PHN LOI KHNG SINHTnKSMt s i din
Cc Penicilin
Pen. GPen.G v Pen. V
Pen. MMeticilin, Oxacilin, Cloxacilin, Nafcilin
Pen. AAmpicilin v tin cht Amoxicilin
Dit P. aeruCarbenicilin,Ticarcilin, Piperacilin
CephalosporinTh h 1Cephalexin, Cefazolin, Cefadroxin
Th h 2Cefaclor, Cefuroxim, Cefoxitin
Th h 3Cefotaxim, Ceftriaxon, Ceftazidim, Cefoperazon,
Cefixim*
Th h 4Cefepim, Cefpirom
Betalactamin +Khng betalactamaseAmpicilin /
Sulbbactam,Amoxicilin / a.ClavulanicTicarcilin / a.
ClavulanicCefoperazol / Sulbactam
Monobactam(Dit P.aeruginosa)Aztreonam, Carumonam, Tigemonam
Carbapenem(Dit B. fragilis)Imipenem, Meropenem,Thienamycin, Acid
Olivanic
AminosidStreptomycin, Kanamycin, Neomycin
Gentamicin -> Tobramycin, Netilmicin -> Dibekacin ->
Amikacin
Macrolid14 CErythromycin, Clarithromycin, Roxithromycin.
15 CAzithromycin
16 CSpiramycin, Josamycin, Midecamycin
QuinolonTh h I* Acid nalidixic, Acid pipemidic
Th h II* Norfloxacin, Ciprofloxacin, Pefloxacin, Ofloxacin,
Lomefloxacin, Sparfloxacin, Gemefloxacin...
CyclinTh h 1Tetracyclin, Oxitetracyclin
Th h 2Doxycyclin, Minocyclin
PhenicolCloramphenicol, Thiamphenicol
LincosamidLincomycin, Clindamycin
Dit MRSA:SynergistinPristinamycin
FusidaninAcid fusidic
GlycopeptidVancomycin, Teicoplanin
Polypeptid(Polymycin)Polymycin B (Colistin)
Co-trimoxazolSulfamethoxazol / Trimethoprim
ImidazolMetronidazol, Tinidazol, Secnidazol, Ornidazol
TrchNguyn tc s dng khng sinh-GS.TSHong Kim HuynCC LOI THUC KHNG
SINH (ANTIBIOTICS) - Do LQT Bin Dch10:53 PMTHAMKHAOYHOCNO
COMMENTS-Mc d cc bc s mun s dng cc loi thuc khng sinh (thuc tr
sinh) iu tr cho cc bnh nhim trng c bit do vi khun gy ra, nhng i khi
cc bc s cng c th bt u cho s dng thuc khng sinh m khng cn phi i cc
kt qu xt nghim nhn dng vi khun c th.-Vi khun c th pht trin tnh nng
khng i vi tc dng ca cc loi thuc khng sinh (thuc tr sinh).-S dng
thuc khng sinh (thuc tr sinh) theo ch dn, thm ch sau khi cc triu
chng bin mt, l rt cn thit cha khi hn s nhim trng v ngn nga s pht
trin tnh nng khng trong cc vi khun.-Cc loi thuc khng sinh (thuc tr
sinh) c th c tc dng ph, chng hn nh au d dy, tiu chy, vnhim nm men m
o ph n(vaginal yeast infections).-Mt vi ngi b d ng vi mt s loi thuc
khng sinh (thuc tr sinh).
Khng sinh (khng khun) l cc loi thuc c ngun gc hon ton hoc mt phn
t vi khun hoc cc loi nm mc, v c dng cha tr cc bnh nhim trng do vi
khun gy ra. Chng khng c tc dng chng li cc bnh nhim trng do virt v
nm gy ra. Cc loi thuc khng sinh (thuc tr sinh) c tc dng tiu dit cc
loi vi sinh vt hoc lm ngng qu trnh sn sinh ca chng, cho php h thng
phng th t nhin ca c th loi b cc loi vi sinh vt ny.
LA CHN THUC KHNG SINH
Mi loi thuc khng sinh (thuc tr sinh) ch c tc dng chng li mt s
loi vi khun nht nh. Trong vic la chn loi thuc khng sinh cha tr cho
ngi b nhim trng, cc bc s s d on loi vi khun c kh nng gy ra bnh. V
d, mt s bnh nhim trng ch do mt s loi vi khun nht nh gy ra. Nu nh mt
loi thuc khng sinh c d on l c tc dng chng li tt c cc loi vi khun,
th khng cn thit phi xt nghim thm na. Nu tnh trng nhim trng c th do
nhiu loi vi khun khc nhau hoc mt loi vi khun gy ra m c d on l khng
b nh hng bi thuc khng sinh, th xt nghim s c yu cu thc hin xc nh cc
loi vi khun gy ra tnh trng nhim trng t cc mu mu, nc tiu, hay m ly t
bnh nhn . Cc loi vi khun gy nhim trng ny sau c th nghim tnh nhy cm
vi cc loi thuc khng sinh khc nhau. Kt qu ca cc xt nghim ny thng mt
t mt n hai ngy v do khng th ch dn s la chn ban u v vic s dng thuc
khng sinh.
Cc loi khng sinh (thuc tr sinh) c hiu qu trong phng th nghim th
khng nht thit s c tc dng i vi ngi b nhim bnh. Hiu qu ca vic iu tr
da vo mc thuc c hp th vo mu, s lng thuc n c nhng ni b nhim trng, v
tc c th bi tit thuc, cc yu t ny khc nhau tng ngi, ty thuc vo cc loi
thuc khc nhau ang dng, s hin din ca mt ri lon khc, v tui ca ngi .
Trong vic la chn thuc khng sinh (thuc tr sinh), cc bc s cng xem xt
n tnh cht v mc nguy him ca tnh trng nhim trng, kh nng gy ra cc tc
dng ph, kh nng gy d ng v cc phn ng nghim trng khc ca thuc v gi c ca
thuc.
S kt hp cc loi thuc khng sinh (thuc tr sinh) i khi cn thit iu tr
cc trng hp sau:
-i vi nhng bnh nhim trng nghim trng, c bit trong sut nhng ngy u
khi m s nh hng ca thuc khng sinh i vi vi khun cha c bit r.-Mt s tnh
trng nhim trng do vi khun gy ra m pht trin mt cch nhanh chng tnh
nng khng mt loi khng sinh n l.-Cc bnh nhim trng do nhiu loi vi khun
gy ra nu nh mi loi vi khun b nh hng bi mt loi khng sinh khc
nhau.
CC LOI THUC KHNG SINH (THUC TR SINH)
Tn thucTc dng thng thngCc tc dng ph
Aminoglycosides
AmikacinGentamicinKanamycinNeomycinNetilmicinStreptomycinTobramycinCc
nhim trng do vi khun gram-m (gram-negative bacteria) gy ra, chng hn
nhEscherichia coliv cc chngKlebsiella
Gim thnh gicChng mtTn thng thn
Carbapenems
ErtapenemDoripenemImipenem-cilastatinMeropenemChng hoi t, nhim
khun huyt, vim phi, nhim trng bng v ng tit niu, cc nhim trng do vi
khun khng li cc loi thuc khng sinh khc v (ngoi tr ertapenem), nhim
khunPseudomonas
ng kinh, c bit vi imipenemTnh trng ri lon tinh thn.
Cephalosporins, 1st generation
CefadroxilCefazolinCephalexinCh yu l cc nhim trng da v m mmRi
lon ng tiu ha v tiu chyBun nnCc phn ng d ng
Cephalosporins, 2nd generation
CefaclorCefoxitinCefprozilCefuroximeLoracarbefMt vi nhim trng ng
h hp, v i vi thuc cefoxitin, dng cho nhim trng bngRi lon ng tiu ha
v tiu chyBun nnCc phn ng d ng
Cephalosporins, 3rd generation
CefiximeCefdinirCefditorenCefoperazoneCefotaximeCefpodoximeCeftazidimeCeftibutenCeftizoximeCeftriaxonec
ung bng ming: c hiu qu din rng i vi nhiu loi vi khun cho nhng ngi b
nhim trng nh n va phi, bao gm nhim trng da v cc m mm.Thuc tim: Cc
nhim trng nghim trng (chng hn nh vim mng no hoc cc nhim trng mc phi
bnh vin).
Ri lon ng tiu ha v tiu chyBun nnCc phn ng d ng
Cephalosporins, 4th generation
CefepimeCc nhim trng nghim trng (bao gm nhim khun Pseudomonas) c
bit nhng ngi c h thng min dch yu v cc nhim trng do kh nng khng ca
vi khun i vi cc loi thuc khng sinh khc
Ri lon ng tiu ha v tiu chyBun nnCc phn ng d ng
Cephalosporins, 5th generation
CeftobiproleCc nhim trng da phc tp bao gm nhim trng bn chn i vi
nhng ngi b bnh tiu ng, do cc vi khun gy ra nhEscherichia
coli,Pseudomonas aeruginosa, v vi khun khngmethicillin
Staphylococcus aureus(MRSA vi khun gy ra bnh nht, chng nhim m huyt,
vim ty xng, mng m vt thng, v ng c thc phm)
Fluoroquinolones
CiprofloxacinLevofloxacinLomefloxacinMoxifloxacinNorfloxacinOfloxacinTrovafloxacinNhim
trng huyt, nhim trng ng tit niu, vim tuyn tin lit do vi khun, tiu
chy do vi khun, v bnh luBun nn (him)Lo lng, rng mnh, v ng kinhTnh
trng vim hay t dy chng (gn)Nhp tim bt thng (chng lon nhp tim)Chng
tiu chy c lin quan n thuc khng sinh v vim rut kt (vim i trng)i vi
thuc trovafloxacin i khi lm tn thng gan c th gy t vong.
Glycylcycline
TigecyclineCc bin chng nhim trng bng v cc bin chng nhim trng da
do cc vi khun b nh hng, chng hn nhEscherichia coli,Staphylococcus
aureus (k c cc vi khun khng methicillin) v vi khun k kh
Cc ri lon thuc v tiu haS nhy cm vi nh sng mt triB en rng vnh vin
thai nhi nu nh dng thuc giai on cui thi k mang thai hoc i vi tr em
di 8 tui.
Macrolides
AzithromycinClarithromycinDirithromycinErythromycinTroleandomycin
Nhim khun cu chui, bnh giang mai, nhim trng ng h hp, nhim vi
sinh vt mycoplasma v bnh Lyme (l mt cn bnh vim sng do vi khun
Borrelia burgdorferi gy ra v b ly nhim khi b ve cn).
Bun nn, i ma, v tiu chy (c bit l dng liu lng cao)Bnh vng daNhp
tim bt thng
Monobactam
AztreonamCc nhim trng do vi khun gram-m gy raCc phn ng d ngC th
dng cho cc bnh nhn b d ng vi cc loi thuc khng sinh nh penicillins,
cephalosporins, v carbapenems
Penicillins
AmoxicillinAmpicillinCarbenicillinCloxacillinDicloxacillinNafcillinOxacillinPenicillin
GPenicillin VPiperacillinTicarcillinMt s ln cc nhim trng bao gm
nhim khun cu chui, bnh giang mai, v bnh LymeBun nn, i ma v tiu chyD
ng vi cc loi phn ng d ng e da tnh mng nghim trngTn thng no v thn
(him)
Polypeptides*
BacitracinColistinPolymyxin BCc nhim trng tai, mt, da, hoc bng
quangThng bi trc tip ln da, v him khi tim.
Tn thng thn v dy thn kinh (khi tim)
Sulfonamides
MafenideSulfacetamideSulfamethizoleSulfasalazineSulfisoxazoleTrimethoprim-sulfamethoxazoleNhim
trng ng tit niu (ngoi trsulfasalazine,sulfacetamide, vmafenide)i vi
mafenide ch dng thoa (bi) trn da cho cc trng hp b phngBun nn, i ma,
v tiu chyD ng (bao gm pht ban da)Sn trong nc tiu (him)Gim s lng bch
cu v tiu cuNhy cm vi nh sng mt triC kh nng gia tng khuynh hng chy
mu cam nu c dng chung vi warfarin
Tetracyclines
DemeclocyclineDoxycyclineMinocyclineOxytetracyclineTetracycline
Bnh giang mai, nhim vi khun gram-m chlamydia, bnh Lyme, nhim vi
sinh vt mycoplasma, v cc nhim trng do vi khun rickettsia gy ra.Ri
lon tiu haNhy cm vi nh sng mt triB en rng tr em di 8 tui hoc thai
nhi nu s dng thuc vo cui giai on mang thai.
Miscellaneous antibiotics
ChloramphenicolBnh thng hn, nhim khun salmonella, v vim mng
no
Gim s lng bch cu nghim trng (him)
ClindamycinNhim khun cu chui Streptococcus v khun cu chm
gram-dng staphylococcus, nhim trng ng h hp, v chng p xe phi
Tiu chy c lin quan n vic s dng thuc khng sinh v vim sng rut kt
(vim kt trng)
DaptomycinCc loi nhim trng da gy bin chng, nhim trng mu, v mt s
nhim trng van tim (vim mng trong tim) do cc vi khun b nh hng gy ra,
bao gm vi khun khng methicillinStaphylococcus aureus(MRSA)Khng c
dng khi b nhim trng c lin quan n phi
Ri lon tiu haau c v ui sc
EthambutolBnh lao
Ri lon th gic
FosfomycinNhim trng bng quang
Tiu chy
IsoniazidBnh laoBun nn v i maBnh vng da
LinezolidCc nhim trng nghim trng gy ra bi vi khun gram-dng, c kh
nng khng li nhiu loi thuc khng sinh khc.Bun nnau uTiu chyBnh thiu
mu v tnh trng s lng tiu cu v bch cu xung thpT v nga ran tay v chn
(au thn kinh ngoi vi)Ri lon th gicNhm ln, kch ng, rng mnh hoc hn m
nhng ngi m cng s dng cc loi thuc c ch tit serotonin chn lc
(SSRIs)
MetronidazoleVim m o do chng loiTrichomonashocGardnerella, nhim
trng khung chu v nhim trng bngBun nnau u (c bit nu thuc c ung vi
ru)C mi v kim loiT v nga ran tay chn (au thn kinh ngoi vi)Nc tiu
sm
NitrofurantoinNhim trng ng tit niuBun nn v i maD ng
PyrazinamideBnh laoRi lon chc nng ganBnh gt (i khi)
Quinupristin-dalfopristinCc nhim trng nghim trng gy ra bi vi
khun gram-dng khng li cc loi thuc khng sinh khc.
au nhc c v cc khp
RifampinBnh lao v bnh phong ciPht ban (m ay)Ri lon chc nng ganNc
bt, m hi, nc mt, nc tiu c mu -cam
SpectinomycinBnh luD ngSt
TelithromycinVim phi cng ng mc phit nh n trung bnh (bnh vim phi
cng ng mc phi l bnh vim phi khng xy ra bn trong bnh vin v nhng
trung tm y t chm sc di hn)Ri lon th gicTn thng gan (c th gy t
vong)Lm cho cc triu chng bnh nhng ngi b nhc c mn tnh (myasthenia
gravis) tr nn trm trng (c th gy t vong)
VancomycinCc loi nhim trng nghim trng, c bit l nhng loi nhim
trng do MRSA hoc khun cu rut khng gy bnh (Enterococcus) gy ra, v cc
trng hp i khng vi cc loi khng sinh khc.
Da ng , ngaCc phn ng d ngGim s lng tiu cu v bch cu
*Polypeptide antibiotics are usually applied directly to the
skin or eye and are rarely given by injection.Cc thuc khng sinh
polypeptide thng c bi trc tip ln da hoc nh vo mt v him khi tim.
Bnh lu(Gonorrhea) ly truyn mt cch d dng v c th dn n tnh trng v
sinh nam v n, nu khng c cha tr. Cc loi thuc khng sinh c th ngn chn
c bnh nhim trng ny.
Cc triu chng: Cc triu chng thng thng l cm gic au rt khi i tiu v
chy m, nhng thng khng c cc triu chng ban u. Sau , s nhim trng c th
gy pht ban da hoc lan truyn n cc khp v mu.
Nam Gii: chy m dng vt, sng tinh hon.
Ph N: Chy m m o, au khung chu, chy mu t cung (thnh thong, bt
thng, v vi s lng nh). Cc triu chng c th nh v d b nhm ln vi tnh trng
nhim trng ng tit niu hoc nhim trng m o.
a s bnh nhn khng ch n cc triu chng ban u cabnh giang
mai(syphilis). Nu khng c cha tr, cn bnh c th dn n tnh trng bi lit,
m, v t vong. Bnh giang mai c th c cha tr bng cc loi thuc khng
sinh.
Cc Du Hiu v Cc Triu Chng: Du hiu ban u thng l cm gic kh chu gy
ch v ko di khu vc b phn sinh dc hoc hu mn. Cn bnh ny ly truyn bng
vic tip xc trc tip khi b cm gic kh chu ny. Sau , c th xut hin tnh
trng pht ban lng bn chn, lng bn tay, hoc nhng phn khc ca c th (xem
hnh), cng nh nhng tuyn b sng, st, rng tc, hoc cm gic mt mi. giai on
cui, cc triu chng pht xut t s hy hoi cc c quan nh tim, no, gan, dy
thn kinh, v mt.
Chlamydial mt chng bnh ly truyn qua ng sinh dc ph bin m c th dn
n tnh trng v sinh nu khng c cha tr. Chng bnh ny c th bin mt mt cch
nhanh chng nu s dng thuc khng sinh. Nhng chng bnh ny thng ra i m
thm bi v cc triu chng thng khng r rng v thng khng xut hin. Vi khun
Chlamydia cng c th ly nhim cho trc trng v c hng.
Cc Triu Chng Nam Gii: Cm gic rt v nga u dng vt, chy m, v i tiu b
au.
Cc Triu Chng Ph N: Nga m o, chy m m c th c mi, b au khi quan h
tnh dc, i tiu b au.
BnhTrichomoniasisgy ra bi mt loi k sinh trng m ly truyn qua tip
xc tnh dc. Chng bnh ny c th c cha khi bng cc loi thuc do bc s k
toa.
Cc Du Hiu v Cc Triu Chng Nam Gii: a s n ng khng c cc triu chng r
rng. Mt s nam gii pht trin tnh trng chy m nh hoc cm gic au rt nh
khi i tiu.
Cc Du Hiu v Cc Triu Chng Ph N: Ph n c th pht trin tnh trng chy m
mu vng xanh nng mi, nga m o, hoc cm gic au khi quan h tnh dc hoc i
tiu. Cc triu chng thng bt u t 5 n 28 ngy sau khi nhim k sinh trng
ny.
Bn thn n khng phi l mt chng bnh truyn nhim qua ng sinh dc,bnh
vim khung xng chu(pelvic inflammatory disease - PID) l mt bin chng
nghim trng ca cc chng bnh truyn nhim qua ng sinh dc m khng c cha
tr, c bit l bnh chlamydia v bnh lu. N xy ra khi vi khun ly nhim n t
cung v cc c quan sinh sn khc ca ph n. iu tr kp thi th rt cn thit
ngn nga s tn thng n kh nng sinh sn ca ph n.
Cc Du Hiu v Cc Triu Chng: au vng bng di, st, chy m bt thng, b au
khi quan h tnh dc, b au khi i tiu, v chy mu t cung (thnh thong, bt
thng, v vi s lng nh). Thng khng c cc du hiu cnh bo.
BnhLymel mt chng bnh do vi khun, gy ra bi mt loi vi khun c gi l
spirochete, m c th ly truyn cho ngi khi b cc loi ve b nhim khun
(Ixodes scapularisvIxodes pacificus) cn phi. Tn tht ca loi vi khun
ny Hoa K lBorrelia burgdorferi. Chu u, c mt loi vi khun khc, gi
lBorrelia afzelii, cng gy ra bnh Lyme.
Staphylococcus(vi khun hnh cu, khun cu chm) l mt nhm vi khun m c
th gy ra mt s chng bnh l kt qu ca mt s m trong c th b nhim trng.
Staphylococcus thng c bit n di ci tn Staph (c pht m nh ch staff).
Chng bnh c lin quan n vi khun Staph c th t nh v khng cn iu tr n
nghim trng v c nguy c t vong. C trn 30 loi vi khunStaphylococcic th
gy nhim trng cho ngi, nhng phn ln tnh trng nhim trng l do chng
loiStaphylococcus aureusgy ra. Khun cu chm c th thng c tm thy mi v
trn da (v t c tm thy cc khu vc khc trn c th) trong khong 25% - 30%
nhng ngi trng thnh khe mnh. Trong a s cc trng hp, loi vi khun ny
khng gy ra bnh. Tuy nhin, tn thng da hoc chn thng khc c th cho php
vi khun nh bi c ch phng th t nhin ca c th, dn n tnh trng nhim
trng.
Chm vi khun rt nh ny c tn lStaphylococcus aureus khng
methicillin(methicillin-resistant Staphylococcus aureus - MRSA), c
nhn qua knh hin vi. Chng loi ny thuc nhm vi khun staph ph bin gy
nhim trng cc phn khc nhau ca c th - bao gm da, phi, v nhng khu vc
khc. MRSA thnh thong c gi l siu khun - superbug bi v n c kh nng
khng li nhiu loi thuc khng sinh. Mc d a s tnh trng nhim trng do
MRSA khng nghim trng, nhng mt vi tnh trng nhim trng c th e da n tnh
mng.
Nhim Trng Da do MRSA: Cc Triu Chng
Cc nhim trng do MRSA c th rt ging cc nhim trng da thng thng do
vi khun staph: mt khi u nh, mn, hoc inh nht. Khu vc b nhim c th b ,
au nhc, b sng, hoc c cm gic m khi chm vo. M hoc cc cht dch khc c th
chy ra t vt thng. a s cc nhim trng da do MRSA thng l nh, nhng chng
c th thay i, v tr nn n su vo cc m v tr nn nghim trng hn.
MRSA, Nhn Cn Hay Cc Vn Khc?
Su b cn, pht ban, v cc tnh trng v da khc c th b nhm ln vi MRSA
bi v cc triu chng c th ging nhau: b , sng, cm gic m, hoc b au.Cc bc
s phng cp cu(ER doctors) thng hi nhng bnh nhn m nhp vin vi mt vt
nhn cn xem h c tht s nhn thy con nhn khng, bi v nhng vt cn ny thng
ha ra l do MRSA. Khi mt tnh trng nhim trng da lan rng ra hoc khng
ci thin sau 2-3 ngy dng thuc khng sinh, n c th l do MRSA.
Nhim Trng Da do MRSA: Vim T Bo
MRSA c th dn n tnh trngvim t bo(Cellulitis), mt tnh trng nhim
trng nhng lp da v nhng lp m su bn di. Trn b mt, da c mu hng hoc ,
ging nh vt chy nng, v c th c cm gic m, au, v sng ln. Vim t bo c th
lan rng ra rt nhanh trong vng vi gi.
Nhim Trng Da do MRSA: p xe (tnh trng t m cc b)MRSA thnh thong c
th gy ra mt tnh trng nhim trng su hn c gi lp xe(abscess), l mt tnh
trng tch t m m c th nm di da. Mt tnh trng nhim trng da nh m khng c
cha tr hp l v kp thi, c th pht trin thnh chng p xe. Loi nhim trng
ny c th i hi phu thut x m v dng thuc khng sinh cha tr.
MRSA: Lm Th No Bnh Nhn B Ly Nhim?MRSA c th ly truyn bng cch tip
xc trc tip vi ngi b nhim hoc nhng vt bn chm vo. Cc trng hp tr gip
vic ly lan MRSA bao gm: tip xc da; cc vt ct hoc try xc trn da; dng
chung vt dng v sinh c nhn nh dao co v khn tm; v tip xc vi nhng vt
dng nhim vi khun bao gm nm ca v dng c th dc. C khong mt trong 100
ngi mang vi khun trn ngi, nhng khng tr bnh.
Ai Mc Phi MRSA?Nhng ngi m gn y tip nhn phu thut hoc nhp vin c
nhiu nguy c pht trin MRSA. iu ny cng c tm thy nhng ngi cao tui,
nhng ngi sng trong nhng nh dng lo, v nhng ngi c h thng min dch suy
yu. Mt chng bnh mn tnh nh tiu ng, ung th, hoc HIV s lm gia tng c hi
bnh nhn mc phi tnh trng nhim trng kh tr ny.CC TC DNG PH V CC PHN NG
D NG
Cc tc dng ph thng gp ca thuc khng sinh bao gm au bng, tiu chy, v
ph n, lnhim trng men m o(vaginal yeast infection). Mt vi tc dng ph
nghim trng hn, ty thuc vo loi thuc khng sinh, c th lm suy yu cc chc
nng ca thn, gan, ty xng, hoc cc c quan khc. Xt nghim mu i khi cng c
s dng kim tra nhng nh hng ln thn v cc chc nng ni tng khc.
Mt s ngi dng thuc khng sinh, c bit l cephalosporins,clindamycin,
hoc fluoroquinolones, s pht trin chng vim kt trng, mt tnh trng vim
sng rut gi. Loi vim kt trng ny l do mt c t do loi vi
khunClostridium difficilesn sinh, m loi vi khun ny khng vi nhiu loi
thuc khng sinh v chng s sinh trng mt cch khng kim sot trong rut khi
cc vi khun bnh thng khc trong rut b tiu dit bi cc loi thuc khng
sinh.
Cc loi thuc khng sinh cng c th gy ra cc phn ng d ng. Phn ng d ng
nh bao gm mt tnh trng pht ban (m ay) gy nga hoc th kh kh nh. Cc phn
ng d ng nghim trng (phn ng phn v-anaphylaxis) c th e da n tnh mng v
thng bao gm sng c hng, kh th, v huyt p thp.
Nhiu bnh nhn k vi bc s ca h rng h b d ng vi mt loi thuc khng
sinh trong khi h ch gp phi cc tc dng ph m khng lin quan n d ng. S
khc bit ny rt quan trng bi v nhng ngi m b d ng vi mt loi thuc khng
sinh s khng c dng loi thuc hoc loi thuc khng sinh c lin quan gn vi
n. Tuy nhin, bnh nhn ch gp phi cc tc dng ph nh thng c th dng cc loi
thuc c lin quan hoc thm ch tip tc dng loi thuc . Cc bc s c th xc nh
c tm quan trng ca bt k cc phn ng gy kh chu no m nhng bnh nhn gp phi
i vi mt loi thuc khng sinh.
