Kev kho tshuaj tua kab mob tsis yog ib qho - hom kev coj cwj pwm noj tshuaj, tab sis ib txoj hauv kev sib koom ua ke nrog kev ntsuam xyuas etiological, kev sib txuam tshuaj, cov tswv yim noj tshuaj, thiab kev saib xyuas kev ua tau zoo. Nws lub hom phiaj yog txhawm rau tiv thaiv lossis tshem tawm cov kab mob hauv lub sijhawm luv tshaj plaws nrog kev pheej hmoo tsawg tshaj plaws ntawm kev tiv thaiv, thaum tswj tus neeg mob lub cev homeostasis thiab plab microbiota tshuav nyiaj li cas.
Thawj txoj kev yog etiologically coj precision xaiv tshuaj. Qhov zoo tshaj plaws, ua ntej kev kho mob, hom thiab tshuaj rhiab heev ntawm cov kab mob pathogenic yuav tsum raug txheeb xyuas los ntawm kab lis kev cai microbial, nrhiav kom pom cov molecular, los yog loj spectrometry, yog li txheeb xyuas qhov nqaim -spectrum, cov tshuaj tua kab mob zoo heev. Kev kho mob empirical yog tsim rau cov neeg mob hnyav lossis cov xwm txheej uas tsis muaj pov thawj etiological tam sim ntawd. Nws yuav tsum muaj kev saib xyuas dav dav ntawm cov nroj tsuag ntawm qhov chaw kis kab mob, tus neeg mob lub cev tiv thaiv kab mob, thiab cov ntaub ntawv tshuaj xyuas cov tshuaj tiv thaiv hauv zos los xaiv cov tshuaj uas tsim nyog thiab tswj tau kev nyab xeeb. Thaum tau txais cov txiaj ntsig tshuaj rhiab heev, cov phiaj xwm kho tau pib los txo qis - spectrum raug.
In terms of pharmacological matching, the mechanism of action and pharmacodynamic/pharmacodynamic (PK/PD) characteristics of the antibiotic must be considered. Concentration-dependent bactericidal drugs (such as aminoglycosides and fluoroquinolones) emphasize a single, adequate dose to achieve a peak concentration to minimum inhibitory concentration (Cmax/MIC). Time-dependent bactericidal drugs (such as β-lactams) focus on maintaining plasma concentrations above the MIC for the specified duration (T>MIC), feem ntau siv fractionated los yog nruam infusion. Kev nkag mus rau cov ntaub so ntswg kuj tseem ceeb heev; Piv txwv li, cov tshuaj uas muaj cov kua dej cerebrospinal siab yog qhov nyiam rau kev kho mob meningitis, thaum cov neeg uas muaj cov zis tso zis siab yog tsim rau cov kab mob urinary.
Txoj kev tswj hwm yuav tsum tau tsim los ntawm tus kheej. Rau cov kab mob loj heev lossis cov neeg mob tsis tuaj yeem noj cov tshuaj hauv qhov ncauj, kev tswj hwm txoj hlab ntshav yog qhov zoo dua los xyuas kom meej cov tshuaj xa mus raws sijhawm. Rau cov neeg mob uas muaj kev ruaj ntseg thiab kev ua haujlwm ntawm lub plab zom mov zoo, kev tswj xyuas qhov ncauj los yog qhov ncauj tuaj yeem siv los txhim kho kev yooj yim thiab txo kev pheej hmoo ntawm tsev kho mob - kis tau tus kab mob. Kev kho cov tshuaj yuav tsum tau ua nrog rau lub siab thiab lub raum kev ua haujlwm, qhov hnyav, hnub nyoog, thiab cov tshuaj sib xyaw ua ke kom tsis txhob muaj tshuaj lom lossis tsis txaus. Lub sijhawm kho yog nyob ntawm hom kab mob thiab cov lus teb rau kev kho mob. Feem ntau, zej zog- kis mob ntsws yuav tsum tau 5-7 hnub ntawm kev kho mob, thaum muaj kab mob celiac nyuaj lossis osteomyelitis yuav xav tau ob peb lub lis piam, ntxiv los ntawm kev tshuaj xyuas thiab ua raws cov cim inflammatory.
Kev sib xyaw ua ke yog qhov muaj txiaj ntsig zoo hauv cov xwm txheej tshwj xeeb, xws li hauv kev mob hnyav hnyav kom nthuav dav dav lossis sib koom ua ke tua cov kab mob, hauv kev sib xyaw anaerobic thiab aerobic kab mob uas xav tau cov tshuaj nrog ntau lub tswv yim ntawm kev ua, lossis hauv cov kab mob ntev xws li tuberculosis los tiv thaiv cov tshuaj tiv thaiv. Txawm li cas los xij, yuav tsum tau ceev faj kom tsis txhob ua qhov muag tsis pom kev sib txuas tshuaj, uas tuaj yeem ua rau muaj kev cuam tshuam ntau ntxiv thiab tiv thaiv tshuaj.
Cov kev ntsuas kev ua tau zoo yog siv thoob plaws hauv chav kho mob, suav nrog cov kev hloov pauv hauv cov cim inflammatory xws li lub cev kub, suav cov qe ntshav dawb, thiab procalcitonin, nrog rau kev txhim kho hauv cov kab mob qog nqaij hlav. Ineffectiveness los yog relapse yuav tsum tau ib tug re-kev soj ntsuam ntawm etiological kuaj thiab tshuaj rhiab heev rau cov tshuaj, thiab kev soj ntsuam ntawm tej yam xws li tsis zoo abscess drainage los yog cov tshuaj disorders.
Zuag qhia tag nrho, kev kho mob tshuaj tua kab mob yog ib qho kev sib koom ua ke ntawm cov kab mob ntawm cov kab mob meej, kev siv tshuaj kho mob, kev coj noj coj ua zoo, kev kho kom tsim nyog, thiab kev ntsuam xyuas dynamic. Clinically, nws yuav tsum tau siv yooj yim raws li cov ntaub ntawv pov thawj kom ua tiav lub hom phiaj ntawm kev ua kom tau txais txiaj ntsig zoo tshaj plaws thiab txo qis cov tshuaj tiv thaiv.