Bungwe la Infectious Diseases Society of America pakali pano limalimbikitsa amoxicillin ndi ampicillin, maantibayotiki a aminopenicillin (AP), ngati mankhwala osankhidwa pochiza.enterococcusUTIs.2 Kuchuluka kwa enterococcus yosamva ampicillin kwachuluka.

Makamaka, zochitika za vancomycin zosagwiraenterococci(VRE) yawonjezeka pafupifupi kuwirikiza kawiri m'zaka zaposachedwa, ndipo 30% ya matenda a enterococcal isolate akunenedwa kuti samva vancomycin.3 Kutengera muyeso wamakono wa Clinical and Laboratory Standards Institute,EnterococcusMitundu yokhala ndi zoletsa pang'ono (MIC) ≥ 16 μg/mL imatengedwa kuti imalimbana ndi ampicillin.

Ma laboratories a Microbiology amagwiritsa ntchito malo omwewo mosasamala kanthu za malo omwe ali ndi kachilomboka. Pharmacokinetic, pharmacodynamics, ndi deta yoyesera yachipatala imathandizira kugwiritsa ntchito maantibayotiki a aminopenicillin pochiza matenda a enterococcus UTIs, ngakhale pamene odzipatula ali ndi MIC yomwe imaposa chiopsezo cha breakpoint.4,5

Chifukwa maantibayotiki a AP amatsukidwa kudzera mu impso, titha kukwaniritsa kuchuluka kwambiri mumkodzo kuposa m'magazi. Kafukufuku wina adawonetsa kuchuluka kwa mkodzo wa 1100 μg/mL wosonkhanitsidwa patatha maola 6 mutangomwa mlingo umodzi wa amoxicillin 500 mg.

Kafukufuku wina adasanthula ampicillin-resistantenterococcus faecium(E. Faecium) mkodzo umalekanitsa ndi ma MIC omwe amanenedwa a 128 μg / mL (30%), 256 μg / mL (60%), ndi 512 μg / mL (10%).4 Pogwiritsa ntchito deta kuchokera ku mayeserowa, ndizomveka kunena kuti AP concentrations kufika ndende yokwanira mu mkodzo thirakiti kuchiza ambiri akuti kusamva matenda.

Mu kafukufuku wina, adapezeka kuti ampicillin-resistantE. faeciumzodzipatula za mkodzo zinali ndi ma MIC osiyanasiyana, okhala ndi MIC yapakatikati ya 256 μg/mL5. Zopatula 5 zokha zomwe zinali ndi mtengo wa MIC> 1000 μg/mL, koma zodzipatula zonsezi zinali mkati mwa 1 dilution ya 512 μg/mL.

Maantibayotiki a penicillin amawonetsa kupha kutengera nthawi ndipo kuyankhidwa koyenera kudzachitika bola ngati mkodzo wachuluka kwambiri kuposa MIC kwa nthawi yosachepera 50% ya nthawi ya mlingo. chithandizoEnterococcusmitundu, komanso osamva ampicillinenterococcusodzipatula mu UTIs otsika, bola ngati atamwa moyenerera.

Kuphunzitsa olembera ndi njira imodzi yomwe tingachepetsere kuchuluka kwa maantibayotiki ambiri omwe amagwiritsidwa ntchito pochiza matendawa, monga linezolid ndi daptomycin. Njira ina ndikukhazikitsa ndondomeko m'mabungwe omwe angathandize kutsogolera olembera kuti agwirizane ndi malangizo omwe aperekedwa.

Njira imodzi yabwino yothanirana ndi vutoli imayambira mu labu ya microbiology. Malo odulira mkodzo angatipatse chidziwitso chodalirika chazovuta; komabe, izi sizikupezeka kwambiri pakadali pano.

Zipatala zambiri zidasiya kuyezetsa chizolowezi chawoenterococcusmkodzo umadzilekanitsa ndikunena kuti onse amatengeka nthawi zonse ndi aminopenicillins.6 Kafukufuku wina adawonetsa zotsatira za chithandizo pakati pa odwala omwe amathandizidwa ndi VRE UTI ndi AP antibiotic poyerekeza ndi omwe amachiritsidwa ndi mankhwala osagwiritsa ntchito beta-lactam.

Mu kafukufukuyu, chithandizo cha AP chinkawoneka chogwira ntchito nthawi zonse, mosasamala kanthu za kutengeka kwa ampicillin. Mkati mwa gulu la AP, wothandizira wodziwika kwambiri yemwe adasankhidwa kuti adziwe chithandizo chotsimikizika anali amoxicillin wotsatiridwa ndi mtsempha wa ampicillin, ampicillin-sulbactam, ndi amoxicillin-clavulanate.

Mu gulu losakhala la beta-lactam, wothandizira wodziwika kwambiri yemwe adasankhidwa kuti athandizidwe bwino anali linezolid, kenako daptomycin ndi fosfomycin. Mlingo wa chithandizo chamankhwala unali 83.9% odwala mu gulu la AP ndi 73.3% mu gulu losakhala la beta-lactam.

Kuchiza kwachipatala ndi AP therapy kunawonedwa mu 84% ya milandu yonse ndi 86% ya odwala omwe ali ndi zodzipatula zolimbana ndi ampicillin, popanda kusiyana kwachiwerengero komwe kunapezeka pakati pa zotsatira za omwe adalandira mankhwala omwe si a β-lactam.