhekene nesimo sezempilo esiphuthumayo, shayela u-911 noma uye esibhedlela esiphuthumayo esiseduze ngokushesha.