Malangizo a extentsef

Zotsalira Amagwiritsidwa ntchito pochiza matenda oyambitsidwa ndi tizilombo tating'ono tomwe timayamwa mankhwala:
- kuchepetsa kupuma thirakiti matenda: pachimake bronchitis ndi kufalikira kwa chifuwa, chibayo
- matenda a kwamkodzo thirakiti: pyelonephritis, cystitis, urethritis ndi prostatitis
- matenda a pakhungu ndi minofu yofewa,
- Matumbo am'mimba: peritonitis, matenda amtundu wa biliary,
- Matenda azamatenda,
- septicemia,
- thandizo mankhwala febrile neutropenia,
- bakiteriya meningitis.

Maulamuliro a pharmacological / Atsogoleri azachilengedwe komanso azamoyo

Cefepim prigny synthesis wa michere ya bacterium klitini і ma д osiyanasiyana mabakiteriya osiyanasiyana a gramopositive ndi gram-negative. Cephepium imakhala yowoneka bwino kwambiri ku hydrolysis ya b-lactamase, mpikisano pang'ono umapezeka pamaso pa b-lactamase, womwe umakhazikika ndi majini a chromosome, komanso kulowa kwa shvidko m'mitundu yama bakiteriya yopanda gram.

Tsefepіm yogwira schodo mwa tizilombo tosiyanasiyana:

grampositive aerobi:Staphylococcus aureus kuti Staphylococcus epidermidis (kuphatikiza šx shtami, scho kubala b-lactamase), іshi shti stafіlokokіv, kuphatikiza S. hominis, S. saprophyticus, Streptococcus pyogene (Gulu A streptococci), Streptococcus agalactiae (Gulu la Streptococcus B), Streptococcus pneumoniae (kuphatikiza ndi shtami kuyambira kalembedwe mpaka penicillin - IPC mtundu wa 0.1 mpaka 1 μg / ml), ma b-hemolitic streptococci (magulu C, G, F) onse, S. bovis (gulu D), gulu streptococci Viridans. (Bіlshіst straіnt enterokokіv, mwachitsanzo: Enterecoccus faecalis, staphylococcus, kugonjetsedwa ndi methicillin, yogonjetsedwa ndi mankhwala ochulukirapo a cephalosporin, kuphatikizapo cefepim),

Gram-negative aerobi:Pseudomonas spp ., kuphatikizapo P. aeruginosa, P. putida, P. stutzeri, Escherichia coli, Klebsiella sppK. chibayo, K. oxytoca, K.aleenae, Enterobacter spp E. cloacae, E. aerogene, E. agolomeratus, E. sakazakii, Proteus spp P. mirabilis, P. vulgaris, Acinetobacter calcoaceticus (subsp. anitratus lwoffi), Aeromonas hydrophila, Capnocytophaga spp., Choprobacter spp C. diversus, C. freundii, Campylobacter jejuni, Gardnerella vaginalis, Haemophilus ducreyi, H. fuluwenza (kuphatikiza ndi shtami, kuti apange beta-lactamase), H. parainfluenzae, Hafnia alvei, Legionella spp., Morganella morganii, Moraxella catarrhalis ( Branhamella catarrhalis) (kuphatikiza ndi shtami, kuti apange b-lactamase), Neisseria gonorrhoeae (kuphatikiza ndi shtami, kuti apange b-lactamase), Nessera meningitidis, Pantoea agglomerans (vіdomiy yak Enterobacter agglomerans), Providencia spp. (kuphatikizaP. rettgeri, P. stuartii), Salmonella spp., Serratia (kuphatikiza S. marcescens, S. liquefaciens), Shigella spp., Yersinia enterocolitica.

(Cefepim wosagwira Xanthomonas maltophilia i Pseudomonas maltophilia),

anaerobi:Mabakiteriya spp., B. melaninogenicus, gonani pansi Mabakiteriya, Clostridium perfringens, Fusobacterium spp., Mobiluncus spp., Peptostreptococcus spp., Veillonella spp.

(Cefepim wosagwira Bacteroides fragilis і Clostridium Hardile).

Pafupifupi kuchuluka kwa cefepima mu plasma kudzera ola lotseguka pambuyo pa nthawi imodzi makonzedwe akuwonetsedwa patebulo.

Ndende ya plasma mu plasma (μg / ml) ndi mkati (mtsempha) komanso mkati (mtsempha)

Mankhwala

Cepepime imalepheretsa kuphatikizira kwa michere ya cell bacteria ndipo imakhala ndi mawonekedwe osiyanasiyana pochita ndi mabakiteriya ena okhudzana ndi gramu komanso gram-negative. Cepepime imagwirizana kwambiri ndi hydrolysis yokhala ndi ma b-lactamase ambiri ndipo imakhala yotsika kwambiri kwa ma b-lactamases omwe amalembedwa ndi majini a chromosomal, ndipo imalowa mwachangu ma cell mabakiteriya osagwiritsa ntchito gramu.

Cepepime imagwira ntchito motsutsana ndi tizilombo:

gram-zabwino ma grobesStaphylococcus aureus ndi Staphylococcus epidermidis ( kuphatikiza zovuta zawo zomwe zimatulutsa b-lactamase) zovuta zina za staphylococci, kuphatikiza S. hominis, S. saprophyticus, Streptococcus pyogene (Gulu la Streptococcus A), Streptococcus agalactiae (Gulu la Streptococcus B), Streptococcus pneumoniae (kuphatikiza tizilombo ta kukana kwa penicillin - MIC kuchokera ku 0,1 mpaka 1 μg / ml), ena a b-hemolytic streptococci (magulu C, G, F), S. bovis (gulu D), gulu streptococci Viridans . (Mitundu yambiri ya enterococci, mwachitsanzo Enterecoccus faecalis, staphylococci yogonjetsedwa ndi methicillin amalimbana ndi mankhwala ambiri a cephalosporin, kuphatikizapo cefepime

gram zoipa zoyipaPseudomonas spp ., kuphatikizapo P. aeruginosa, P. putida, P. stutzeri, Escherichia coli, Klebsiella spp K. chibayo, K. oxytoca, K.aleenae, Enterobacter spp E. cloacae, E. aerogene, E. agolomeratus, E. sakazakii, Proteus spp P. mirabilis, P. vulgaris, Acinetobacter calcoaceticus (subsp. Anitratus, lwoffi ) , Aeromonas hydrophila, Capnocytophaga spp., Choprobacter spp C. diversus, C. freundii, Campylobacter jejuni, Gardnerella vaginalis, Haemophilus ducreyi, H. fuluwenza (kuphatikizapo zovuta zopanga beta-lactamase) H. parainfluenzae, Hafnia alvei, Legionella spp., Morganella morganii, Moraxella catarrhalis ( Branhamella catarrhalis ) (kuphatikizapo b-lactamase yopanga tizilombo ta) Neisseria gonorrhoeae (kuphatikizapo zovuta zopanga b-lactamase) Nessera meningitidis, Pantoea agglomerans (amadziwika kuti Enterobacter agglomerans) Providencia spp. (kuphatikiza P. rettgeri, P. stuartii ) Salmonella spp., Serratia (kuphatikiza S. marcescens , S. liquefaciens) Shigella spp., Yersinia enterocolitica .

(Cefepime sichitha ntchito pazingwe zambiri Xanthomonas maltophilia ndi Pseudomonas maltophilia )

anaerobes:Mabakiteriya spp., B. melaninogenicus zogwirizana ndi Mabakiteriya , Clostridium perfringens, Fusobacterium spp., Mobiluncus spp ., Peptostreptococcus spp., Veillonella spp.

(Cefepime sichitha ndi Bacteroides fragilis ndi Clostridium Hardile ).

Kuphatikizika kwa plasma kwa cefepime nthawi zosiyanasiyana pambuyo pobayira limodzi ndi mu mnofu wowonekera.

Plasma cefepime moyikirapo (mcg / ml) ndi mtsempha wamkati (i / v) ndi makonzedwe amkati (i / m)

Njira yogwiritsira ntchito

minofu. Pa jet makonzedwe, muyezo umodzi wa mankhwalawa umaphatikizidwa mu 5 kapena 10 ml ya isotonic sodium chloride solution, 5% shuga kapena madzi osabala a jekeseni ndikuwonjezera pang'onopang'ono kupitirira mphindi 3 - 5.
Ndi mtsempha wowerengeka wokoka mankhwalawa, 500 kapena 1000 mg ndi kuchepetsedwa mu 100 - 250 ml ya isotonic sodium chloride solution kapena 5% shuga, makonzedwe akuchitika kwa mphindi zosachepera 30.

Akuluakulu.
Matenda amkodzo thirakiti, wodekha pang'ono: 500 mg - 1 g kudzera m'mitsempha kapena 12:00 koloko
Matenda, ofatsa kusinthira 1 g kudzera mu mtsempha 12:00 iliyonse
Matenda akulu: 2 g aliyense 12:00
Matenda oopsa kwambiri komanso oopsa a 2 g iliyonse 8:00
Odwala ndi mkhutu aimpso ntchito (creatinine chilolezo 60 2 g aliyense 8:00 2 g aliyense 12:00 1 g aliyense 12:00 1 g uliwonse 12:00
Kusintha kwa 30 - 50 Mlingo kutengera chilolezo cha creatinine
2 g aliyense 12:00 2 g aliyense 24 maola 1 g aliyense 24 maola 500 mg mg maola 24 aliwonse
11 - 29 2 g maola 24 aliwonse 1 g maola 24 aliwonse 500 mg mg aliyense 24 maola 500 mg mg maola 24 aliwonse

Atsogoleri azachipatala.

Cefepim prigny synthesis wa michere ya bacterium klitini і ma д osiyanasiyana mabakiteriya osiyanasiyana a gramopositive ndi gram-negative. Cephepium ndiwowonekera bwino ku hydrolysis ya b-lactamase, pali mpikisano wochepa wa b-lactamase, umayikidwa ndi majini a chromosome, ndipo umatchulidwa makamaka m'maselo a bakiteriya osavomerezeka.

Tsefepіm yogwira schodo mwa tizilombo tosiyanasiyana:

grampositive aerobi:Staphylococcus aureus kuti Staphylococcus epidermidis (Kuphatikiza шхні shtami, scho kubala b-lactamase), інші shtami stafіlokokіv, kuphatikiza S. hominis, S. saprophyticus, Streptococcus pyogene (Gulu A streptococci), Streptococcus agalactiae (Gulu la Streptococcus B), Streptococcus pneumoniae (kuphatikiza ndi masitayilo apakatikati mpaka penicillin - kuchuluka kosasunthika ndi 0.1 mpaka 1 μg / ml), b-hemolitic streptococci (magulu C, G, F), S. bovis (gulu D), gulu streptococci Viridans. (Bіlshіst strainіnterokokіv, mwachitsanzo Enterecoccus faecalis, ст staphylococci yogonjetsedwa ndi methicillin, yogonjetsedwa ndi mankhwala ochulukirapo a cephalosporin, kuphatikizapo cefepim),

Gram-negative aerobi:Pseudomonasspp., kuphatikizapo P. aeruginosa, P. putida, P. stutzeri, Escherichia coli, Klebsiellaspp., kuphatikiza K. chibayo, K. oxytoca, K.aleenae, Enterobacter spp., kuphatikiza E. cloacae, E. aerogene, E.agolomeratus, E. sakazakii, Proteusspp., kuphatikiza P. mirabilis, P. vulgaris, Acinetobacter calcoaceticus (subsp.anitratus lwoffi), Aeromonas hydrophila, Capnocytophagaspp., Choprobacterspp., kuphatikiza C. diversus, C. freundii, Campylobacter jejuni, Gardnerella vaginalis, Haemophilus ducreyi, H. fuluwenza (kuphatikiza ndi shtami, kuti apange beta-lactamase), H. parainfluenzae, Hafnia alvei, Legionella spp., Morganella morganii, Moraxella catarrhalis (Branhamella catarrhalis) (kuphatikiza ndi shtami, scho kupanga b-lactamase), Neisseria gonorrhoeae (kuphatikiza ndi shtami, scho kupanga b-lactamase), Nnkhanimeningitidis, Pantoea agglomerans ( vidomy yak Enterobacter agglomerans), Providencia spp. (kuphatikiza P. rettgeri, P. stuartii), Salmonella spp., Serratia (kuphatikiza S. marcescens, S. liquefaciens), Shigellaspp., Yersinia enterocolitica.

(Cefepim wosagwira Xanthomonas maltophilia і Pseudomonas maltophilia),

anaerobi:Bacteroides spp. , B. melaninogenicus, gonani pansi Mabakiteriya, Clostridium perfringens, Fusobacterium spp., Mobiluncus spp., Peptostreptococcus spp., Veillonella spp. (Cefepim wosagwira Bacteroides fragilis і Clostridium Hardile).

Pafupifupi kuchuluka kwa cefepima mu plasma kudzera ola lotseguka pambuyo pa nthawi imodzi makonzedwe akuwonetsedwa patebulo.

Plasma imagwiritsa ntchito plasma (μg / ml) yamkati (yamkati) ndi mkati 'ulcerative (mtsempha wamitsempha)

Sich, zhovchі, peritoneal ridin, mucous secretion of bronchial machubu, sputum, prostate, appendices ndi zhovchnomu mikhury amakhalanso ndi zochizira zozama za cefepima.

Pakati nthawi napivvidendenny cefepіmu ndi chamoyo kukhala pafupifupi 2 zaka. Zotsatira zaumoyo wathanzi, chifukwa, mankhwala opita mpaka 2 g anali kutumikiridwa mkati ndi nthawi yayitali ya zaka 8, masiku 9, kuphatikizidwa kwa mankhwala m'thupi sikunakwezedwe.

Cepepime imapangidwira ku N-methylpyrrolidine, ndipo imapangidwa mwachangu ku N-methylpyrolidine oxide. Masamba a zagalny apakati amakhala 120 ml / hv. Mutha kuwona kuchuluka komwe mungathe kuwona kuposa Vinyatkovo wa mahogany a magwiritsidwe antchito pafupipafupi - malo apamwamba ndi chipewa cha kusefera kwa glomerular (chivomerezo cha nirkovy chokwanira ndi 110 ml / hv). Pafupifupi 85% ya mlingo wochotsedwa wa mpandawo, 1% N-methylpyrolidine, pafupifupi 6.8% ya N-methylpyrolidine oxide, ndipo pafupifupi 2.5% ya nthawi ya kuphikayi imawonekera. Phokoso lanyumba ya cefepime yokhala ndimitsempha yamagazi imakhala yochepera 19% ndipo osanama popanga mankhwala m'magazi.

Kwa anthu odwala omwe ali ndi malingaliro owoneka ngati abwinobwino, sayenera kusintha mlingo kuti ukhale wofanana, komanso kukula kwa chilolezo sichimayimiranso ndi achichepere.

Lipoti lapitalo, lomwe lidachitika kwa omwe adadwala kwambiri, adawonetsa nthawi yayitali yolinganiza. Pakati, mwachitsanzo, mwa anthu odwala omwe ali ndi vuto lolephera, ndiyenera kufunsa pang'ono, ndikuwongolera, ndikukhala wazaka 13 ndi hemodialysis ndi wazaka 19 wokhala ndi diitysis ya peritoneal.

Pharmacokinetics ya cefepim mu matenda osokonezeka a chiwindi sadziwika ndi mucoviscidosis. Corriguvanny dozi pazovuta zotere sizofunikira.

Panthawi ya makonzedwe, mlingo wa cefepime 50 mg / kg wa khungu zaka 12 sunali wowerengeka; zikopa zaka 8.

Makhalidwe a Klіnіchnі.

Matenda, chifukwa cha kukhudzika kwa mankhwala a mikroflora:

- ma dichalny, kuphatikizapo chibayo, bronchitis,

- Shkіri ndi pidshkіrno klіtkovini,

- Іntraabdomіnalі інфекції, kuphatikizapo kuchuluka kwa peritonitis ndi інфекціц жовчовивідних хлавів,

Empiric mankhwala вvorich iz iz neutropenichnoy garyachkoy.

Kupewa kwa ntchito yodzidzimutsa mkati mwa chipatala cha mkati.

- Інфекції secchivividnyh maonekedwe, kuphatikiza pyonephritis,

- zambiri shkіri ndi pidshkіrno klіtkovini,

- mankhwala othandizira ориvorich iz ot neutropenichesky hotachka,

Kulumikizana ndi ma tabu ofunikira kwambiri ndikuwona kusinthana.

Zastosovuchi waukulu Mlingo wa aminoglycosides nthawi yomweyo ndi Likesky trick Extentsef, mwaulemu ndikusintha ntchito za ma nickel kudzera mu mphamvu ya nephrotoxicity ndi ototoxicity ya aminoglycoside maantibayotiki. Nephrotoxicity adawonetsedwa pakupanga munthawi yomweyo cephalosporins omwe ali ndi okodzeya, monga furosemide.

Extentsef ndende ya 1 mpaka 40 mg / ml yonse yokhala ndiubwino wotere: 0.9% sodium chloride chloride ya 5%, shuga 10%, 6% sodium chloride kwa 5%, 5% glucose ndi 0,9% sodium chloride wa inoculation, mayeso a Ringer a lactate ndi 5% glucose pakuyambitsa.

Simungathe kutumizira mankhwala mwachangu ndi mankhwala ofunikira, gwiritsani ntchito mankhwala a extentsef (komanso mankhwala othandizira kwambiri a b-lactam), musamayendetsere metronidazole, vancomycin, sulfate, ndi asidi. Panthawi ya mankhwala mankhwala extentsef ndi mankhwala zotchulidwa, lowetsani mankhwala okremo a pakhungu.

Kuyika chifukwa cha mayeso a labotale.

Zomwe zimachitika nthawi ya cefepime zimapangitsa kuti glucose achulukane pamaso pa Benedict. Ndikulimbikitsidwa kuyesedwa kwa glucose, potengera momwe enzymatic reaction ya gluidose oxidation.

Zina zastosuvannya.

Kwa odwala omwe ali pachiwopsezo chachikulu cha matenda oyambitsidwa (mwachitsanzo, kwa odwala ndi ana, apatsirana ubongo wa ng'ombeyo ndi ntchito yochepetsedwa, ndipo ndi chithandizo chochepa chochepa chomwe chikuwonetsedwa pamenepa).

Ndikofunikira kudziwa omwe adawonekeranso poyambitsa matenda oopsa a hypertrophy mu cefepime, cephalosporini, penicillin, ndi antibacterial. Ma Antibiotic varto kukondwerera ndi chisamaliro tonse timayamika mtundu uliwonse wa ziwopsezo, makamaka pokonzekera mankhwala. Ngati thupi siligwirizana, mankhwalawa amayenera kukhazikika. Zovuta zazikuluzikulu za mtundu wosagwiritsa ntchito chiphunzitso cha hyperpathy zitha kutheka kwa adrenaline ndi mitundu yotsika yamankhwala.

Zastosovuvati ndi kusunga kwa odwala іz kulanda thirakiti la udzu (zobisika m'mbiri), makamaka kuwerengera.

Pankhani ya stasis, pafupifupi maantibayotiki onse amitundu yosiyanasiyana ya pseudomembranous colitis ali osiyana kwambiri. Ndikofunika kuti muthane ndi makulidwe a matenda a zamisala panthawi yomwe akuchiza ana ndi ana omwe ali ndi mankhwala a Ekstentsef Dosledzhennya kulanga omwe ali ndi poizoni yemwe amatha kupanga Clostridium Hardile, cause choyambitsa chachikulu cha gulu la antibayotiki. Kuti mupeze matenda a pseudomembranous colitis, ndikofunikira kukhazikitsa maulendo achire. Pseudomembranous colitis yam'manda kwambiri ya zovuta amatha kuonekera pakakonzedwa. Mu vipadok, kuchuluka kwa anthu omwe ali ndi mtendere komanso njira zovuta kwambiri ayenera kuyang'ananso bwino pakufunika kwa kusala komanso electrolyte, njira yabwino kwambiri yolimbitsira ndikukhazikitsa mankhwala a antibacterial, njira yothandiza Clostridium Hardile.

Kwa odwala omwe ali ndi vuto la ntchito (chilolezo cha creatinine ≤ 60 ml / hv), mankhwalawa amayenera kuwongolera pang'onopang'ono kuthamanga kwa mankhwalawa. Kupyola masiku amenewo, pakakhala kusintha kwamphamvu kwa cefep mwa odwala omwe alibe mankhwalawa, amatha kuyimitsanso ntchito ya nirk, komanso titha kukulitsa kuwonekera kwawo. Ndi muyeso wokhumudwitsa woteteza, pang'onopang'ono kuchepetsa ntchito, kuopsa kwa matendawa komanso chidwi champhamvu cha ma tizilombo. Munjira yakuwoneka pambuyo pakutsatsa, mankhwala atha kuvulala kwambiri, akhala owopseza moyo, kapena kuwopseza: Ambiri a vipadas amatetezedwa ndi odwala omwe ali ndi vuto la nirok; chifukwa chake, Mlingo wa cefepima unakonzedwa, koma ndikulimbikitsidwa kuti uigawirenso. Inkoli imakhudzidwa kwambiri pamadyerero, makulidwe a yakimiruyut, otenthedwa kuchokera kwa urahuvannyam funktsії nirok. Nthawi zambiri, zizindikiro za nephrotoxicity zimagwirizanitsidwa ndi ma waswolves, ndipo panalibe zisonyezo zakukhazikika kwa cefepima ndi / kapena hemodialysis.

Pakufunika kakang'ono kosintha ngati pali umboni wochepa woletsa moto ngati pali kuwonjezeka kwa matenda obwera ndi mabakiteriya mtsogolo. Trivale kuchulukitsa cefepіmu (yak іnshih maantibayotiki) ikhoza kubweretsa kukulitsa kwa kupambana. Ndikofunikira kuchita mobwerezabwereza mobwerezabwereza ku patsenta. Panthawi yakukhulupirira zamphamvu, muyenera kukhala ndiulendo waposachedwa kwambiri.

Bagato cephalosporins, kuphatikizapo cefepim, amagwirizana ndi ntchito yochepetsedwa ya prothrombin.Musanagawe magulu, muyenera kulowa ndi odwala omwe akuthyoka ndi chitofu, koma anyamata, ana, ana akung'ung'udza, nawonso, adutsa njira yopusa ya antimicrobial mankhwala. Ndikofunikira kuwongolera prothrombin mwa odwala omwe ali ndi gulu komanso ngati pakufunika tanthauzo la K. K.

Panthawi ya kuchulukitsa, cefepim imatha kukhala yabwino koma osati yotsimikizika kuchokera ku mayeso achindunji a Coombs. Panthawi ya hematologic kapena njira yoika munthu magazi, pomwe magazi amtunduwu adachitidwa m'njira yowonjezereka, ngati kuyesedwa kwa antiglobulin kudachitika, koma mayeso a Coombs adagwiritsidwa ntchito kwa anthu atsopano, amayi adathetsedwa ma antiquiporin a cephalosporins, tidatha kupeza zotsatira zabwino zoyeserera.

Bulo adaleredwa, kotero kuti L-arginine mankhwala a glucose metabolism nthawi yomweyo mumagazi omwe ali ndi Mlingo wokhazikika, mochulukitsa katatu kuchuluka kokwanira bwino kwa nthawi ya cefepime. Zotsatira zotsika Mlingo wambiri wa chaka chatsopano.

Pamene zasosuvannі lіdokainu yak rozniknika slіd vrakhovuvati іnformatsіy ndi bezpeki lіdokainu.

Zastosuvannya pa nthawi vaginosti chaka chamabele.

Kuwongolera koyenera kwa gawo la moyo wa azimayi sikunachitike, kotero Owonjezera amatha kukhala ndi zaka zofanana ndi mayi, ngati tsitsi limayatsidwa kuti mayi agawire potency ya mwana wosabadwayo.

Cefepim posamba ndi yaying'ono, kulowa kwa bere kuli mkaka, ndiyo nthawi yakudziwana kwa chaka cha Extentsef cha mabere.

Health kuthyola kuthamanga kwa zomwe zimachitika cheruvannі magalimoto komanso njira zina.

Vala vefepim yokhudza kuthamanga kwa mayankho panjira yoyendetsa galimoto ya cheruwere, chifukwa ma loboti sanachite phokoso ndi njira zaposachedwa, komabe, amatenga m'bale wanga mwaulemu, koma patatha ola limodzi ndikatha kumwa mankhwalawo, sindingathe kuthana ndi mbali yamanjenje.

Sposib zososuvannya kuti dozi.

Mlingo wa Mwinaayna woyambirira kukhala 1 g, woperekedwa mkati kapena mkati mwa zaka 12. Mwinaayna triviality of the expression - masiku 7 - 10, matenda oopsa amatha kudya zambiri.

Dosuvannya i shlyakh uvdennya var_yuyut mokoma mtima kuzindikira tizilombo, chisamaliro chaumoyo, kuchuluka kwa matenda, komanso msasa wogwira wa nikor. Malangizo a pazipita mlingo wa mankhwala a extentsef wothira mankhwala ambiri pagome.

Їнфекції сечових ххіів zosavutaї ndi katundu wolemera

500 mg - 1 g mkati koma zilonda zamkati

Burdensнші інфекції zopepuka ndi zapakatikati

1 g mkati koma mkati