{"id":13373,"date":"2023-10-05T15:10:12","date_gmt":"2023-10-05T08:10:12","guid":{"rendered":"http:\/\/12point.net\/?p=13373"},"modified":"2023-10-05T15:10:31","modified_gmt":"2023-10-05T08:10:31","slug":"mhra-nhac-lai-ve-nguy-co-phan-ung-co-hai-gay-tan-tat-va-keo-dai-hoac-khong-hoi-phuc-lien-quan-den-khang-sinh-fluoroquinolon","status":"publish","type":"post","link":"https:\/\/12point.net\/mhra-nhac-lai-ve-nguy-co-phan-ung-co-hai-gay-tan-tat-va-keo-dai-hoac-khong-hoi-phuc-lien-quan-den-khang-sinh-fluoroquinolon\/","title":{"rendered":"MHRA: NH\u1eaeC L\u1ea0I V\u1ec0 NGUY C\u01a0 PH\u1ea2N \u1ee8NG C\u00d3 H\u1ea0I G\u00c2Y T\u00c0N T\u1eacT V\u00c0 K\u00c9O D\u00c0I HO\u1eb6C KH\u00d4NG H\u1ed2I PH\u1ee4C LI\u00caN QUAN \u0110\u1ebeN KH\u00c1NG SINH FLUOROQUINOLON"},"content":{"rendered":"

DS. Nguy\u1ec5n Th\u1ecb Thanh B\u00ecnh- K. D\u01b0\u1ee3c<\/span><\/em><\/span><\/p>\n

C\u01a1 quan Qu\u1ea3n l\u00fd D\u01b0\u1ee3c ph\u1ea9m Anh (MHRA) nh\u1eafc l\u1ea1i c\u1ea3nh b\u00e1o v\u1ec1 nguy c\u01a1 xu\u1ea5t hi\u1ec7n ph\u1ea3n \u1ee9ng c\u00f3 h\u1ea1i k\u00e9o d\u00e0i ho\u1eb7c g\u00e2y t\u00e0n t\u1eadt kh\u00f4ng h\u1ed3i ph\u1ee5c li\u00ean quan \u0111\u1ebfn kh\u00e1ng sinh fluoroquinolon (ciprofloxacin, delafloxacin, levofloxacin, moxifloxacin, ofloxacin). MHRA khuy\u1ebfn c\u00e1o kh\u00f4ng k\u00ea \u0111\u01a1n fluoroquinolon trong tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m khu\u1ea9n \u1edf m\u1ee9c \u0111\u1ed9 nh\u1eb9 t\u1edbi trung b\u00ecnh (nh\u01b0 \u0111\u1ee3t c\u1ea5p c\u1ee7a vi\u00eam ph\u1ebf qu\u1ea3n m\u1ea1n t\u00ednh v\u00e0 b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh), nhi\u1ec5m khu\u1ea9n kh\u00f4ng nghi\u00eam tr\u1ecdng ho\u1eb7c c\u00f3 th\u1ec3 t\u1ef1 kh\u1ecfi m\u00e0 kh\u00f4ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb, tr\u1eeb khi kh\u00f4ng c\u00f3 kh\u00e1ng sinh ph\u00f9 h\u1ee3p thay th\u1ebf. MHRA khuy\u1ebfn c\u00e1o ng\u1eebng \u0111i\u1ec1u tr\u1ecb b\u1eb1ng fluoroquinolon khi b\u1eaft \u0111\u1ea7u xu\u1ea5t hi\u1ec7n d\u1ea5u hi\u1ec7u c\u1ee7a ph\u1ea3n \u1ee9ng c\u00f3 h\u1ea1i, bao g\u1ed3m \u0111au ho\u1eb7c vi\u00eam g\u00e2n.<\/span><\/p>\n

Fluoroquinolon d\u00f9ng \u0111\u01b0\u1eddng to\u00e0n th\u00e2n v\u00e0 \u0111\u01b0\u1eddng kh\u00ed dung c\u00f3 nguy c\u01a1 g\u00e2y ra ph\u1ea3n \u1ee9ng c\u00f3 h\u1ea1i nghi\u00eam tr\u1ecdng, g\u00e2y t\u00e0n t\u1eadt k\u00e9o d\u00e0i v\u00e0 kh\u00f4ng h\u1ed3i ph\u1ee5c. Nh\u1eefng ph\u1ea3n \u1ee9ng n\u00e0y \u0111\u01b0\u1ee3c ghi nh\u1eadn tr\u00ean c\u00e1c b\u1ec7nh nh\u00e2n trong m\u1ecdi \u0111\u1ed9 tu\u1ed5i v\u1edbi b\u1ea5t k\u1ec3 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 k\u00e8m theo, v\u00e0 c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng kh\u00e1c nhau tr\u00ean c\u00e1c h\u1ec7 c\u01a1 quan, bao g\u1ed3m h\u1ec7 c\u01a1 x\u01b0\u01a1ng, th\u1ea7n kinh, t\u00e2m th\u1ea7n v\u00e0 gi\u00e1c quan. M\u1ed9t trong s\u1ed1 \u0111\u00f3 l\u00e0 t\u1ed5n th\u01b0\u01a1ng g\u00e2n (th\u00f4ng th\u01b0\u1eddng tr\u00ean g\u00e2n Achilles nh\u01b0ng c\u00e1c g\u00e2n kh\u00e1c c\u00f3 th\u1ec3 b\u1ecb \u1ea3nh h\u01b0\u1edfng) x\u1ea3y ra trong v\u00f2ng 48 gi\u1edd k\u1ec3 t\u1eeb khi b\u1eaft \u0111\u1ea7u d\u00f9ng thu\u1ed1c, ho\u1eb7c c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n mu\u1ed9n sau v\u00e0i th\u00e1ng v\u00e0 bi\u1ec3u hi\u1ec7n r\u00f5 r\u1ec7t sau khi ng\u1eebng thu\u1ed1c.<\/span><\/p>\n

Hi\u1ec7n nay, ch\u01b0a c\u00f3 thu\u1ed1c n\u00e0o \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 c\u00e1c nh\u1eefng t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n \u0111\u01b0\u1ee3c \u0111\u1ec1 c\u1eadp \u1edf tr\u00ean. Tuy nhi\u00ean, MHRA khuy\u1ebfn c\u00e1o c\u1ea7n \u0111\u00e1nh gi\u00e1 ch\u00ednh x\u00e1c c\u00e1c tri\u1ec7u ch\u1ee9ng n\u00e0y v\u00e0 d\u1eebng \u0111i\u1ec1u tr\u1ecb b\u1eb1ng fluoroquinolon ngay\u00a0 khi b\u1eaft \u0111\u1ea7u xu\u1ea5t hi\u1ec7n c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a ph\u1ea3n \u1ee9ng c\u00f3 h\u1ea1i.<\/span><\/p>\n

Gi\u1edbi h\u1ea1n ch\u1ec9 \u0111\u1ecbnh fluoroquinolon \u0111\u01b0\u1ee3c ban h\u00e0nh n\u0103m 2019 nh\u1eb1m gi\u1ea3m thi\u1ec3u nguy c\u01a1 xu\u1ea5t hi\u1ec7n ph\u1ea3n \u1ee9ng c\u00f3 h\u1ea1i k\u1ec3 tr\u00ean. Kh\u00f4ng n\u00ean k\u00ea \u0111\u01a1n fluoroquinolon trong \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m khu\u1ea9n \u1edf m\u1ee9c \u0111\u1ed9 nh\u1eb9 \u0111\u1ebfn trung b\u00ecnh (nh\u01b0 \u0111\u1ee3t c\u1ea5p c\u1ee7a vi\u00eam ph\u1ebf qu\u1ea3n m\u1ea1n t\u00ednh v\u00e0 b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh), tr\u1eeb khi kh\u00f4ng c\u00f3 kh\u00f4ng c\u00f3 kh\u00e1ng sinh ph\u00f9 h\u1ee3p thay th\u1ebf, bao g\u1ed3m:<\/span><\/p>\n

– \u0110\u1ec1 kh\u00e1ng v\u1edbi nh\u1eefng kh\u00e1ng sinh l\u1ef1a ch\u1ecdn \u0111\u1ea7u tay th\u01b0\u1eddng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o.<\/span><\/p>\n

– Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u1edbi kh\u00e1ng sinh l\u1ef1a ch\u1ecdn \u0111\u1ea7u tay th\u01b0\u1eddng \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o.<\/span><\/p>\n

– Ghi nh\u1eadn c\u00e1c t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n v\u00e0 kh\u00f4ng th\u1ec3 ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb v\u1edbi kh\u00e1ng sinh l\u1ef1a ch\u1ecdn \u0111\u1ea7u tay \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o.<\/span><\/p>\n

– Th\u1ea5t b\u1ea1i \u0111i\u1ec1u tr\u1ecb v\u1edbi nh\u1eefng kh\u00e1ng sinh l\u1ef1a ch\u1ecdn \u0111\u1ea7u tay kh\u00e1c.<\/span><\/p>\n

L\u1eddi khuy\u00ean cho c\u00e1c nh\u00e2n vi\u00ean y t\u1ebf<\/span><\/p>\n

Fluoroquinolon d\u00f9ng \u0111\u01b0\u1eddng to\u00e0n th\u00e2n (\u0111\u01b0\u1eddng u\u1ed1ng, ti\u00eam truy\u1ec1n ho\u1eb7c kh\u00ed dung) c\u00f3 th\u1ec3 g\u00e2y ra nh\u1eefng t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n k\u00e9o d\u00e0i (c\u00f3 th\u1ec3 trong v\u00e0i th\u00e1ng ho\u1eb7c nhi\u1ec1u n\u0103m), g\u00e2y t\u00e0n t\u1eadt kh\u00f4ng h\u1ed3i ph\u1ee5c, c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng tr\u00ean nhi\u1ec1u h\u1ec7 c\u01a1 quan v\u00e0 gi\u00e1c quan kh\u00e1c nhau.<\/span><\/p>\n

Khuy\u1ebfn c\u00e1o b\u1ec7nh nh\u00e2n ng\u1eebng s\u1eed d\u1ee5ng thu\u1ed1c v\u00e0 li\u00ean h\u1ec7 v\u1edbi nh\u00e2n vi\u00ean y t\u1ebf n\u1ebfu ghi nh\u1eadn xu\u1ea5t hi\u1ec7n c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a ph\u1ea3n \u1ee9ng c\u00f3 h\u1ea1i nghi\u00eam tr\u1ecdng bao g\u1ed3m vi\u00eam g\u00e2n ho\u1eb7c \u0111\u1ee9t g\u00e2n, \u0111au c\u01a1, y\u1ebfu c\u01a1, \u0111au kh\u1edbp, s\u01b0ng kh\u1edbp ho\u1eb7c nh\u1eefng \u1ea3nh h\u01b0\u1edfng tr\u00ean th\u1ea7n kinh ngo\u1ea1i vi v\u00e0 th\u1ea7n kinh trung \u01b0\u01a1ng.<\/span><\/p>\n

Kh\u00f4ng n\u00ean k\u00ea \u0111\u01a1n fluoroquinolon trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p sau:<\/span><\/p>\n

– V\u1edbi nhi\u1ec5m tr\u00f9ng kh\u00f4ng nghi\u00eam tr\u1ecdng, c\u00f3 th\u1ec3 t\u1ef1 kh\u1ecfi, ho\u1eb7c kh\u00f4ng c\u00f3 vi khu\u1ea9n x\u00e2m nh\u1eadp, nh\u01b0 vi\u00eam tuy\u1ebfn ti\u1ec1n li\u1ec7t kh\u00f4ng do vi khu\u1ea9n (m\u1ea1n t\u00ednh).<\/span><\/p>\n

– V\u1edbi nhi\u1ec5m khu\u1ea9n m\u1ee9c \u0111\u1ed9 t\u1eeb nh\u1eb9 \u0111\u1ebfn trung b\u00ecnh (nh\u01b0 \u0111\u1ee3t c\u1ea5p vi\u00eam ph\u1ebf qu\u1ea3n m\u1ea1n t\u00ednh v\u00e0 b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh) tr\u1eeb khi kh\u00f4ng c\u00f3 kh\u00e1ng sinh ph\u00f9 h\u1ee3p thay th\u1ebf.<\/span><\/p>\n

– Kh\u00f4ng k\u00ea ciprofloxacin v\u00e0 levofloxacin v\u1edbi vi\u00eam b\u00e0ng quang kh\u00f4ng ph\u1ee9c t\u1ea1p tr\u1eeb khi kh\u00f4ng c\u00f3 kh\u00e1ng sinh ph\u00f9 h\u1ee3p thay th\u1ebf.<\/span><\/p>\n

– Tr\u00e1nh s\u1eed d\u1ee5ng fluoroquinolon tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e3 c\u00f3 ti\u1ec1n s\u1eed xu\u1ea5t hi\u1ec7n nh\u1eefng ph\u1ea3n \u1ee9ng c\u00f3 h\u1ea1i nghi\u00eam tr\u1ecdng v\u1edbi kh\u00e1ng sinh quinolon (acid nalidixic) v\u00e0 fluoroquinolon.<\/span><\/p>\n

– Th\u1eadn tr\u1ecdng khi k\u00ea \u0111\u01a1n fluoroquinolon cho b\u1ec7nh nh\u00e2n tr\u00ean 60 tu\u1ed5i, b\u1ec7nh nh\u00e2n suy th\u1eadn ho\u1eb7c gh\u00e9p t\u1ea1ng do nguy c\u01a1 t\u1ed5n th\u01b0\u01a1ng g\u00e2n cao h\u01a1n nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00e1c.<\/span><\/p>\n

– Tr\u00e1nh s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi corticosteroid v\u1edbi c\u00e1c kh\u00e1ng sinh fluoroquinolon\u00a0do nguy c\u01a1 l\u00e0m tr\u1ea7m tr\u1ecdng h\u01a1n t\u00ecnh tr\u1ea1ng vi\u00eam g\u00e2n v\u00e0 \u0111\u1ee9t g\u00e2n g\u00e2y ra b\u1edfi fluoroquinolon.<\/span><\/p>\n

H\u00ecnh \u1ea3nh m\u1ed9t s\u1ed1 thu\u1ed1c c\u00f3 ch\u1ee9a valproat hi\u1ec7n c\u00f3 t\u1ea1i khoa D\u01b0\u1ee3c<\/span><\/p>\n

$\"\"$ <\/p>\n

\u00a0Theo:canhgiacduoc.org.vn\/<\/em><\/span><\/p>\n

Ngu\u1ed3n:\u00a0Fluoroquinolone antibiotics: reminder of the risk of disabling and potentially long-lasting or irreversible side effects – GOV.UK (www.gov.uk)<\/a><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"