I-Infectious Diseases Society yaseMelika ngoku icebisa i-amoxicillin kunye ne-ampicillin, i-aminopenicillin (AP) antibiotics, njengamachiza akhethiweyo onyango.i-enterococcusUTIs.2 Ukuxhaphaka kwe-enterococcus echasene ne-ampicillin iye yanda.

Ngokukodwa, iziganeko ze-vancomycin-resistanti-enterococci(I-VRE) iphantse yaphindaphindeka kabini kwiminyaka yakutshanje, kunye ne-30% yeekliniki ze-enterococcal isolates ezichazwe njengezichasene ne-vancomycin.3 Ngokusekelwe kumgangatho wangoku we-Clinical and Laboratory Standards Institute,Enterococcusiintlobo ezine-concentration encinci ye-inhibitory (MIC) ≥ 16 μg / mL zibhekwa njenge-ampicillin-resistant.

Iilebhu zeMicrobiology zisebenzisa le ndawo yoqhawulo nokuba yeyiphi na indawo yosulelo. I-Pharmacokinetic, i-pharmacodynamics, kunye nedatha yovavanyo lweklinikhi ixhasa ukusetyenziswa kwe-aminopenicillin antibiotics kunyango lwe-enterococcus UTIs, nangona i-isolates ine-MIC edlula i-breakpoint susceptibility.4,5.

Ngenxa yokuba ii-antibiotics ze-AP zicocwa ngezintso, sinokufikelela kwiindawo eziphezulu kakhulu kumchamo kunomsinga wegazi. Olunye uphononongo lukwazile ukubonisa umyinge wokuxinana komchamo we-1100 μg/mL oqokelelwe ngaphezulu kweeyure ezi-6 emva kwedosi nje enye yomlomo ye-amoxicillin engama-500 mg.

Olunye uphando luhlalutye i-ampicillin-resistanti-enterococcus faecium(E. IFaecium) umchamo uhlukanisa kunye ne-MICs exeliweyo ye-128 μg / mL (30%), i-256 μg / mL (60%), kunye ne-512 μg / mL (10%).4 Ukusebenzisa idatha kwezi zilingo, kunengqiqo ukutsho ukuba i-AP concentrations ukufikelela kugxininiso olwaneleyo kumzila womchamo ukunyanga izifo ezininzi ezixeliweyo ezixhathisayo.

Kolunye uphononongo, kwafunyaniswa ukuba i-ampicillin-resistantE. ifaeciumUkuhlukaniswa komchamo kwakune-MICs ezahlukeneyo, kunye ne-MIC ephakathi kwe-256 μg / mL5. Ii-isolate ezi-5 kuphela zinexabiso le-MIC> 1000 μg/mL, kodwa nganye kwezi zodwa yayingaphakathi kwe-1 dilution ye-512 μg/mL.

I-antibiotics ye-Penicillin ibonisa ukubulawa kwexesha elixhomekeke kwixesha kunye nempendulo efanelekileyo iya kwenzeka nje ukuba ukugxininiswa komchamo kungaphezulu kwe-MIC ubuncinane ubuncinane be-50% yexesha le-dosing. phathaEnterococcusiintlobo, kodwa kunye ne-ampicillin-resistanti-enterococcuszibekwe zodwa kwii-UTIs ezisezantsi, ukuba nje ithamo elifanelekileyo.

Ukufundisa amayeza yenye indlela esinokunciphisa ngayo umlinganiselo wamayeza okubulala iintsholongwane abanzi asetyenziselwa ukunyanga olu sulelo, olufana ne-linezolid kunye ne-daptomycin. Enye indlela kukuphuhlisa iprothokholi kwiziko ngalinye ukunceda ukukhokela ababhalisi malunga nemigqaliselo ejolise kwisikhokelo.

Enye yeendlela ezilungileyo zokulwa le ngxaki iqala kwilebhu ye-microbiology. Iindawo zokuqhawula umchamo ngokuthe ngqo zinokusinika idatha ethembekileyo yokuchaphazeleka; nangona kunjalo, oku akufumaneki ngokubanzi ngeli xesha.

Izibhedlele ezininzi ziye zaluyeka uvavanyo lwazo lokuba sesichengenii-enterococcusi-urinary isolate kwaye ichaze zonke njengesiqhelo ezithintekayo kwi-aminopenicillins.6 Olunye uphando luvavanye iziphumo zonyango phakathi kwezigulane eziphathwa nge-VRE UTI kunye ne-AP antibiotic xa kuthelekiswa nalabo baphathwa nge-non-beta-lactam antibiotic.

Kolu phononongo, unyango lwe-AP lwaluthathwa njengento esebenzayo kuzo zonke iimeko, kungakhathaliseki ukuba buthathaka kwe-ampicillin. Ngaphakathi kweqela le-AP, eyona arhente ixhaphakileyo ekhethelwe unyango oluqinisekileyo yayiyi-amoxicillin elandelwa yi-ampicillin ene-intravenous, ampicillin-sulbactam, kunye ne-amoxicillin-clavulanate.

Kwiqela le-non-beta-lactam, i-arhente eqhelekileyo ekhethiweyo yonyango oluchanekileyo yayiyi-linezolid, ilandelwa yi-daptomycin kunye ne-fosfomycin. Izinga lokunyangwa kweklinikhi laliyi-83.9% yezigulane kwiqela le-AP kunye ne-73.3% kwiqela le-non-beta-lactam.

Ukunyangwa kweklinikhi ngonyango lwe-AP kwabonwa kwi-84% yazo zonke iimeko kunye ne-86% yezigulane ezine-ampicillin-resistant isolate, kungekho mahluko wezibalo ofunyenweyo phakathi kweziphumo zabo baphathwa ngee-non-β-lactam.