{"id":19838,"date":"2020-06-21T22:23:09","date_gmt":"2020-06-21T15:23:09","guid":{"rendered":"https:\/\/pharmog.com\/wp\/?p=19838"},"modified":"2025-01-08T20:57:10","modified_gmt":"2025-01-08T13:57:10","slug":"ciprofloxacin-serviflox","status":"publish","type":"post","link":"https:\/\/pharmog.com\/wp\/ciprofloxacin-serviflox\/","title":{"rendered":"Ciprofloxacin &#8211; Serviflox"},"content":{"rendered":"<p><strong>1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c: <\/strong><\/p>\n<p><strong><em>Ho\u1ea1t ch\u1ea5t :<\/em> <a href=\"https:\/\/pharmog.com\/wp\/ciprofloxacin\/\">Ciprofloxacin<\/a><\/strong><\/p>\n<p><strong><em>Ph\u00e2n lo\u1ea1i: <\/em><\/strong><em>Thu\u1ed1c Kh\u00e1ng sinh nh\u00f3m Quinolon, Fluoroquinolon th\u1ebf h\u1ec7 2<\/em><\/p>\n<p><strong><em>Nh\u00f3m<\/em><\/strong> <strong><em>ph\u00e1p l\u00fd: <\/em><\/strong><em>Thu\u1ed1c k\u00ea \u0111\u01a1n ETC \u2013 (Ethical drugs, prescription drugs, Prescription only medicine)<\/em><\/p>\n<p><strong><em>M\u00e3 ATC<\/em><\/strong> (Anatomical Therapeutic Chemical): J01MA02, S01AE03, S02AA15, S03AA07.<\/p>\n<p><strong><em>Bi\u1ec7t d\u01b0\u1ee3c g\u1ed1c:<\/em> <a href=\"https:\/\/pharmog.com\/wp\/ciprofloxacin-ciprobay\/\">CIPROBAY<\/a><\/strong><\/p>\n<p><strong><em>Bi\u1ec7t d\u01b0\u1ee3c:<\/em><\/strong> Serviflox<\/p>\n<p><strong><em>H\u00e3ng s\u1ea3n xu\u1ea5t <\/em><\/strong>: C\u00f4ng ty Sandoz (Novartis)<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>2. D\u1ea1ng b\u00e0o ch\u1ebf &#8211; H\u00e0m l\u01b0\u1ee3ng: <\/strong><\/p>\n<p><strong><em>D\u1ea1ng thu\u1ed1c v\u00e0 h\u00e0m l\u01b0\u1ee3ng<\/em><\/strong><\/p>\n<p>Vi\u00ean n\u00e9n 500 mg<\/p>\n<p><strong><em>Thu\u1ed1c tham kh\u1ea3o:<\/em><\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td colspan=\"2\"><strong><em>SERVIFLOX 500<\/em><\/strong><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><em>M\u1ed7i vi\u00ean n\u00e9n bao phim c\u00f3 ch\u1ee9a:<\/em><\/td>\n<td><\/td>\n<\/tr>\n<tr>\n<td>Ciprofloxacin<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>500 mg<\/td>\n<\/tr>\n<tr>\n<td>T\u00e1 d\u01b0\u1ee3c<\/td>\n<td>&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;&#8230;.<\/td>\n<td>v\u1eeba \u0111\u1ee7 (Xem m\u1ee5c 6.1)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><img loading=\"lazy\" decoding=\"async\" width=\"953\" height=\"255\" class=\"wp-image-19840\" src=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/06\/screen-clipping.png\" alt=\"Screen Clipping\" srcset=\"https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/06\/screen-clipping.png 953w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/06\/screen-clipping-300x80.png 300w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/06\/screen-clipping-768x205.png 768w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/06\/screen-clipping-600x161.png 600w, https:\/\/pharmog.com\/wp\/wp-content\/uploads\/2020\/06\/screen-clipping-280x75.png 280w\" sizes=\"auto, (max-width: 953px) 100vw, 953px\" \/><\/p>\n<p><strong>3. Video by Pharmog:<\/strong><\/p>\n<p><strong>[VIDEO D\u01af\u1ee2C L\u00dd]<\/strong><\/p>\n<div class=\"ast-oembed-container \" style=\"height: 100%;\"><iframe loading=\"lazy\" title=\"[Pharmog SS1 - T\u1eadp 08] - D\u01b0\u1ee3c l\u00fd c\u00e1c thu\u1ed1c kh\u00e1ng sinh\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/0TIIfoiJFwA?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe><\/div>\n<p>&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;&#8212;<\/p>\n<p>\u25ba K\u1ecbch B\u1ea3n: PharmogTeam<\/p>\n<p>\u25ba Youtube: https:\/\/www.youtube.com\/c\/pharmog<\/p>\n<p>\u25ba Facebook: https:\/\/www.facebook.com\/pharmog\/<\/p>\n<p>\u25ba Group : H\u1ed9i nh\u1eefng ng\u01b0\u1eddi m\u00ea d\u01b0\u1ee3c l\u00fd<\/p>\n<p>\u25ba Instagram : https:\/\/www.instagram.com\/pharmogvn\/<\/p>\n<p>\u25ba Website: pharmog.com<\/p>\n<p><strong>4. \u1ee8ng d\u1ee5ng l\u00e2m s\u00e0ng: <\/strong><\/p>\n<p><strong>4.1. Ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/p>\n<p>Ciprofloxacin \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong \u0111i\u1ec1u tr\u1ecb c\u00e1c nhi\u1ec5m khu\u1ea9n d\u01b0\u1edbi \u0111\u00e2y (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T v\u00e0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG v\u00e0 D\u01af\u1ee2C \u0110\u1ed8NG H\u1eccC). N\u00ean \u0111\u1eb7c bi\u1ec7t ch\u00fa \u00fd c\u00e1c d\u1eef li\u1ec7u hi\u1ec7n c\u00f3 v\u1ec1 t\u00ecnh h\u00ecnh \u0111\u1ec1 kh\u00e1ng ciprofloxacin tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p>C\u1ea7n xem x\u00e9t c\u00e1c h\u01b0\u1edbng d\u1eabn ch\u00ednh th\u1ee9c v\u1ec3 s\u1eed d\u1ee5ng kh\u00e1ng sinh h\u1ee3p l\u00fd.<\/p>\n<p><em>Ng\u01b0\u1eddi l\u1edbn<\/em><\/p>\n<p>Nhi\u1ec5m khu\u1ea9n h\u00f4 h\u1ea5p d\u01b0\u1edbi do vi khu\u1ea9n Gram \u00e2m<\/p>\n<p>C\u00e1c \u0111\u1ee3t c\u1ea5p c\u1ee7a b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh<\/p>\n<p>Nhi\u1ec5m khu\u1ea9n ph\u1ebf qu\u1ea3n &#8211; ph\u1ed5i trong b\u1ec7nh x\u01a1 nang ho\u1eb7c gi\u00e3n ph\u1ebf qu\u1ea3n<\/p>\n<p>Vi\u00eam ph\u1ed5i<\/p>\n<p>Vi\u00eam tai gi\u1eefa c\u00f3 m\u1ee7 m\u1ea1n t\u00ednh<\/p>\n<p>\u0110\u1ee3t c\u1ea5p c\u1ee7a vi\u00eam xoang m\u1ea1n t\u00ednh \u0111\u1eb7c bi\u1ec7t do vi khu\u1eafn Gram \u00e2m g\u00e2y ra<\/p>\n<p>Nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u<\/p>\n<p>Nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng sinh d\u1ee5c<\/p>\n<p>Vi\u00eam ni\u1ec7u \u0111\u1ea1o do l\u1eadu c\u1ea7u v\u00e0 vi\u00eam c\u1ed5 t\u1eed cung do c\u00e1c ch\u1ee7ng l\u1eadu c\u1ea7u (Neisseria gonorrhoeae) nh\u1ea1y c\u1ea3m g\u00e2y ra<\/p>\n<p>Vi\u00eam m\u00e0o tinh ho\u00e0n v\u00e0 tinh ho\u00e0n bao g\u1ed3m c\u1ea3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p do c\u00e1c ch\u1ee7ng l\u1eadu c\u1ea7u nh\u1ea1y c\u1ea3m g\u00e2y ra<\/p>\n<p>Vi\u00eam v\u00f9ng ch\u1eadu bao g\u1ed3m c\u00e1c c\u00e1c tr\u01b0\u1eddng h\u1ee3p do c\u00e1c ch\u1ee7ng l\u1eadu c\u1ea7u nh\u1ea1y c\u1ea3m g\u00e2y ra<\/p>\n<p>Nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ti\u00eau h\u00f3a (nh\u01b0 ti\u00eau ch\u1ea3y \u1edf ng\u01b0\u1eddi \u0111i du l\u1ecbch)<\/p>\n<p>Nhi\u1ec5m khu\u1ea9n \u1ed5 b\u1ee5ng<\/p>\n<p>Nhi\u1ec5m khu\u1ea9n da v\u00e0 m\u00f4 m\u1ec1m do vi khu\u1ea9n Gram \u00e2m<\/p>\n<p>Vi\u00eam tai ngo\u00e0i \u00e1c t\u00ednh<\/p>\n<p>Nhi\u1ec5m khu\u1ea9n x\u01b0\u01a1ng v\u00e0 kh\u1edbp<\/p>\n<p>D\u1ef1 ph\u00f2ng nhi\u1ec5m khu\u1ea9n x\u00e2m l\u1ea5n do m\u00e0ng n\u00e3o c\u1ea7u (Neisseria meningitides)<\/p>\n<p>H\u00edt ph\u1ea3i tr\u1ef1c khu\u1ea9n than (d\u1ef1 ph\u00f2ng sau ph\u01a1i nhi\u1ec5m v\u00e0 \u0111i\u1ec1u tr\u1ecb)<\/p>\n<p><em>Tr\u1ebb em v\u00e0 tr\u1ebb v\u1ecb th\u00e0nh ni\u00ean<\/em><\/p>\n<p>Nhi\u1ec5m khu\u1ea9n ph\u1ebf qu\u1ea3n &#8211; ph\u1ed5i trong b\u1ec7nh x\u01a1 nang do tr\u1ef1c khu\u1ea9n m\u1ee7 xanh (Pseudomonas aeruginosa)<\/p>\n<p>Nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u v\u00e0 vi\u00eam b\u1ec3 th\u1eadn c\u00f3 bi\u1ebfn ch\u1ee9ng<\/p>\n<p>H\u00edt ph\u1ea3i tr\u1ef1c khu\u1ea9n than (d\u1ef1 ph\u00f2ng sau ph\u01a1i nhi\u1ec5m v\u00e0 \u0111i\u1ec1u tr\u1ecb)<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb ch\u1ec9 n\u00ean b\u1eaft \u0111\u1ea7u b\u1edfi b\u00e1c s\u0129 c\u00f3 kinh nghi\u1ec7m trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh x\u01a1 nang v\u00e0\/ho\u1eb7c c\u00e1c nhi\u1ec5m khu\u1ea9n n\u1eb7ng tr\u00ean tr\u1ebb em v\u00e0 tr\u1ebb v\u1ecb th\u00e0nh ni\u00ean (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG v\u00e0 D\u01af\u1ee2C \u0110\u1ed8NG H\u1eccC).<\/p>\n<p><strong>4.2. Li\u1ec1u d\u00f9ng &#8211; C\u00e1ch d\u00f9ng:<\/strong><\/p>\n<p><strong><em>C\u00e1ch d\u00f9ng<\/em><\/strong> :<\/p>\n<p>Thu\u1ed1c \u0111\u01b0\u1ee3c nu\u1ed1t kh\u00f4ng nhai v\u1edbi n\u01b0\u1edbc. C\u00f3 th\u1ec3 d\u00f9ng thu\u1ed1c \u0111\u1ed9c l\u1eadp v\u1edbi b\u1eefa \u0103n. N\u1ebfu u\u1ed1ng l\u00fac \u0111\u00f3i, ho\u1ea1t ch\u1ea5t s\u1ebd \u0111\u01b0\u1ee3c h\u1ea5p thu nhanh h\u01a1n. Kh\u00f4ng n\u00ean d\u00f9ng vi\u00ean n\u00e9n ciprofloxacin c\u00f9ng v\u1edbi c\u00e1c s\u1ea3n ph\u1ea9m s\u1eefa (nh\u01b0 s\u1eefa, s\u1eefa chua) ho\u1eb7c n\u01b0\u1edbc hoa qu\u1ea3 c\u00f3 b\u1ed5 sung kho\u00e1ng ch\u1ea5t (nh\u01b0 n\u01b0\u1edbc cam c\u00f3 b\u1ed5 sung canxi) (xem m\u1ee5c T\u01af\u01a0NG T\u00c1C THU\u1ed0C V\u00c0 C\u00c1C D\u1ea0NG T\u01af\u01a0NG T\u00c1C KH\u00c1C).<\/p>\n<p>Trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p n\u1eb7ng ho\u1eb7c n\u1ebfu b\u1ec7nh nh\u00e2n kh\u00f4ng d\u00f9ng \u0111\u01b0\u1ee3c thu\u1ed1c (nh\u01b0 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c cho \u0103n x\u00f4ng), khuy\u1ebfn c\u00e1o n\u00ean b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ciprofloxacin \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch cho \u0111\u1ebfn khi c\u00f3 th\u1ec3 chuy\u1ec3n sang \u0111\u01b0\u1eddng u\u1ed1ng.<\/p>\n<p><em>N\u1ebfu u\u1ed1ng Serviflox 500 nhi\u1ec1u h\u01a1n ch\u1ec9 \u0111\u1ecbnh<\/em><\/p>\n<p>N\u1ebfu u\u1ed1ng thu\u1ed1c nhi\u1ec1u h\u01a1n ch\u1ec9 \u0111\u1ecbnh, b\u1ea1n c\u1ea7n s\u1ef1 tr\u1ee3 gi\u00fap y t\u1ebf ngay l\u1eadp t\u1ee9c. N\u1ebfu c\u00f3 th\u1ec3, h\u00e3y \u0111em theo vi\u00ean thu\u1ed1c ho\u1eb7c h\u1ed9p thu\u1ed1c \u0111\u1ec3 \u0111\u01b0a cho b\u00e1c s\u0129 xem.<\/p>\n<p><em>N\u1ebfu qu\u00ean u\u1ed1ng thu\u1ed1c Serviflox 500<\/em><\/p>\n<p>H\u00e3y u\u1ed1ng li\u1ec1u th\u00f4ng th\u01b0\u1edfng ngay khi nh\u1edb ra, sau \u0111\u00f3 ti\u1ebfp t\u1ee5c d\u00f9ng thu\u1ed1c theo ch\u1ec9 \u0111\u1ecbnh. Tuy nhi\u00ean, n\u1ebfu th\u1eddi gian n\u00e0y l\u00e0 th\u1eddi gian ph\u1ea3i d\u00f9ng li\u1ec1u ti\u1ebfp theo, kh\u00f4ng \u0111\u01b0\u1ee3c u\u1ed1ng li\u1ec1u b\u1ecf qu\u00ean v\u00e0 ti\u1ebfp t\u1ee5c d\u00f9ng thu\u1ed1c nh\u01b0 b\u00ecnh th\u01b0\u01a1ng. Kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng g\u1ea5p \u0111\u00f4i li\u1ec1u \u0111\u1ec3 b\u1ed5 sung cho li\u1ec1u \u0111\u00e3 qu\u00ean. C\u1ea7n ch\u1eafc ch\u1eafn ho\u00e0n t\u1ea5t \u0111\u1ee3t \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u1ea1n.<\/p>\n<p><em>N\u1ebfu ng\u01b0ng d\u00f9ng thu\u1ed1c Serviflox 500<\/em><\/p>\n<p>\u0110i\u1ec1u quan tr\u1ecdng l\u00e0 b\u1ea1n c\u1ea7n ho\u00e0n t\u1ea5t \u0111\u1ee3t \u0111i\u1ec1u tr\u1ecb ngay c\u1ea3 khi b\u1ea1n c\u1ea3m th\u1ea5y kh\u1ecfe h\u01a1n sau v\u00e0i ng\u00e0y d\u00f9ng thu\u1ed1c. N\u1ebfu ng\u01b0ng d\u00f9ng thu\u1ed1c qu\u00e1 s\u1edbm, b\u1ec7nh nhi\u1ec5m khu\u1ea9n c\u00f3 th\u1ec3 kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1eefa kh\u1ecfi ho\u00e0n to\u00e0n v\u00e0 c\u00e1c tri\u1ec7u ch\u1ee9ng nhi\u1ec5m khu\u1ea9n c\u00f3 th\u1ebf t\u00e1i ph\u00e1t ho\u1eb7c tr\u1edf n\u00ean x\u1ea5u \u0111i. B\u1ea1n c\u0169ng c\u00f3 th\u1ec3 tr\u1edf n\u00ean t\u0103ng \u0111\u1ec1 kh\u00e1ng v\u1edbi kh\u00e1ng sinh.<\/p>\n<p>N\u1ebfu c\u00f3 b\u1ea5t k\u1ef3 th\u1eafc m\u1eafc n\u00e0o v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c n\u00e0y, h\u00e3y h\u1ecfi b\u00e1c s\u0129 ho\u1eb7c d\u01b0\u1ee3c s\u0129 c\u1ee7a b\u1ea1n.<\/p>\n<p><strong><em>Li\u1ec1u d\u00f9ng:<\/em><\/strong><\/p>\n<p>Li\u1ec1u d\u00f9ng t\u00f9y theo ch\u1ec9 \u0111\u1ecbnh, m\u1ee9c \u0111\u1ed9 n\u1eb7ng nh\u1eb9 v\u00e0 v\u1ecb tr\u00ed nhi\u1ec5m khu\u1ea9n, \u0111\u1ed9 nh\u1ea1y c\u1ea3m c\u1ee7a vi khu\u1ea9n g\u00e2y b\u1ec7nh, ch\u1ee9c n\u0103ng th\u1eadn c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 d\u1ef1a tr\u00ean tr\u1ecdng l\u01b0\u1ee3ng c\u01a1 th\u1ec3 c\u1ee7a tr\u1ebb em v\u00e0 tr\u1ebb v\u1ecb th\u00e0nh ni\u00ean. Th\u1eddi gian \u0111i\u1ec1u tr\u1ecb ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 n\u1eb7ng nh\u1eb9 c\u1ee7a b\u1ec7nh v\u00e0 t\u00f9y theo \u0111\u00e1p \u1ee9ng l\u00e2m s\u00e0ng v\u00e0 vi sinh v\u1eadt c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb nhi\u1ec5m khu\u1ea9n g\u00e2y ra b\u1edfi Pseudomonas aeruginosa, Acinetobacter ho\u1eb7c Staphylococci c\u00f3 th\u1ec3 c\u1ea7n ph\u1ea3i d\u00f9ng li\u1ec1u ciprofloxacin cao h\u01a1n v\u00e0 k\u1ebft h\u1ee3p v\u1edbi c\u00e1c kh\u00e1ng sinh kh\u00e1c.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb nhi\u1ec5m khu\u1ea9n trong b\u1ec7nh vi\u00eam x\u01b0\u01a1ng ch\u1eadu, nhi\u1ec5m khu\u1ea9n \u1ed5 b\u1ee5ng, nhi\u1ec5m khu\u1ea9n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh v\u00e0 nhi\u1ec5m khu\u1ea9n x\u01b0\u01a1ng v\u00e0 kh\u1edbp c\u1ea7n ph\u1ea3i d\u00f9ng ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c kh\u00e1ng sinh kh\u00e1c t\u00f9y thu\u1ed9c v\u00e0o lo\u1ea1i vi khu\u1ea9n g\u00e2y b\u1ec7nh.<\/p>\n<p><em>Ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh<\/em><\/p>\n<table>\n<tbody>\n<tr>\n<td colspan=\"2\"><strong>Chi \u0111\u1ecbnh<\/strong><\/td>\n<td><strong>Li\u1ec1u d\u00f9ng trong ng\u00e0y c\u1ee7a ciprofloxacin (mg)<\/strong><\/td>\n<td><strong>T\u1ed5ng th\u1eddi gian \u0111i\u1ec1u tr\u1ecb v\u1edbi ciprofloxacin (b\u1ea5t k\u1ec3 \u0111\u01b0\u1eddng d\u00f9ng)<\/strong><\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\">Nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p d\u01b0\u1edbi<\/td>\n<td>500mg x 2 l\u1ea7n\/ng\u00e0y \u0111\u1ebfn 750mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>7 &#8211; 14 ng\u00e0y<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"3\">Nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean<\/td>\n<td>B\u1ec7nh c\u1ea5p t\u00ednh c\u1ee7a vi\u00eam xoang m\u1ea1n t\u00ednh<\/td>\n<td>500mg x 2 l\u1ea7n\/ng\u00e0y \u0111\u1ebfn 750mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>7 &#8211; 14 ng\u00e0y<\/td>\n<\/tr>\n<tr>\n<td>Vi\u00eam tai gi\u1eefa m\u1ea1n t\u00ednh c\u00f3 m\u01b0ng m\u1ee7<\/td>\n<td>500mg x 2 l\u1ea7n\/ng\u00e0y \u0111\u1ebfn 750mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>7 &#8211; 14 ng\u00e0y<\/td>\n<\/tr>\n<tr>\n<td>Vi\u00eam tai ngo\u00e0i \u00e1c t\u00ednh<\/td>\n<td>750mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>28 ng\u00e0y \u0111\u1ebfn 3 th\u00e1ng<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"5\">Nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u<\/td>\n<td rowspan=\"2\">Vi\u00eam b\u00e0ng quang kh\u00f4ng bi\u1ebfn ch\u1ee9ng<\/td>\n<td>250mg x 2 l\u1ea7n\/ng\u00e0y \u0111\u1ebfn 500mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>3 ng\u00e0y<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\">\u0110\u1ed1i v\u1edbi ph\u1ee5 n\u1eef ti\u1ec1n m\u00e3n kinh, c\u00f3 th\u1ec3 d\u00f9ng li\u1ec1u duy nh\u1ea5t 500mg<\/td>\n<\/tr>\n<tr>\n<td>Vi\u00eam b\u00e0ng quang c\u00f3 bi\u1ebfn ch\u1ee9ng, vi\u00eam b\u1ec3 th\u1eadn kh\u00f4ng bi\u1ebfn ch\u1ee9ng<\/td>\n<td>500mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>7 ng\u00e0y<\/td>\n<\/tr>\n<tr>\n<td>Vi\u00eam b\u1ec3 th\u1eadn c\u00f3 bi\u1ebfn ch\u1ee9ng<\/td>\n<td>500mg x 2 l\u1ea7n\/ng\u00e0y \u0111\u1ebfn 750mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>\u00cdt nh\u1ea5t 10 ng\u00e0y, c\u00f3 th\u1ec3 k\u00e9o d\u00e0i l\u00e2u h\u01a1n 21 ng\u00e0y trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p (v\u00ed d\u1ee5 nh\u01b0 b\u1ecb \u00e1p &#8211; xe)<\/td>\n<\/tr>\n<tr>\n<td>Vi\u00eam tuy\u1ebfn ti\u1ec1n li\u1ec7t<\/td>\n<td>500mg x 2 l\u1ea7n\/ng\u00e0y \u0111\u1ebfn 750mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>2 &#8211; 4 tu\u1ea7n (n\u1ebfu b\u1ec7nh c\u1ea5p t\u00ednh) \u0111\u1ebfn 4 &#8211; 6 tu\u1ea5n (n\u1ebfu b\u1ec7nh m\u1ea1n t\u00ednh)<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"2\">Nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng sinh d\u1ee5c<\/td>\n<td>Vi\u00eam ni\u1ec7u \u0111\u1ea1o do l\u1eadu c\u1ea7u v\u00e0 vi\u00eam c\u1ed5 t\u1eed cung<\/td>\n<td>500mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>1 ng\u00e0y (li\u1ec1u duy nh\u1ea5t)<\/td>\n<\/tr>\n<tr>\n<td>Vi\u00eam m\u00e0o tinh ho\u00e0n &#8211; tinh ho\u00e0n v\u00e0 vi\u00eam x\u01b0\u01a1ng ch\u1eadu<\/td>\n<td>500mg x 2 l\u1ea7n\/ng\u00e0y \u0111\u1ebfn 750mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>\u00cdt nh\u1ea5t 14 ng\u00e0y<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"5\">Vi\u00eam d\u1ea1 d\u00e0y &#8211; ru\u1ed9t v\u00e0 trong \u1ed5 b\u1ee5ng<\/td>\n<td>Ti\u00eau ch\u1ea3y do vi khu\u1ea9n g\u00e2y b\u1ec7nh g\u1ed3m c\u00f3 Shigella spp. ngo\u1ea1i tr\u1eeb Shigella dysenteriae lo\u1ea1i 1 v\u00e0 \u0111i\u1ec1u tr\u1ecb ti\u00eau ch\u1ea3y n\u1eb7ng khi \u0111i du l\u1ecbch.<\/td>\n<td>500mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>1 ng\u00e0y<\/td>\n<\/tr>\n<tr>\n<td>Ti\u00eau ch\u1ea3y do vi khu\u1ea9n g\u00e2y b\u1ec7nh g\u1ed3m c\u00f3 Shigella dysenteriae lo\u1ea1i 1<\/td>\n<td>500mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>5 ng\u00e0y<\/td>\n<\/tr>\n<tr>\n<td>Ti\u00eau ch\u1ea3y do vi khu\u1ea9n Vibrio diolerae<\/td>\n<td>500mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>3 ng\u00e0y<\/td>\n<\/tr>\n<tr>\n<td>S\u1ed1t th\u01b0\u01a1ng h\u00e0n<\/td>\n<td>500mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>7 ng\u00e0y<\/td>\n<\/tr>\n<tr>\n<td>Nhi\u1ec5m khu\u1ea9n \u1ed5 b\u1ee5ng do vi khu\u1ea9n Gram \u00e2m<\/td>\n<td>500mg x 2 l\u1ea7n\/ng\u00e0y \u0111\u1ebfn 750mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>5 &#8211; 14 ng\u00e0y<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\">Nhi\u1ec5m khu\u1ea9n da v\u00e0 m\u00f4 m\u1ec1m<\/td>\n<td>500mg x 2 l\u1ea7n\/ng\u00e0y \u0111\u1ebfn 750mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>7 &#8211; 14 ng\u00e0y<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\">Nhi\u1ec5m khu\u1ea9n x\u01b0\u01a1ng v\u00e0 kh\u1edbp<\/td>\n<td>500mg x 2 l\u1ea7n\/ng\u00e0y \u0111\u1ebfn 750mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>T\u1ed1i \u0111a 3 th\u00e1ng<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\">\u0110i\u1ec1u tr\u1ecb nhi\u1ec5m khu\u1ea9n ho\u1eb7c ph\u00f2ng ng\u1eeba nhi\u1ec5m khu\u1ea9n tr\u00ean b\u1ec7nh nh\u00e2n b\u1ecb gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh. N\u00ean d\u00f9ng k\u1ebft h\u1ee3p Ciprofloxacin v\u1edbi c\u00e1c kh\u00e1ng sinh kh\u00e1c theo h\u01b0\u1edbng d\u1eabn ch\u00ednh th\u1ee9c<\/td>\n<td>500mg x 2 l\u1ea7n\/ng\u00e0y \u0111\u1ebfn 750mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>Vi\u1ec7c \u0111i\u1ec1u tr\u1ecb n\u00ean \u0111\u01b0\u1ee3c k\u00e9o d\u00e0i trong su\u1ed1t th\u1eddi gian b\u1ecb gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\">Ph\u00f2ng ng\u1eeba nhi\u1ec5m khu\u1ea9n x\u00e2m l\u1ea5n do vi khu\u1ea9n Neisseria meningitidis<\/td>\n<td>500mg li\u1ec1u duy nh\u1ea5t<\/td>\n<td>1 ng\u00e0y (li\u1ec1u duy nh\u1ea5t)<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\">Ph\u00f2ng ng\u1eeba sau ti\u1ebfp x\u00fac v\u1edbi b\u1ec7nh nh\u00e2n qua \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p v\u00e0 \u0111i\u1ec1u tr\u1ecb cho nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 th\u1ebf d\u00f9ng thu\u1ed1c b\u1eb1ng \u0111\u01b0\u1eddng u\u1ed1ng khi th\u00edch h\u1ee3p tr\u00ean l\u00e2m s\u00e0ng. Vi\u1ec7c d\u00f9ng thu\u1ed1c n\u00ean b\u1eaft \u0111\u1ea7u c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t sau khi c\u00f3 nghi ng\u1edd ho\u1eb7c c\u00f3 x\u00e1c nh\u1eadn b\u1ecb nhi\u1ec5m b\u1ec7nh<\/td>\n<td>500mg x 2 l\u1ea7n\/ng\u00e0y<\/td>\n<td>60 ng\u00e0y t\u1eeb l\u00fac c\u00f3 x\u00e1c nh\u1eadn b\u1ecb nhi\u1ec5m Bacillus anthracis<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><em>B\u1ec7nh nh\u00e2n cao tu\u1ed5i<\/em><\/p>\n<p>D\u00f9ng thu\u1ed1c cho b\u1ec7nh nh\u00e2n cao tu\u1ed5i ph\u1ea3i t\u00f9y thu\u1ed9c m\u1ee9c \u0111\u1ed9 nhi\u1ec5m khu\u1ea9n v\u00e0 \u0111\u1ed9 thanh th\u1ea3i creatinin c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n<p><em>Suy gan v\u00e0 th\u1eadn<\/em><\/p>\n<p>Li\u1ec1u kh\u1edfi \u0111\u1ea7u v\u00e0 duy tr\u00ec cho nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb suy th\u1eadn \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o nh\u01b0 sau:<\/p>\n<table>\n<tbody>\n<tr>\n<td><strong>\u0110\u1ed9 thanh th\u1ea3i creatinine [ ml\/ph\u00fat\/1,73 m<sup>2<\/sup>]<\/strong><\/td>\n<td><strong>N\u1ed3ng \u0111\u1ed9 creatinine trong m\u00e1u [\u03bcmol\/L]<\/strong><\/td>\n<td><strong>Li\u1ec1u u\u1ed1ng [mg]<\/strong><\/td>\n<\/tr>\n<tr>\n<td>&gt; 60<\/td>\n<td>&lt; 124<\/td>\n<td>Xem ph\u1ea5n li\u1ec1u d\u00f9ng th\u00f4ng th\u01b0\u1eddng<\/td>\n<\/tr>\n<tr>\n<td>30 &#8211; 60<\/td>\n<td>124 \u0111\u1ebfn 168<\/td>\n<td>250 &#8211; 500mg m\u1ed7i 12 gi\u1edd<\/td>\n<\/tr>\n<tr>\n<td>&lt; 30<\/td>\n<td>&gt; 169<\/td>\n<td>250 &#8211; 500mg m\u1ed7i 24 gi\u1edd<\/td>\n<\/tr>\n<tr>\n<td>B\u1ec7nh nh\u00e2n ph\u1ea3i th\u1eabm t\u00e1ch m\u00e1u<\/td>\n<td>&gt; 169<\/td>\n<td>250 &#8211; 500mg m\u1ed7i 24 gi\u1edd (sau th\u1ea9m t\u00e1ch m\u00e1u)<\/td>\n<\/tr>\n<tr>\n<td>B\u1ec7nh nh\u00e2n ph\u1ea3i th\u1ea9m t\u00e1ch ph\u00fac m\u1ea1c<\/td>\n<td>&gt; 169<\/td>\n<td>250 &#8211; 500mg m\u1ed7i 24 gi\u1edd<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>\u0110\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n b\u1ecb suy gan, kh\u00f4ng c\u1ea7n thi\u1ebft ph\u1ea3i \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u.<\/p>\n<p>Li\u1ec1u l\u01b0\u1ee3ng d\u00f9ng cho tr\u1ebb em b\u1ecb suy th\u1eadn v\u00e0\/ho\u1eb7c suy gan v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u.<\/p>\n<p><em>Tr\u00ean b\u1ec7nh nhi<\/em><\/p>\n<table>\n<tbody>\n<tr>\n<td><strong>Ch\u1ec9 \u0111\u1ecbnh<\/strong><\/td>\n<td><strong>Li\u1ec1u d\u00f9ng h\u00e0ng ng\u00e0y t\u00ednh theo mg<\/strong><\/td>\n<td><strong>T\u1ed5ng th\u1eddi gian \u0111i\u1ec1u tr\u1ecb (c\u00f3 th\u1ec3 bao g\u1ed3m \u0111i\u1ec1u tr\u1ecb b\u1eb1ng \u0111\u01b0\u1eddng ti\u00eam ban \u0111\u1ea7u v\u1edbi ciprofloxacin)<\/strong><\/td>\n<\/tr>\n<tr>\n<td>X\u01a1 nang<\/td>\n<td>20mg\/kg tr\u1ecdng l\u01b0\u1ee3ng c\u01a1 th\u1ec3, hai l\u1ea7n trong ng\u00e0y v\u1edbi li\u1ec1u t\u1ed1i \u0111a m\u1ed9t l\u1ea7n l\u00e0 750mg<\/td>\n<td>10 \u0111\u1ebfn 14 ng\u00e0y<\/td>\n<\/tr>\n<tr>\n<td>Nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u v\u00e0 vi\u00eam b\u1ec3 th\u1eadn c\u00f3 bi\u1ebfn ch\u1ee9ng<\/td>\n<td>10mg\/kg \u0111\u1ebfn 20mg\/kg tr\u1ecdng l\u01b0\u1ee3ng c\u01a1 th\u1ec3, hai l\u1ea7n trong ng\u00e0y v\u1edbi li\u1ec1u t\u1ed1i \u0111a m\u1ed9t l\u1ea7n l\u00e0 750mg<\/td>\n<td>10 \u0111\u1ebfn 21 ng\u00e0y<\/td>\n<\/tr>\n<tr>\n<td>D\u1ef1 ph\u00f2ng sau ph\u01a1i nhi\u1ec5m v\u00e0 \u0111i\u1ec1u tr\u1ecb cho c\u00e1c b\u1ec7nh nh\u00e2n h\u00edt ph\u1ea3i tr\u1ef1c khu\u1ea9n than, c\u00f3 th\u1ec3 d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng v\u1edbi b\u1ec7nh c\u1ea3nh l\u00e2m s\u00e0ng th\u00edch h\u1ee3p. N\u00ean b\u1eaft \u0111\u1ea7u d\u00f9ng thu\u1ed1c s\u1edbm nh\u1ea5t c\u00f3 th\u1ec3 sau khi c\u00f3 nghi ng\u1edd ph\u01a1i nhi\u1ec5m ho\u1eb7c ph\u01a1i nhi\u1ec5m \u0111\u00e3 \u0111\u01b0\u1ee3c kh\u1eb3ng \u0111\u1ecbnh.<\/td>\n<td>10mg\/kg \u0111\u1ebfn 15mg\/kg tr\u1ecdng l\u01b0\u1ee3ng c\u01a1 th\u1ec3, hai l\u1ea7n trong ng\u00e0y v\u1edbi li\u1ec1u t\u1ed1i \u0111a m\u1ed9t l\u1ea7n l\u00e0 500mg<\/td>\n<td>60 ng\u00e0y t\u00ednh t\u1eeb ng\u00e0y kh\u1eb3ng \u0111\u1ecbnh nhi\u1ec5m tr\u1ef1c khu\u1ea9n than (Bacillus anthrocis)<\/td>\n<\/tr>\n<tr>\n<td>C\u00e1c nhi\u1ec5m khu\u1ea9n n\u1eb7ng kh\u00e1c<\/td>\n<td>20mg\/kg tr\u1ecdng l\u01b0\u1ee3ng c\u01a1 th\u1ec3, hai l\u1ea7n trong ng\u00e0y v\u1edbi li\u1ec1u t\u1ed1i \u0111a m\u1ed9t l\u1ea7n l\u00e0 750mg<\/td>\n<td>T\u00f9y theo lo\u1ea1i nhi\u1ec5m khu\u1ea9n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>4.3. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh:<\/strong><\/p>\n<p>Kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng Serviflox 500 trong tr\u01b0\u1eddng h\u1ee3p sau:<\/p>\n<p>Qu\u00e1 m\u1eabn v\u1edbi ho\u1ea1t ch\u1ea5t, v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c thu\u1ed9c nh\u00f3m quinolone ho\u1eb7c v\u1edbi b\u1ea5t k\u1ef3 th\u00e0nh ph\u1ea7n n\u00e0o c\u1ee7a thu\u1ed1c.<\/p>\n<p>\u0110ang s\u1eed d\u1ee5ng tizanidine.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>4.4 Th\u1eadn tr\u1ecdng:<\/strong><\/p>\n<p><em>C\u00e1c nhi\u1ec5m khu\u1ea9n n\u1eb7ng v\u00e0 nhi\u1ec5m khu\u1ea9n h\u1ed7n h\u1ee3p do vi khu\u1ea9n Gram (+) v\u00e0 vi khu\u1ea9n k\u1ef5 kh\u00ed<\/em><\/p>\n<p>\u0110i\u1ec1u tr\u1ecb b\u1eb1ng ciprofloxacin \u0111\u01a1n \u0111\u1ed9c kh\u00f4ng th\u00edch h\u1ee3p trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m khu\u1ea9n n\u1eb7ng v\u00e0 nhi\u1ec5m khu\u1ea9n c\u00f3 th\u1ec3 do vi khu\u1ea9n Gram (+) ho\u1eb7c vi khu\u1ea9n k\u1ef5 kh\u00ed g\u00e2y ra. Trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y, ph\u1ea3i s\u1eed d\u1ee5ng k\u1ebft h\u1ee3p ciprofloxacin v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1ng khu\u1ea9n th\u00edch h\u1ee3p kh\u00e1c.<\/p>\n<p><em>Nhi\u1ec5m khu\u1ea9n do li\u00ean c\u1ea7u (bao g\u1ed3m ph\u1ebf c\u1ea7u khu\u1ea9n Streptococus pneumoniae)<\/em><\/p>\n<p>Kh\u00f4ng khuy\u1ebfn c\u00e1o d\u00f9ng ciprofloxacin trong c\u00e1c nhi\u1ec5m khu\u1ea9n do li\u00ean c\u1ea7u do hi\u1ec7u qu\u1ea3 kh\u00f4ng \u0111\u1ea7y \u0111\u1ee7.<\/p>\n<p><em>Nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng sinh d\u1ee5c.<\/em><\/p>\n<p>Vi\u00eam ni\u1ec7u \u0111\u1ea1o do l\u1eadu c\u1ea7u, vi\u00eam c\u1ed5 t\u1eed cung, vi\u00eam m\u00e0o tinh ho\u00e0n &#8211; tinh ho\u00e0n v\u00e0 vi\u00eam v\u00f9ng ch\u1eadu c\u00f3 th\u1ec3 do ch\u1ee7ng l\u1eadu c\u1ea7u (Neisseria gononhoeae) kh\u00e1ng fluoroquinolon.<\/p>\n<p>Do \u0111\u00f3, ch\u1ec9 n\u00ean d\u00f9ng ciprofloxacin trong \u0111i\u1ec1u tr\u1ecb vi\u00eam ni\u1ec7u \u0111\u1ea1o ho\u1eb7c c\u1ed5 t\u1eed cung trong tr\u01b0\u1eddng h\u1ee3p lo\u1ea1i tr\u1eeb \u0111\u01b0\u1ee3c nguy\u00ean nh\u00e2n do l\u1eadu c\u1ea7u kh\u00e1ng ciprofloxacin g\u00e2y ra.<\/p>\n<p>Trong vi\u00eam m\u00e0o tinh ho\u00e0n &#8211; tinh ho\u00e0n v\u00e0 vi\u00eam v\u00f9ng ch\u1eadu, ch\u1ec9 n\u00ean d\u00f9ng ciprofloxacin k\u1ebft h\u1ee3p v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1ng khu\u1ea9n th\u00edch h\u1ee3p kh\u00e1c (nh\u01b0 cephalosporin) cho \u0111\u1ebfn khi lo\u1ea1i tr\u1eeb \u0111\u01b0\u1ee3c nguy\u00ean nh\u00e2n do l\u1eadu c\u1ea7u kh\u00e1ng ciprofloxacin g\u00e2y ra. N\u1ebfu b\u1ec7nh kh\u00f4ng \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n sau 3 ng\u00e0y \u0111i\u1ec1u tr\u1ecb, n\u00ean c\u00e2n nh\u1eafc l\u1ea1i ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p><em>Nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u<\/em><\/p>\n<p>M\u1ee9c \u0111\u1ed9 \u0111\u1ec1 kh\u00e1ng v\u1edbi fluoroquinolon c\u1ee7a Escherichia coli &#8211; t\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh th\u01b0\u1eddng g\u1eb7p bao g\u1ed3m c\u1ea3 nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u &#8211; thay \u0111\u1ed5i theo v\u00f9ng [C\u1ed9ng \u0111\u1ed3ng ch\u00e2u \u00c2u]. Thu\u1ed1c ch\u1ec9 n\u00ean \u0111\u01b0\u1ee3c k\u00ea \u0111\u01a1n d\u1ef1a tr\u00ean t\u1ef7 l\u1ec7 kh\u00e1ng fluoroquinolon c\u1ee7a Escherichia coli t\u1ea1i \u0111\u1ecba ph\u01b0\u01a1ng.<\/p>\n<p>Vi\u1ec7c s\u1eed d\u1ee5ng li\u1ec1u \u0111\u01a1n ciprofloxacin trong vi\u00eam b\u00e0ng quang kh\u00f4ng bi\u1ebfn ch\u1ee9ng \u1edf ph\u1ee5 n\u1eef ti\u1ec1n m\u00e3n kinh \u0111\u01b0\u1ee3c cho l\u00e0 c\u00f3 li\u00ean quan \u0111\u1ebfn hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb th\u1ea5p h\u01a1n l\u00e0 do th\u1eddi gian \u0111i\u1ec1u tr\u1ecb k\u00e9o d\u00e0i h\u01a1n. Nh\u1eefng v\u1ea5n \u0111\u1ec1 n\u00e0y ph\u1ea3i \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc li\u00ean quan \u0111\u1ebfn s\u1ef1 gia t\u0103ng m\u1ee9c \u0111\u1ed9 \u0111\u1ec1 kh\u00e1ng c\u1ee7a Escherichia coli v\u1edbi c\u00e1c quinolon.<\/p>\n<p><em>Nhi\u1ec5m khu\u1ea9n \u1ed5 b\u1ee5ng<\/em><\/p>\n<p>C\u00e1c d\u1eef li\u1ec7u v\u1ec1 hi\u1ec7u qu\u1ea3 c\u1ee7a ciprofloxacin trong \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m khu\u1ea9n \u1ed5 b\u1ee5ng sau ph\u1eabu thu\u1eadt c\u00f2n h\u1ea1n ch\u1ebf.<\/p>\n<p><em>Ti\u00eau ch\u1ea3y \u1edf ng\u01b0\u1eddi \u0111i du l\u1ecbch<\/em><\/p>\n<p>C\u00e2n nh\u1eafc khi l\u1ef1a ch\u1ecdn ciprofloxacin d\u1ef1a tr\u00ean m\u1ee9c \u0111\u1ed9 \u0111\u1ec1 kh\u00e1ng c\u1ee7a vi khu\u1ea9n g\u00e2y b\u1ec7nh v\u1edbi ciprofloxacin t\u1ea1i \u0111\u1ecba ph\u01b0\u01a1ng \u0111\u1ebfn.<\/p>\n<p><em>Nhi\u1ec5m khu\u1ea9n c\u01a1 x\u01b0\u01a1ng v\u00e0 kh\u1edbp<\/em><\/p>\n<p>N\u00ean s\u1eed d\u1ee5ng ciprofloxacin k\u1ebft h\u1ee3p v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1ng khu\u1ea9n kh\u00e1c t\u00f9y thu\u1ed9c v\u00e0o k\u1ebft qu\u1ea3 vi sinh.<\/p>\n<p><em>H\u00edt ph\u1ea3i tr\u1ef1c khu\u1ea9n than<\/em><\/p>\n<p>S\u1eed d\u1ee5ng thu\u1ed1c tr\u00ean ng\u01b0\u1eddi d\u1ef1a tr\u00ean c\u00e1c d\u1eef li\u1ec7u v\u1ec1 \u0111\u1ed9 nh\u1ea1y c\u1ea3m in vitro v\u00e0 c\u00e1c d\u1eef li\u1ec7u th\u1eed nghi\u1ec7m tr\u00ean \u0111\u1ed9ng v\u1eadt c\u00f9ng v\u1edbi c\u00e1c d\u1eef li\u1ec7u c\u00f2n h\u1ea1n ch\u1ebf tr\u00ean ng\u01b0\u1eddi. B\u00e1c s\u0129 \u0111i\u1ec1u tr\u1ecb n\u00ean tham kh\u1ea3o c\u00e1c h\u01b0\u1edbng d\u1eabn \u0111i\u1ec1u tr\u1ecb qu\u1ed1c gia v\u00e0\/ho\u1eb7c qu\u1ed1c t\u1ebf li\u00ean quan \u0111\u1ebfn vi\u1ec7c \u0111i\u1ec1u tr\u1ecb b\u1ec7nh than.<\/p>\n<p><em>S\u1eed d\u1ee5ng thu\u1ed1c tr\u00ean b\u1ec7nh nhi<\/em><\/p>\n<p>S\u1eed d\u1ee5ng ciprofloxacin tr\u00ean tr\u1ebb em v\u00e0 tr\u1ebb v\u1ecb th\u00e0nh ni\u00ean n\u00ean tu\u00e2n theo c\u00e1c h\u01b0\u1edbng d\u1eabn ch\u00ednh th\u1ee9c hi\u1ec7n c\u00f3. Ch\u1ec9 n\u00ean b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ciprofloxacin b\u1edfi c\u00e1c b\u00e1c s\u0129 c\u00f3 kinh nghi\u1ec7m trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh x\u01a1 nang v\u00e0\/ho\u1eb7c c\u00e1c nhi\u1ec5m khu\u1ea9n n\u1eb7ng \u1edf tr\u1ebb em v\u00e0 tr\u1ebb v\u1ecb th\u00e0nh ni\u00ean.<\/p>\n<p>Ciprofloxacin \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 g\u00e2y ra b\u1ec7nh kh\u1edbp \u1edf c\u00e1c kh\u1edbp ch\u1ecbu tr\u1ecdng l\u1ef1c tr\u00ean \u0111\u1ed9ng v\u1eadt ch\u01b0a tr\u01b0\u1edfng th\u00e0nh. C\u00e1c d\u1eef li\u1ec7u v\u1ec1 \u0111\u1ed9 an to\u00e0n t\u1eeb m\u1ed9t nghi\u00ean c\u1ee9u ng\u1eabu nhi\u00ean, m\u00f9 \u0111\u00f4i v\u1ec1 s\u1eed d\u1ee5ng ciprofloxacin \u1edf tr\u1ebb em (ciprofloxacin: n = 335, tu\u1ed5i trung b\u00ecnh = 6,3 tu\u1ed5i; nh\u00f3m \u0111\u1ed1i ch\u1ee9ng: n = 349, tu\u1ed5i trung b\u00ecnh = 6,2 tu\u1ed5i; tu\u1ed5i dao \u0111\u1ed9ng t\u1eeb 1 \u0111\u1ebfn 17 tu\u1ed5i) cho th\u1ea5y m\u1ed9t t\u1ef7 l\u1ec7 nghi ng\u1edd v\u1ec1 b\u1ec7nh kh\u1edbp li\u00ean quan \u0111\u1ebfn thu\u1ed1c. C\u00e1c bi\u1ebfn c\u1ed1 v\u1ec1 b\u1ec7nh kh\u1edbp li\u00ean quan \u0111\u1ebfn thu\u1ed1c sau m\u1ed9t n\u0103m theo d\u00f5i t\u01b0\u01a1ng \u1ee9ng l\u00e0 9,0% v\u00e0 5,7%. M\u1ee9c \u0111\u1ed9 gia t\u0103ng c\u00e1c tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh kh\u1edbp c\u00f3 nghi ng\u1edd li\u00ean quan \u0111\u1ebfn thu\u1ed1c theo th\u1eddi gian kh\u00f4ng c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea gi\u1eefa c\u00e1c nh\u00f3m. Ch\u1ec9 n\u00ean b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb sau khi \u0111\u00e3 c\u00e2n nh\u1eafc c\u1ea9n th\u1eadn l\u1ee3i \u00edch\/nguy c\u01a1 do c\u00e1c bi\u1ebfn c\u1ed1 b\u1ea5t l\u1ee3i c\u00f3 th\u1ec3 x\u1ea3y ra li\u00ean quan \u0111\u1ebfn kh\u1edbp v\u00e0\/ho\u1eb7c m\u00f4 xung quanh.<\/p>\n<p><em>Nhi\u1ec5m khu\u1ea9n ph\u1ebf qu\u1ea3n &#8211; ph\u1ed5i trong b\u1ec7nh x\u01a1 nang<\/em><\/p>\n<p>C\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng bao g\u1ed3m tr\u1ebb em v\u00e0 tr\u1ebb v\u1ecb th\u00e0nh ni\u00ean t\u1eeb 5 \u0111\u1ebfn 17 tu\u1ed5i. Kinh nghi\u1ec7m \u0111i\u1ec1u tr\u1ecb cho tr\u1ebb em t\u1eeb 1 \u0111\u1ebfn 5 tu\u1ed5i c\u00f2n h\u1ea1n ch\u1ebf.<\/p>\n<p><em>Nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u v\u00e0 vi\u00eam b\u1ec3 th\u1eadn c\u00f3 bi\u1ebfn ch\u1ee9ng<\/em><\/p>\n<p>N\u00ean xem x\u00e9t s\u1eed d\u1ee5ng ciprofloxacin trong \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m khu\u1ea9n \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u khi kh\u00f4ng th\u1ec3 s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c kh\u00e1c v\u00e0 n\u00ean d\u00f9ng thu\u1ed1c d\u1ef1a tr\u00ean k\u1ebft qu\u1ea3 kh\u00e1ng sinh \u0111\u1ed3.<\/p>\n<p>C\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n tr\u00ean tr\u1ebb em v\u00e0 tr\u1ebb v\u1ecb th\u00e0nh ni\u00ean t\u1eeb 1 \u0111\u1ebfn 17 tu\u1ed5i.<\/p>\n<p><em>C\u00e1c nhi\u1ec5m khu\u1ea9n n\u1eb7ng \u0111\u1eb7c bi\u1ec7t kh\u00e1c<\/em><\/p>\n<p>\u0110i\u1ec1u tr\u1ecb c\u00e1c nhi\u1ec5m khu\u1ea9n n\u1eb7ng kh\u00e1c tu\u00e2n theo c\u00e1c h\u01b0\u1edbng d\u1eabn ch\u00ednh th\u1ee9c, ho\u1eb7c sau khi \u0111\u00e1nh gi\u00e1 c\u1ea9n th\u1eadn l\u1ee3i \u00edch &#8211; nguy c\u01a1 khi kh\u00f4ng th\u1ec3 s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c kh\u00e1c ho\u1eb7c khi th\u1ea5t b\u1ea1i v\u1edbi c\u00e1c \u0111i\u1ec1u tr\u1ecb th\u00f4ng th\u01b0\u1eddng v\u00ec khi k\u1ebft qu\u1ea3 kh\u00e1ng sinh \u0111\u1ed3 minh ch\u1ee9ng cho vi\u1ec7c s\u1eed d\u1ee5ng ciprofloxacin.<\/p>\n<p>S\u1eed d\u1ee5ng ciprofloxacin trong c\u00e1c nhi\u1ec5m khu\u1ea9n n\u1eb7ng \u0111\u1eb7c bi\u1ec7t ngo\u00e0i c\u00e1c nhi\u1ec5m khu\u1ea9n \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1ec1 c\u1eadp \u1edf tr\u00ean ch\u01b0a \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 trong c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng v\u00e0 kinh nghi\u1ec7m s\u1eed d\u1ee5ng tr\u00ean l\u00e2m s\u00e0ng c\u00f2n h\u1ea1n ch\u1ebf. Do \u0111\u00f3, c\u1ea7n th\u1eadn tr\u1ecdng khi \u0111i\u1ec1u tr\u1ecb cho c\u00e1c b\u1ec7nh nh\u00e2n trong tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m khu\u1ea9n n\u00e0y.<\/p>\n<p><em>Qu\u00e1 m\u1eabn<\/em><\/p>\n<p>Qu\u00e1 m\u1eabn v\u00e0 c\u00e1c ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng, bao g\u1ed3m c\u1ea3 s\u1ed1c ph\u1ea3n v\u1ec7 v\u00e0 ph\u1ea3n \u1ee9ng ph\u1ea3n v\u1ec7 c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n sau khi d\u00f9ng li\u1ec1u \u0111\u01a1n (xem m\u1ee5c T\u00c1C D\u1ee4NG KH\u00d4NG MONG MU\u1ed0N) v\u00e0 c\u00f3 th\u1ec3 \u0111e d\u1ecda \u0111\u1ebfn t\u00ednh m\u1ea1ng. N\u1ebfu xu\u1ea5t hi\u1ec7n ph\u1ea3n \u1ee9ng n\u00e0y, n\u00ean ng\u1eebng d\u00f9ng ciprofloxacin v\u00e0 c\u00f3 bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p.<\/p>\n<p><em>H\u1ec7 c\u01a1 x\u01b0\u01a1ng<\/em><\/p>\n<p>Th\u00f4ng th\u01b0\u1eddng kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng ciprofloxacin cho c\u00e1c b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed b\u1ec7nh v\u1ec1 gan ho\u1eb7c c\u00e1c r\u1ed1i lo\u1ea1n li\u00ean quan \u0111\u1ebfn vi\u1ec7c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng quinolon. Tuy nhi\u00ean, trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p r\u1ea5t hi\u1ebfm g\u1eb7p, sau khi \u0111\u00e3 c\u00f3 k\u1ebft qu\u1ea3 kh\u00e1ng sinh \u0111\u1ed3 v\u1ec1 vi khu\u1ea9n g\u00e2y b\u1ec7nh v\u00e0 \u0111\u00e1nh gi\u00e1 c\u00e2n b\u1eb1ng gi\u1eefa l\u1ee3i \u00edch v\u00e0 nguy c\u01a1, c\u00f3 th\u1ec3 k\u00ea \u0111\u01a1n ciprofloxacin cho c\u00e1c b\u1ec7nh nh\u00e2n n\u00e0y \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb m\u1ed9t s\u1ed1 nhi\u1ec5m khu\u1ea9n n\u1eb7ng, \u0111\u1eb7c bi\u1ec7t trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p th\u1ea5t b\u1ea1i v\u1edbi c\u00e1c \u0111i\u1ec1u tr\u1ecb th\u00f4ng th\u01b0\u1eddng ho\u1eb7c vi khu\u1ea9n kh\u00e1ng thu\u1ed1c, trong \u0111\u00f3 c\u00e1c d\u1eef li\u1ec7u v\u1ec1 vi sinh c\u00f3 th\u1ec3 cung c\u1ea5p b\u1eb1ng ch\u1ee9ng cho vi\u1ec7c s\u1eed d\u1ee5ng ciprofloxacin.<\/p>\n<p>Vi\u00eam g\u00e2n v\u00e0 \u0111\u1ee9t g\u00e2n (\u0111\u1eb7c bi\u1ec7t g\u00e2n Achilles), \u0111\u00f4i l\u00fac c\u1ea3 hai, c\u00f3 th\u1ec3 xu\u00e1t hi\u1ec7n khi d\u00f9ng ciprofloxacin, th\u1eadm ch\u00ed trong v\u00f2ng 48 gi\u1edd \u0111\u1ea7u sau khi \u0111i\u1ec1u tr\u1ecb. Vi\u00eam v\u00e0 \u0111\u1ee9t g\u00e2n c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n th\u1eadm ch\u00ed v\u00e0i th\u00e1ng sau khi ng\u1eebng \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ciprofloxacin. Nguy c\u01a1 c\u00e1c b\u1ec7nh v\u1ec1 g\u00e2n c\u00f3 th\u1ec3 t\u0103ng l\u00ean tr\u00ean b\u1ec7nh nh\u00e2n cao tu\u1ed5i ho\u1eb7c tr\u00ean b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb \u0111\u1ed3ng th\u1eddi v\u1edbi c\u00e1c corticosteroid (xem m\u1ee5c T\u00c1C D\u1ee4NG KH\u00d4NG MONG MU\u1ed0N). C\u1ea7n ch\u0103m s\u00f3c c\u1ea9n th\u1eadn \u0111\u1ec3 gi\u1eef l\u1ea1i ph\u1ea7n chi b\u1ecb \u1ea3nh h\u01b0\u1edfng.<\/p>\n<p>N\u00ean th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng ciprofloxacin tr\u00ean b\u1ec7nh nh\u00e2n b\u1ecb nh\u01b0\u1ee3c c\u01a1 do thu\u1ed1c c\u00f3 th\u1ec3 l\u00e0m n\u1eb7ng th\u00eam c\u00e1c tri\u1ec7u ch\u1ee9ng b\u1ec7nh (xem m\u1ee5c T\u00c1C D\u1ee4NG KH\u00d4NG MONG MU\u1ed0N).<\/p>\n<p><em>Nh\u1ea1y c\u1ea3m v\u1edbi \u00e1nh s\u00e1ng<\/em><\/p>\n<p>Ciprofloxacin \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh c\u01a1 th\u1ec3 g\u00e2y ra c\u00e1c ph\u1ea3n \u1ee9ng m\u1eabn c\u1ea3m v\u1edbi \u00e1nh s\u00e1ng. B\u1ec7nh nh\u00e2n d\u00f9ng ciprofloxacin n\u00ean \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n tr\u00e1nh ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi \u00e1nh s\u00e1ng m\u1eb7t tr\u1eddi c\u01b0\u1eddng \u0111\u1ed9 m\u1ea1nh ho\u1eb7c tia UV trong th\u1eddi gian \u0111i\u1ec1u tr\u1ecb (xem m\u1ee5c T\u00c1C D\u1ee4NG KH\u00d4NG MONG MU\u1ed0N).<\/p>\n<p><em>H\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng<\/em><\/p>\n<p>Ciprofloxacin c\u0169ng nh\u01b0 c\u00e1c quinolon kh\u00e1c \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u1ebfn g\u00e2y k\u00edch ho\u1ea1t c\u01a1n \u0111\u1ed9ng kinh ho\u1eb7c l\u00e0m gi\u1ea3m ng\u01b0\u1ee1ng \u0111\u1ed9ng kinh. C\u00e1c tr\u01b0\u1eddng h\u1ee3p tr\u1ea1ng th\u00e1i \u0111\u1ed9ng kinh \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o. N\u00ean th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng ciprofloxacin cho c\u00e1c b\u1ec7nh nh\u00e2n b\u1ecb r\u1ed1i lo\u1ea1n th\u1ea7n kinh trung \u01b0\u01a1ng d\u1ec5 b\u1ecb c\u00e1c c\u01a1n \u0111\u1ed9ng kinh. N\u1ebfu xu\u1ea5t hi\u1ec7n c\u00e1c c\u01a1n \u0111\u1ed9ng kinh, n\u00ean ng\u1eebng d\u00f9ng thu\u1ed1c (xem m\u1ee5c T\u00c1C D\u1ee4NG KH\u00d4NG MONG MU\u1ed0N). Ph\u1ea3n \u1ee9ng t\u00e2m th\u1ea7n c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n th\u1eadm ch\u00ed ngay sau l\u1ea7n d\u00f9ng ciprofloxacin \u0111\u1ea7u ti\u00ean. Trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p hi\u1ebfm g\u1eb7p, tr\u1ea7m c\u1ea3m ho\u1eb7c r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn \u00fd \u0111\u1ecbnh ho\u1eb7c suy ngh\u0129 t\u1ef1 t\u1eed ho\u1eb7c h\u00e0nh \u0111\u1ed9ng t\u1ef1 t\u1eed. Trong tr\u01b0\u1eddng h\u1ee3p nh\u01b0 v\u1eady, n\u00ean ng\u1eebng d\u00f9ng ciprofloxacin.<\/p>\n<p>C\u00e1c tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh l\u00fd \u0111a th\u1ea7n kinh (tr\u00ean c\u01a1 s\u1edf c\u00e1c tri\u1ec7u ch\u1ee9ng th\u1ea7n kinh nh\u01b0 \u0111au, b\u1ecfng r\u00e1t, c\u00e1c r\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c ho\u1eb7c y\u1ebfu c\u01a1, \u0111\u01a1n l\u1ebb ho\u1eb7c k\u1ebft h\u1ee3p) \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o do tr\u00ean b\u1ec7nh nh\u00e2n d\u00f9ng ciprofloxacin. N\u00ean ng\u1eebng d\u00f9ng ciprofloxacin tr\u00ean b\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng b\u1ec7nh l\u00fd th\u1ea7n kinh, bao g\u1ed3m \u0111au, r\u00e1t, ng\u1ee9a ran, t\u00ea li\u1ec7t v\u00e0\/ho\u1eb7c m\u1ec7t m\u1ecfi \u0111\u1ec3 tr\u00e1nh ti\u1ebfn tri\u1ec3n sang tr\u1ea1ng th\u00e1i kh\u00f4ng h\u1ed3i ph\u1ee5c (xem m\u1ee5c T\u00c1C D\u1ee4NG KH\u00d4NG MONG MU\u1ed0N).<\/p>\n<p><em>C\u00e1c r\u1ed1i lo\u1ea1n tr\u00ean tim<\/em><\/p>\n<p>Th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng fluoroquinolon, bao g\u1ed3m c\u1ea3 ciprofloxacin, tr\u00ean b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c bi\u1ebft c\u00f3 y\u1ebfu t\u1ed1 nguy c\u01a1 g\u00e2y k\u00e9o d\u00e0i kho\u1ea3ng QT, v\u00ed d\u1ee5 nh\u01b0:<\/p>\n<p>H\u1ed9i ch\u1ee9ng k\u00e9o d\u00e0i kho\u1ea3ng QT b\u1ea9m sinh<\/p>\n<p>S\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi v\u1edbi c\u00e1c thu\u1ed1c \u0111\u00e3 \u0111\u01b0\u1ee3c bi\u1ebft l\u00e0m k\u00e9o d\u00e0i kho\u1ea3ng QT (nh\u01b0 c\u00e1c thu\u1ed1c ch\u1ed1ng lo\u1ea1n nh\u1ecbp nh\u00f3m IA v\u00e0 III, c\u00e1c thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m ba v\u00f2ng, c\u00e1c macrolid v\u00e0 c\u00e1c thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n)<\/p>\n<p>M\u1ea5t c\u00e2n b\u1eb1ng \u0111i\u1ec7n gi\u1ea3i ch\u01b0a \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh (nh\u01b0 h\u1ea1 kali m\u00e1u, h\u1ea1 magie m\u00e1u)<\/p>\n<p>B\u1ec7nh tim (nh\u01b0 suy tim, nh\u1ed3i m\u00e1u c\u01a1 tim, nh\u1ecbp tim ch\u1eadm)<\/p>\n<p>B\u1ec7nh nh\u00e2n cao tu\u1ed5i v\u00e0 ph\u1ee5 n\u1eef c\u00f3 th\u1ec3 nh\u1ea1y c\u1ea3m h\u01a1n v\u1edbi c\u00e1c thu\u1ed1c k\u00e9o d\u00e0i kho\u1ea3ng QT. Do \u0111\u00f3, n\u00ean th\u1eadn tr\u1ecdng khi d\u00f9ng c\u00e1c fluoroquinolon, bao g\u1ed3m c\u1ea3 ciprofloxacin tr\u00ean nh\u00f3m b\u1ec7nh nh\u00e2n n\u00e0y (xem m\u1ee5c B\u1ec7nh nh\u00e2n cao tu\u1ed5i\/T\u01af\u01a0NG T\u00c1C THU\u1ed0C V\u00c0 C\u00c1C D\u1ea0NG T\u01af\u01a0NG T\u00c1C KH\u00c1C, T\u00c1C D\u1ee4NG KH\u00d4NG MONG MU\u1ed0N, QU\u00c1 LI\u1ec0U).<\/p>\n<p><em>H\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft<\/em><\/p>\n<p>C\u0169ng nh\u01b0 c\u00e1c quinolon kh\u00e1c, h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft c\u0169ng th\u01b0\u1eddng \u0111\u01b0\u1ee3c ghi nh\u1eadn tr\u00ean b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, ch\u1ee7 y\u1ebfu tr\u00ean nh\u00f3m b\u1ec7nh nh\u00e2n cao tu\u1ed5i. Trong t\u1ea5t c\u1ea3 c\u00e1c b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, theo d\u00f5i \u0111\u01b0\u1eddng huy\u1ebft c\u1ea9n th\u1eadn \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o (xem m\u1ee5c T\u00c1C D\u1ee4NG KH\u00d4NG MONG MU\u1ed0N).<\/p>\n<p><em>H\u1ec7 ti\u00eau h\u00f3a<\/em><\/p>\n<p>S\u1ef1 xu\u1ea5t hi\u1ec7n ti\u00eau ch\u1ea3y n\u1eb7ng v\u00e0 dai d\u1eb3ng trong ho\u1eb7c sau khi \u0111i\u1ec1u tr\u1ecb (bao g\u1ed3m v\u00e0i tu\u1ea7n sau \u0111i\u1ec1u tr\u1ecb) c\u00f3 th\u1ec3 l\u00e0 bi\u1ec3u hi\u1ec7n c\u1ee7a vi\u00eam \u0111\u1ea1i tr\u00e0ng li\u00ean quan \u0111\u1ebfn kh\u00e1ng sinh (\u0111e d\u1ecda t\u00ednh m\u1ea1ng c\u00f3 th\u1ec3 g\u00e2y t\u1eed vong), \u0111\u00f2i h\u1ecfi ph\u1ea3i \u0111i\u1ec1u tr\u1ecb ngay l\u1eadp t\u1ee9c (xem m\u1ee5c T\u00c1C D\u1ee4NG KH\u00d4NG MONG MU\u1ed0N). Trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p n\u00e0y, n\u00ean ng\u1eebng d\u00f9ng ciprofloxacin ngay l\u1eadp t\u1ee9c v\u00e0 b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p. C\u00e1c thu\u1ed1c gi\u1ea3m nhu \u0111\u1ed9ng ru\u1ed9t b\u1ecb ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y.<\/p>\n<p><em>Th\u1eadn v\u00e0 h\u1ec7 ti\u1ebft ni\u1ec7u<\/em><\/p>\n<p>Tinh th\u1ec3 ni\u1ec7u li\u00ean quan \u0111\u1ebfn vi\u1ec7c s\u1eed d\u1ee5ng ciprofloxacin \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o (xem m\u1ee5c T\u00c1C D\u1ee4NG KH\u00d4NG MONG MU\u1ed0N). B\u1ec7nh nh\u00e2n d\u00f9ng ciprofloxacin n\u00ean tr\u00e1nh u\u1ed1ng \u0111\u1ee7 n\u01b0\u1edbc v\u00e0 tr\u00e1nh ki\u1ec1m h\u00f3a qu\u00e1 m\u1ee9c n\u01b0\u1edbc ti\u1ec3u.<\/p>\n<p><em>Suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn<\/em><\/p>\n<p>Do ciprofloxacin \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft qua th\u1eadn ph\u1ea7n l\u1edbn d\u01b0\u1edbi d\u1ea1ng kh\u00f4ng bi\u1ebfn \u0111\u1ed5i, c\u1ea7n hi\u1ec7u chinh li\u1ec1u tr\u00ean b\u1ec7nh nh\u00e2n suy gi\u1ea3m ch\u00fac n\u0103ng th\u1eadn nh\u01b0 m\u00f4 t\u1ea3 trong m\u1ee5c LI\u1ec0U L\u01af\u1ee2NG VA C\u00c1CH D\u00d9NG \u0111\u1ec3 tr\u00e1nh c\u00e1c ph\u1ea3n \u00fang b\u1ea5t l\u1ee3i c\u1ee7a thu\u1ed1c t\u0103ng l\u00ean do t\u00edch l\u0169y ciprofloxacin.<\/p>\n<p><em>H\u1ec7 gan m\u1eadt<\/em><\/p>\n<p>C\u00e1c tr\u01b0\u1eddng h\u1ee3p ho\u1ea1i t\u1eed gan v\u00e0 suy gan \u0111e d\u1ecda t\u00ednh m\u1ea1ng \u0111\u00e3 \u0111\u01b0\u1ee3c ghi nh\u1eadn v\u1edbi ciprofloxacin (xem m\u1ee5c T\u00c1C D\u1ee4NG KH\u00d4NG MONG MU\u1ed0N). N\u00ean ng\u1eebng \u0111i\u1ec1u tr\u1ecb trong tr\u01b0\u1eddng h\u1ee3p xu\u1ea5t hi\u1ec7n b\u1ea5t c\u1ee9 d\u1ea5u hi\u1ec7u n\u00e0o c\u1ee7a b\u1ec7nh gan (nh\u01b0 ch\u00e1n \u0103n, v\u00e0ng da, n\u01b0\u1edbc ti\u1ec3u s\u1eadm m\u00e0u, ng\u1ee9a ho\u1eb7c \u0111\u1ea7y b\u1ee5ng).<\/p>\n<p><em>Thi\u1ebfu h\u1ee5t enzyme glucose-6-phosphat dehydrogenase<\/em><\/p>\n<p>Ph\u1ea3n \u1ee9ng tan m\u00e1u do ciprofloxacin \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o tr\u00ean b\u1ec7nh nh\u00e2n thi\u1ebfu h\u1ee5t enzym glucose-6-phosphat dehydrogenase. N\u00ean tr\u00e1nh d\u00f9ng ciprofloxacin cho c\u00e1c b\u1ec7nh nh\u00e2n n\u00e0y tr\u1eeb khi hi\u1ec7u qu\u1ea3 c\u1ee7a thu\u1ed1c v\u01b0\u1ee3t tr\u1ed9i h\u01a1n nguy c\u01a1. Trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y n\u00ean theo d\u00f5i kh\u1ea3 n\u0103ng xu\u1ea5t hi\u1ec7n hi\u1ec7n t\u01b0\u1ee3ng tan m\u00e1u.<\/p>\n<p><em>Kh\u00e1ng thu\u1ed1c<\/em><\/p>\n<p>Trong ho\u1eb7c sau m\u1ed9t th\u1eddi gian \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ciprofloxacin, c\u00f3 th\u1ec3 ph\u00e2n l\u1eadp \u0111\u01b0\u1ee3c ch\u1ee7ng vi khu\u1ea9n kh\u00e1ng ciprofloxacin, tr\u00ean l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 b\u1ed9i nhi\u1ec5m, c\u00f3 th\u1ec3 c\u00f3 nguy c\u01a1 ch\u1ecdn l\u1ecdc \u0111\u1eb7c bi\u1ec7t \u0111\u1ed1i v\u1edbi vi khu\u1ea9n kh\u00e1ng ciprofloxacin trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb k\u00e9o d\u00e0i v\u00e0 khi \u0111i\u1ec1u tr\u1ecb nhi\u1ec5m khu\u1ea9n b\u1ec7nh vi\u1ec7n v\u00e0\/ho\u1eb7c nhi\u1ec5m khu\u1ea9n do li\u00ean c\u1ea7u v\u00e0 t\u1ee5 c\u1ea7u.<\/p>\n<p><em>Cytochrom P450<\/em><\/p>\n<p>Ciprofloxacin \u1ee9c ch\u1ebf CYP1A2 v\u00e0 do \u0111\u00f3 c\u00f3 th\u1ec3 l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 trong huy\u1ebft thanh c\u00e1c thu\u1ed1c d\u00f9ng c\u00f9ng \u0111\u01b0\u1ee3c chuy\u1ec3n h\u00f3a b\u1edfi enzym n\u00e0y (nh\u01b0 theophyllin, clozapin, olanzapin, ropinirol, tizanidin, duloxetin). Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh d\u00f9ng \u0111\u1ed3ng th\u1eddi ciprofloxacin v\u00e1 tizanidin. Do \u0111\u00f3, b\u1ec7nh nh\u00e2n d\u00f9ng \u0111\u1ed3ng th\u1eddi c\u00e1c thu\u1ed1c n\u00e0y v\u1edbi ciprofloxacin c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t c\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng v\u1ec1 qu\u00e1 li\u1ec1u v\u00e0 c\u00f3 th\u1ec3 c\u1ea7n thi\u1ebft ph\u1ea3i x\u00e1c \u0111\u1ecbnh n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong huy\u1ebft thanh (nh\u01b0 theophyllin) (xem m\u1ee5c T\u01af\u01a0NG T\u00c1C THU\u1ed0C V\u00c0 C\u00c1C D\u1ea0NG T\u01af\u01a0NG T\u00c1C KH\u00c1C)<\/p>\n<p><em>Methotrexate<\/em><\/p>\n<p>Khuy\u1ebfn c\u00e1o kh\u00f4ng s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi ciprofloxacin v\u00e0 methotrexate (xem m\u1ee5c T\u01af\u01a0NG T\u00c1C THU\u1ed0C V\u00c0 C\u00c1C D\u1ea0NG T\u01af\u01a0NG T\u00c1C KH\u00c1C).<\/p>\n<p><em>T\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c x\u00e9t nghi\u1ec7m<\/em><\/p>\n<p>T\u00e1c d\u1ee5ng in vitro c\u1ee7a ciprofloxacin kh\u00e1ng l\u1ea1i Mycobacterium tuberculosis c\u00f3 th\u1ec3 cho c\u00e1c x\u00e9t nghi\u1ec7m vi khu\u1ea9n \u00e2m t\u00ednh gi\u1ea3 tr\u00ean c\u00e1c m\u1eabu b\u1ec7nh ph\u1ea9m l\u1ea5y t\u1eeb b\u1ec7nh nh\u00e2n \u0111ang d\u00f9ng ciprofloxacin.<\/p>\n<p><strong>T\u00e1c \u0111\u1ed9ng c\u1ee7a thu\u1ed1c tr\u00ean ng\u01b0\u1eddi l\u00e1i xe v\u00e0 v\u1eadn h\u00e0nh m\u00e1y m\u00f3c.<\/strong><\/p>\n<p>Do t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c tr\u00ean h\u1ec7 th\u1ea7n kinh, ciprofloxacin c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn th\u1eddi gian ph\u1ea3n \u1ee9ng. Do \u0111\u00f3, kh\u1ea3 n\u0103ng l\u00e1i xe v\u00e0 v\u1eadn h\u00e0nh m\u00e1y m\u00f3c c\u00f3 th\u1ec3 b\u1ecb suy gi\u1ea3m.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>4.5 S\u1eed d\u1ee5ng cho ph\u1ee5 n\u1eef c\u00f3 thai v\u00e0 cho con b\u00fa:<\/strong><\/p>\n<p><em>X\u1ebfp h\u1ea1ng c\u1ea3nh b\u00e1o<\/em><\/p>\n<p>AU TGA pregnancy category: B3<\/p>\n<p>US FDA pregnancy category: C<\/p>\n<p><em>Th\u1eddi k\u1ef3 mang thai:<\/em><\/p>\n<p>C\u00e1c d\u1eef li\u1ec7u hi\u1ec7n c\u00f3 v\u1ec1 vi\u1ec7c d\u00f9ng ciprofloxacin tr\u00ean ph\u1ee5 n\u1eef c\u00f3 thai kh\u00f4ng cho th\u1ea5y thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y d\u1ecb t\u1eadt ho\u1eb7c \u0111\u1ed9c t\u00ednh c\u1ee7a thu\u1ed1c tr\u00ean b\u00e0o thai\/tr\u1ebb s\u01a1 sinh. C\u00e1c nghi\u00ean c\u1ee9u tr\u00ean \u0111\u1ed9ng v\u1eadt kh\u00f4ng cho th\u1ea5y t\u00e1c h\u1ea1i tr\u1ef1c ti\u1ebfp ho\u1eb7c gi\u00e1n ti\u1ebfp c\u1ee7a thu\u1ed1c li\u00ean quan \u0111\u1ebfn \u0111\u1ed9c t\u00ednh sinh s\u1ea3n. Tr\u00ean \u0111\u1ed9ng v\u1eadt c\u00f2n nh\u1ecf v\u00e0 tr\u01b0\u1edbc khi sinh ph\u01a1i nhi\u00eam v\u1edbi c\u00e1c quinolone, \u1ea3nh h\u01b0\u1edfng c\u1ee7a thu\u1ed1c tr\u00ean s\u1ee5n ch\u01b0a ho\u00e0n ch\u1ec9nh \u0111\u00e3 \u0111\u01b0\u1ee3c quan s\u00e1t th\u1ea5y, do \u0111\u00f3 kh\u00f4ng th\u1ec3 lo\u1ea1i tr\u1eeb kh\u1ea3 n\u0103ng thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y h\u1ea1i cho s\u1ee5n kh\u1edbp tr\u00ean c\u00e1c c\u01a1 quan ch\u01b0a tr\u01b0\u1edfng th\u00e0nh tr\u00ean ng\u01b0\u1eddi ho\u1eb7c thai nhi.<\/p>\n<p>\u0110\u1ec3 ph\u00f2ng ng\u1eeba, n\u00ean tr\u00e1nh d\u00f9ng ciprofloxacin trong th\u1eddi k\u1ef3 mang thai.<\/p>\n<p><em>Th\u1eddi k\u1ef3 cho con b\u00fa:<\/em><\/p>\n<p>Ciprofloxacin \u0111\u01b0\u1ecdc b\u00e0i ti\u1ebft qua s\u1eefa m\u1eb9. Do nguy c\u01a1 g\u00e2y t\u1ed5n th\u01b0\u01a1ng kh\u1edbp, kh\u00f4ng n\u00ean s\u1eed d\u1ee5ng ciprofloxacin trong th\u1eddi gian cho con b\u00fa.<\/p>\n<p><strong>4.6 T\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n (ADR):<\/strong><\/p>\n<p>C\u00e1c ph\u1ea3n \u1ee9ng b\u1ea5t l\u1ee3i c\u1ee7a thu\u1ed1c (ADR) \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o ph\u1ed5 bi\u1ebfn nh\u1ea5t l\u00e0 bu\u1ed3n n\u00f4n v\u00e0 ti\u00eau ch\u1ea3y. C\u00e1c ph\u1ea3n \u1ee9ng b\u1ea5t l\u1ee3i c\u1ee7a ciprofloxacin (\u0111\u01b0\u1eddng u\u1ed1ng, ti\u00eam t\u0129nh m\u1ea1ch v\u00e0 \u0111i\u1ec1u tr\u1ecb ti\u1ebfp n\u1ed1i) thu \u0111\u01b0\u1ee3c t\u1eeb c\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng v\u00e0 theo d\u00f5i sau khi \u0111\u01b0a thu\u1ed1c ra th\u1ecb tr\u01b0\u1eddng ph\u00e2n lo\u1ea1i theo t\u1ea7n su\u1ea5t \u0111\u01b0\u1ee3c li\u1ec7t k\u00ea d\u01b0\u1edbi \u0111\u00e2y. Ph\u00e2n t\u00edch t\u1ea7n su\u1ea5t d\u1ef1a tr\u00ean c\u00e1c d\u1eef li\u1ec7u c\u1ea3 \u0111\u01b0\u1eddng u\u1ed1ng v\u00e0 \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch c\u1ee7a ciprofloxacin. T\u1ea7n su\u1ea5t \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a nh\u01b0 sau: ph\u1ed5 bi\u1ec3n (\u2265 1\/10), th\u01b0\u1eddng g\u1eb7p (\u2265 1\/100 \u0111\u1ebfn &lt; 1\/10), (\u00edt g\u1eb7p (\u2265 1\/1000 \u0111\u1ebfn &lt; 1\/100), hi\u1ebfm g\u1eb7p (\u2265 1\/10000 \u0111\u1ebfn &lt; 1\/1000), r\u1ea5t hi\u1ebfm g\u1eb7p (&lt; 1\/10000), ch\u01b0a bi\u1ebft r\u00f5 (kh\u00f4ng th\u1ebf \u01b0\u1edbc t\u00ednh \u0111\u01b0\u1ee3c t\u1eeb c\u00e1c d\u1eef li\u1ec7u hi\u1ec7n c\u00f3).<\/p>\n<table>\n<tbody>\n<tr>\n<td colspan=\"2\"><strong>Nhi\u1ec5m khu\u1ea9n v\u00e0 nhi\u1ec5m k\u00fd sinh tr\u00f9ng<\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00cdt g\u1eb7p:<\/td>\n<td>B\u1ed9i nhi\u1ec5m n\u1ea5m<\/td>\n<\/tr>\n<tr>\n<td>Hi\u1ebfm g\u1eb7p:<\/td>\n<td>Vi\u00eam \u0111\u1ea1i tr\u00e0ng li\u00ean quan \u0111\u1ebfn kh\u00e1ng sinh (r\u1ea5t hi\u1ebfm khi c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y t\u1eed vong) (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG)<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><strong>R\u1ed1i lo\u1ea1n tr\u00ean m\u00e1u v\u00e0 h\u1ec7 b\u1ea1ch huy\u1ebft<\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00cdt g\u1eb7p:<\/td>\n<td>T\u0103ng b\u1ea1ch c\u1ea7u \u01b0a aeosin<\/td>\n<\/tr>\n<tr>\n<td>Hi\u1ebfm g\u1eb7p:<\/td>\n<td>Gi\u1ea3m b\u1ea1ch c\u1ea7u, thi\u1ebfu m\u00e1u, gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh, t\u0103ng b\u1ea1ch c\u1ea7u, gi\u1ea3m ti\u1ec3u c\u1ea7u, t\u0103ng ti\u1ec3u c\u1ea7u<\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t hi\u1ebfm g\u1eb7p:<\/td>\n<td>Thi\u1ebfu m\u00e1u tan m\u00e1u, m\u1ea5t b\u1ea1ch c\u1ea7u h\u1ea1t, gi\u1ea3m to\u00e0n th\u1ec3 huy\u1ebft c\u1ea7u (\u0111e d\u1ecda t\u00ednh m\u1ea1ng), \u1ee9c ch\u1ebf t\u1ee7y x\u01b0\u01a1ng (\u0111e d\u1ecda t\u00ednh m\u1ea1ng)<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><strong>R\u1ed1i lo\u1ea1n h\u1ec7 mi\u1ec5n d\u1ecbch<\/strong><\/td>\n<\/tr>\n<tr>\n<td>Hi\u1ebfm g\u1eb7p:<\/td>\n<td>Ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng, ph\u00f9 d\u1ecb \u1ee9ng\/ph\u00f9 m\u1ea1ch<\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t hi\u1ebfm g\u1eb7p:<\/td>\n<td>Ph\u1ea3n \u1ee9ng ph\u1ea3n v\u1ec7, s\u1ed1c ph\u1ea3n v\u1ec7 (\u0111e d\u1ecda t\u00ednh m\u1ea1ng) (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG), ph\u1ea3n \u1ee9ng t\u01b0\u01a1ng t\u1ef1 b\u1ec7nh huy\u1ebft thanh<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><strong>R\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a v\u00e0 dinh d\u01b0\u1ee1ng<\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00cdt g\u1eb7p:<\/td>\n<td>Gi\u1ea3m c\u1ea3m gi\u00e1c th\u00e8m \u0103n<\/td>\n<\/tr>\n<tr>\n<td>Hi\u1ebfm g\u1eb7p:<\/td>\n<td>T\u0103ng \u0111\u01b0\u1eddng huy\u1ebft, h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG)<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><strong>R\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n<\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00cdt g\u1eb7p:<\/td>\n<td>T\u0103ng \u0111\u1ed9ng\/k\u00edch \u0111\u1ed9ng<\/td>\n<\/tr>\n<tr>\n<td>Hi\u1ebfm g\u1eb7p:<\/td>\n<td>L\u1eabn l\u1ed9n v\u00e0 m\u1ea5t ph\u01b0\u01a1ng h\u01b0\u1edbng, ph\u1ea3n \u1ee9ng lo \u00e2u, gi\u1ea5c m\u01a1 b\u1ea5t th\u01b0\u1eddng, tr\u1ea7m c\u1ea3m (\u0111\u1ec9nh \u0111i\u1ec3m l\u00e0 \u00fd \u0111\u1ecbnh\/\u00fd ngh\u0129 t\u1ef1 t\u1eed ho\u1eb7c h\u00e0nh vi t\u1ef1 t\u1eed) (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG), \u1ea3o gi\u00e1c.<\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t hi\u1ebfm g\u1eb7p:<\/td>\n<td>Lo\u1ea1n th\u1ea7n (\u0111\u1ec9nh \u0111i\u1ec3m l\u00e0 \u00fd \u0111\u1ecbnh\/\u00fd ngh\u0129 t\u1ef1 t\u1eed ho\u1eb7c h\u00e0nh vi t\u1ef1 t\u1eed) (xem C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG)<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><strong>R\u1ed1i lo\u1ea1n h\u1ec7 th\u1ea7n kinh<\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00cdt g\u1eb7p:<\/td>\n<td>\u0110au \u0111\u1ea7u, ch\u00f3ng m\u1eb7t, r\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7, r\u1ed1i lo\u1ea1n v\u1ecb gi\u00e1c<\/td>\n<\/tr>\n<tr>\n<td>Hi\u1ebfm g\u1eb7p:<\/td>\n<td>D\u1ecb c\u1ea3m v\u00e0 r\u1ed1i lo\u1ea1n x\u00fac gi\u00e1c, gi\u1ea3m x\u00fac gi\u00e1c, run, co gi\u1eadt (bao g\u1ed3m c\u00e1c c\u01a1n \u0111\u1ed9ng kinh, xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG), ch\u00f3ng m\u1eb7t<\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t hi\u1ebfm g\u1eb7p:<\/td>\n<td>\u0110au n\u1eefa \u0111\u1ea7u, r\u1ed1i lo\u1ea1n ph\u1ed1i h\u1ee3p, r\u1ed1i lo\u1ea1n th\u0103ng b\u1eb1ng, r\u1ed1i lo\u1ea1n th\u1ea7n kinh kh\u1ee9u gi\u00e1c, t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd v\u00e0 gi\u1ea3 u n\u00e3o<\/td>\n<\/tr>\n<tr>\n<td>Ch\u01b0a bi\u1ebft r\u00f5:<\/td>\n<td>B\u1ec7nh l\u00fd th\u1ea7n kinh ngo\u1ea1i bi\u00ean v\u00e0 b\u1ec7nh l\u00fd \u0111a th\u1ea7n kinh (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG)<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><strong>R\u1ed1i lo\u1ea1n th\u1ecb gi\u00e1c<\/strong><\/td>\n<\/tr>\n<tr>\n<td>Hi\u1ebfm g\u1eb7p:<\/td>\n<td>R\u1ed1i lo\u1ea1n t\u1ea7m nh\u00ecn (v\u00ed d\u1ee5 nh\u00ecn \u0111\u00f4i)<\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t hi\u1ebfm g\u1eb7p:<\/td>\n<td>R\u1ed1i lo\u1ea1n m\u00e0u s\u1eafc<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><strong>C\u00e1c r\u1ed1i lo\u1ea1n tr\u00ean tai v\u00e0 m\u00ea \u0111\u1ea1o<\/strong><\/td>\n<\/tr>\n<tr>\n<td>Hi\u1ebfm g\u1eb7p:<\/td>\n<td>\u00d9 tai, \u0111i\u1ebfc, gi\u1ea3m th\u00ednh gi\u00e1c<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><strong>R\u1ed1i lo\u1ea1n tr\u00ean tim<\/strong><\/td>\n<\/tr>\n<tr>\n<td>Hi\u1ebfm g\u1eb7p:<\/td>\n<td>Nh\u1ecbp tim nhanh<\/td>\n<\/tr>\n<tr>\n<td>Ch\u01b0a bi\u1ebft r\u00f5:<\/td>\n<td>Lo\u1ea1n nh\u1ecbp th\u1ea5t v\u00e0 xo\u1eafn \u0111\u1ec9nh (c\u00e1c b\u00e1o c\u00e1o ch\u1ee7 y\u1ebfu tr\u00ean b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 k\u00e9o d\u00e0i kho\u1ea3ng QT), k\u00e9o d\u00e0i kho\u1ea3ng QT tr\u00ean \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 (xem C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG v\u00e0 QU\u00c1 LI\u1ec0U)<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><strong>R\u1ed1i loan h\u1ec7 m\u1ea1ch<\/strong><\/td>\n<\/tr>\n<tr>\n<td>Hi\u1ebfm g\u1eb7p:<\/td>\n<td>Gi\u00e3n m\u1ea1ch, h\u1ea1 huy\u1ebft \u00e1p, ng\u1ea5t<\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t hi\u1ebfm g\u1eb7p:<\/td>\n<td>Vi\u00eam m\u1ea1ch<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><strong>R\u1ed1i lo\u1ea1n h\u1ec7 h\u00f4 h\u1ea5p, l\u1ed3ng ng\u1ef1c v\u00e0 trung th\u1ea5t<\/strong><\/td>\n<\/tr>\n<tr>\n<td>Hi\u1ebfm g\u1eb7p:<\/td>\n<td>Kh\u00f3 th\u1edf (bao g\u1ed3m c\u1ea3 t\u00ecnh tr\u1ea1ng hen)<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><strong>R\u1ed1i lo\u1ea1n h\u1ec7 ti\u00eau h\u00f3a<\/strong><\/td>\n<\/tr>\n<tr>\n<td>Th\u01b0\u1eddng g\u1eb7p:<\/td>\n<td>Bu\u1ed3n n\u00f4n, ti\u00eau ch\u1ea3y<\/td>\n<\/tr>\n<tr>\n<td>\u00cdt g\u1eb7p:<\/td>\n<td>N\u00f4n, \u0111au d\u1ea1 d\u00e0y \u2013 ru\u1ed9t v\u00e0 \u0111au b\u1ee5ng, kh\u00f3 ti\u00eau, \u0111\u1ea7y h\u01a1i<\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t hi\u1ebfm g\u1eb7p:<\/td>\n<td>Vi\u00eam t\u1ee5y<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><strong>R\u1ed1i lo\u1ea1n gan m\u1eadt<\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00cdt g\u1eb7p:<\/td>\n<td>T\u0103ng transaminase, t\u0103ng bilirubin<\/td>\n<\/tr>\n<tr>\n<td>Hi\u1ebfm g\u1eb7p:<\/td>\n<td>Suy gan, v\u00e0ng da \u1ee9 m\u1eadt, vi\u00eam gan<\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t hi\u1ebfm g\u1eb7p:<\/td>\n<td>Ho\u1ea1i t\u1eed gan (r\u1ea5t hi\u1ebfm khi ti\u1ebfn tri\u1ec3n th\u00e0nh suy gan \u0111e d\u1ecda t\u00ednh m\u1ea1ng (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG)<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><strong>C\u00e1c r\u1ed1i lo\u1ea1n tr\u00ean da v\u00e0 m\u00f4 d\u01b0\u1edbi da<\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00cdt g\u1eb7p:<\/td>\n<td>Ph\u00e1t ban, ng\u1ee9a, n\u1ed5i m\u1ec1 \u0111ay<\/td>\n<\/tr>\n<tr>\n<td>Hi\u1ebfm g\u1eb7p:<\/td>\n<td>C\u00e1c ph\u1ea3n \u1ee9ng nh\u1ea1y c\u1ea3m v\u1edbi \u00e1nh s\u00e1ng (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG)<\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t hi\u1ebfm g\u1eb7p:<\/td>\n<td>Xu\u1ea5t huy\u1ebft, h\u1ed3ng ban \u0111a d\u1ea1ng, h\u1ed3ng ban n\u00fat h\u1ed9i ch\u1ee9ng Stevens &#8211; Johnson (c\u00f3 th\u1ec3 \u0111e d\u1ecda t\u00ednh m\u1ea1ng), h\u1ecdai t\u1eed bi\u1ec3u b\u00ec (c\u00f3 th\u1ec3 \u0111e d\u1ecda t\u00ednh m\u1ea1ng)<\/td>\n<\/tr>\n<tr>\n<td>Ch\u01b0a bi\u1ebft r\u00f5:<\/td>\n<td>Ph\u00e1t ban m\u1ee5n m\u1ee7 c\u1ea5p to\u00e0n th\u00e2n (AGEP)<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><strong>R\u1ed1i lo\u1ea1n c\u01a1 x\u01b0\u01a1ng v\u00e0 m\u00f4 li\u00ean k\u1ebft<\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00cdt g\u1eb7p:<\/td>\n<td>\u0110au c\u01a1 &#8211; x\u01b0\u01a1ng (nh\u01b0 \u0111au c\u00e1c \u0111\u1ea7u chi, \u0111au l\u01b0ng, \u0111au ng\u1ef1c), \u0111au kh\u1edbp<\/td>\n<\/tr>\n<tr>\n<td>Hi\u1ebfm g\u1eb7p:<\/td>\n<td>\u0110au c\u01a1 vi\u00eam kh\u1edbp, t\u0103ng tr\u01b0\u01a1ng l\u1ef1c c\u01a1 v\u00e0 chu\u1ed9t r\u00fat<\/td>\n<\/tr>\n<tr>\n<td>R\u1ea5t hi\u1ebfm g\u1eb7p:<\/td>\n<td>Y\u1ebfu c\u01a1, vi\u00eam g\u00e2n, \u0111\u1ee9t g\u00e2n (ch\u1ee7 y\u1ebfu l\u00e0 g\u00e2n Achilles) (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG), l\u00e0m tr\u1ea7m tr\u1ecdng th\u00eam tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh nh\u01b0\u1ee3c c\u01a1 (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG)<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><strong>R\u1ed1i lo\u1ea1n tr\u00ean th\u1eadn v\u00e0 \u0111\u01b0\u1eddng ni\u1ec7u<\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00cdt g\u1eb7p:<\/td>\n<td>Suy th\u1eadn<\/td>\n<\/tr>\n<tr>\n<td>Hi\u1ebfm g\u1eb7p:<\/td>\n<td>Suy th\u1eadn, huy\u1ebft ni\u1ec7u, tinh th\u1ec3 ni\u1ec7u (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG), vi\u00eam c\u1ea7u th\u1eadn k\u1ebd<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><strong>R\u1ed1i lo\u1ea1n chung v\u00e0 t\u1ea1i v\u1ecb tr\u00ed \u0111\u01b0a thu\u1ed1c<\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00cdt g\u1eb7p:<\/td>\n<td>Suy nh\u01b0\u1ee3c, s\u1ed1t<\/td>\n<\/tr>\n<tr>\n<td>Hi\u1ebfm g\u1eb7p:<\/td>\n<td>Ph\u00f9, \u0111\u1ed5 m\u1ed5 h\u00f4i (t\u0103ng ti\u1ebft m\u1ed3 h\u00f4i)<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\"><strong>C\u00e1c x\u00e9t nghi\u1ec7m<\/strong><\/td>\n<\/tr>\n<tr>\n<td>\u00cdt g\u1eb7p:<\/td>\n<td>T\u0103ng phosphatase ki\u1ec1m trong m\u00e1u<\/td>\n<\/tr>\n<tr>\n<td>Hi\u1ebfm g\u1eb7p:<\/td>\n<td>T\u0103ng amylase<\/td>\n<\/tr>\n<tr>\n<td>Ch\u01b0a bi\u1ebft r\u00f5:<\/td>\n<td>T\u0103ng INR (tr\u00ean b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb b\u1eb1ng c\u00e1c thu\u1ed1c kh\u00e1ng vitamin K)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><em>Qu\u1ea7n th\u1ec3 b\u1ec7nh nhi<\/em><\/p>\n<p>T\u1ef7 l\u1ec7 m\u1eafc b\u1ec7nh kh\u1edbp, nh\u01b0 \u0111\u00e3 \u0111\u1ec1 c\u1eadp \u1edf tr\u00ean, li\u00ean quan \u0111\u1ebfn c\u00e1c d\u1eef li\u1ec7u thu th\u1eadp t\u1eeb c\u00e1c nghi\u00ean c\u1ee9u tr\u00ean ng\u01b0\u1eddi l\u1edbn. Tr\u00ean tr\u1ebb em, b\u1ec7nh kh\u1edbp \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o l\u00e0 th\u01b0\u1eddng x\u1ea3y ra (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG)<\/p>\n<p><em>Th\u00f4ng b\u00e1o cho B\u00e1c s\u0129 nh\u1eefng t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n g\u1eb7p ph\u1ea3i khi s\u1eed d\u1ee5ng thu\u1ed1c.<\/em><\/p>\n<p><strong>4.7 H\u01b0\u1edbng d\u1eabn c\u00e1ch x\u1eed tr\u00ed ADR:<\/strong><\/p>\n<p>\u00d0\u1ec3 tr\u00e1nh c\u00f3 tinh th\u1ec3 ni\u1ec7u, duy tr\u00ec \u0111\u1ee7 l\u01b0\u1ee3ng n\u01b0\u1edbc u\u1ed1ng v\u00e0o, tr\u00e1nh l\u00e0m n\u01b0\u1edbc ti\u1ec3u qu\u00e1 ki\u1ec1m.<\/p>\n<p>N\u1ebfu b\u1ecb \u1ec9a ch\u1ea3y n\u1eb7ng v\u00e0 k\u00e9o d\u00e0i trong v\u00e0 sau khi \u0111i\u1ec1u tr\u1ecb, ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 \u0111\u00e3 b\u1ecb r\u1ed1i lo\u1ea1n n\u1eb7ng \u1edf ru\u1ed9t (vi\u00eam \u0111\u1ea1i tr\u00e0ng m\u00e0ng gi\u1ea3). C\u1ea7n ng\u1eebng ciprofloxacin v\u00e0 thay b\u1eb1ng m\u1ed9t kh\u00e1ng sinh kh\u00e1c th\u00edch h\u1ee3p (v\u00ed d\u1ee5 vancomycin).<\/p>\n<p>N\u1ebfu c\u00f3 b\u1ea5t k\u1ef3 d\u1ea5u hi\u1ec7u n\u00e0o v\u1ec1 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ea7n ng\u1eebng d\u00f9ng ciprofloxacin v\u00e0 ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb t\u1ea1i m\u1ed9t c\u01a1 s\u1edf y t\u1ebf m\u1eb7c d\u00f9 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 n\u00e0y th\u01b0\u1eddng nh\u1eb9 ho\u1eb7c v\u1eeba v\u00e0 s\u1ebd mau h\u1ebft khi ng\u1eebng d\u00f9ng ciprofloxacin.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>4.8 T\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1c:<\/strong><\/p>\n<p><strong><em>\u1ea2nh h\u01b0\u1edfng c\u1ee7a c\u00e1c thu\u1ed1c kh\u00e1c t\u1edbi ciprofloxacin:<\/em><\/strong><\/p>\n<p><em>C\u00e1c thu\u1ed1c \u0111\u00e3 \u0111\u01b0\u1ee3c bi\u1ebft l\u00e0m k\u00e9o d\u00e0i kho\u1ea3ng QT<\/em><\/p>\n<p>T\u01b0\u01a1ng t\u1ef1 c\u00e1c fluoroquinoion kh\u00e1c, n\u00ean th\u1eadn tr\u1ecdng khi s\u1eed d\u1ee5ng ciprofloxacin cho b\u1ec7nh nh\u00e2n \u0111ang d\u00f9ng c\u00e1c thu\u1ed1c \u0111\u00e3 \u0111\u01b0\u1ee3c bi\u1ebft l\u00e0m k\u00e9o d\u00e0i kho\u1ea3ng QT tr\u00ean \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 (nh\u01b0 c\u00e1c thu\u1ed1c ch\u1ed1ng lo\u1ea1n nh\u1ecbp nh\u00f3m IA v\u00e0 III, c\u00e1c thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m ba v\u00f2ng, c\u00e1c kh\u00e1ng sinh macrolid v\u00e0 c\u00e1c thu\u1ed1c ch\u00f3ng lo\u1ea1n th\u1ea7n) (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG).<\/p>\n<p><em>T\u1ea1o th\u00e0nh ph\u1ee9c h\u1ee3p chelat<\/em><\/p>\n<p>S\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi ciprofloxacin (\u0111\u01b0\u1eddng u\u1ed1ng) v\u00e0 c\u00e1c thu\u1ed1c ch\u1ee9a cation \u0111\u1ed3ng h\u00f3a tr\u1ecb v\u00e0 b\u1ed5 sung ch\u1ea5t kho\u00e1ng (nh\u01b0 canxi, magie, nh\u00f4m, s\u1eaft), ch\u1ea5t g\u1eafn k\u1ebft polyme phosphate (nh\u01b0 sevelamer ho\u1eb7c lanthanum carbonat), thu\u1ed1c b\u1ea3o v\u1ec7 ni\u00eam m\u1ea1c ho\u1eb7c kh\u00e1ng acid v\u00e0 c\u00e1c thu\u1ed1c c\u00f3 kh\u1ea3 n\u0103ng \u0111\u1ec7m cao (nh\u01b0 vi\u00ean n\u00e9n didanosin) ch\u1ee9a magie, nh\u00f4m hay canxi l\u00e0m gi\u1ea3m h\u1ea5p thu ciprofloxacin. Do \u0111\u00f3, n\u00ean d\u00f9ng ciprofloxacin tr\u01b0\u1edbc 1 &#8211; 2 gi\u1edd ho\u1eb7c \u00edt nh\u1ea5t 4 gi\u1edd sau khi d\u00f9ng c\u00e1c thu\u1ed1c n\u00e0y. H\u1ea1n ch\u1ebf n\u00e0y kh\u00f4ng \u00e1p d\u1ee5ng cho c\u00e1c thu\u1ed1c kh\u00e1ng acid thu\u1ed9c nh\u00f3m kh\u00e1ng th\u1ee5 th\u1ec3 H2.<\/p>\n<p><em>Th\u1ee9c \u0103n v\u00e0 c\u00e1c s\u1ea3n ph\u1ea9m t\u1eeb s\u1eefa<\/em><\/p>\n<p>Th\u00e0nh ph\u1ea7n canxi c\u00f3 trong b\u1eefa \u0103n \u1ea3nh h\u01b0\u1edfng kh\u00f4ng c\u00f3 \u00fd ngh\u0129a \u0111\u1ebfn m\u1ee9c \u0111\u1ed9 h\u1ea5p thu c\u1ee7a thu\u1ed1c. Tuy nhi\u00ean, n\u00ean tr\u00e1nh d\u00f9ng \u0111\u1ed3ng th\u1eddi c\u00e1c s\u1ea3n ph\u1ea9m s\u1eefa ho\u1eb7c \u0111\u1ed3 u\u1ed1ng c\u00f3 b\u1ed5 sung ch\u1ea5t kho\u00e1ng (nh\u01b0 s\u1eefa, s\u1eefa chua, n\u01b0\u1edbc cam c\u00f3 b\u1ed5 sung canxi) c\u00f9ng v\u1edbi ciprofloxacin do l\u00e0m gi\u1ea3m kh\u1ea3 n\u0103ng h\u1ea5p thu c\u1ee7a ciprofloxacin.<\/p>\n<p><em>Probenecid<\/em><\/p>\n<p>Probenecid \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 b\u00e0i ti\u1ebft qua th\u1eadn c\u1ee7a ciprofloxacin. D\u00f9ng \u0111\u1ed3ng th\u1eddi ciprofloxacin v\u00e0 Probenecid l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 ciprofloxacin huy\u1ebft thanh.<\/p>\n<p><em>Metoclopramid<\/em><\/p>\n<p>Metoclopramid l\u00e0m t\u0103ng t\u1ed1c \u0111\u1ed9 h\u1ea5p thu c\u1ee7a ciprofloxacin (\u0111\u01b0\u1eddng u\u1ed1ng) d\u1eabn \u0111\u1ebfn l\u00e0m gi\u1ea3m th\u1eddi gian \u0111\u1ea1t n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh c\u1ee7a thu\u1ed1c trong huy\u1ebft t\u01b0\u01a1ng. Kh\u00f4ng quan s\u00e1t th\u1ea5y \u1ea3nh h\u01b0\u1edfng c\u1ee7a thu\u1ed1c \u0111\u1ebfn sinh kh\u1ea3 d\u1ee5ng c\u1ee7a ciprofloxacin.<\/p>\n<p><em>Omeprazol<\/em><\/p>\n<p>D\u00f9ng \u0111\u1ed3ng th\u1eddi ciprofloxacin v\u00e0 c\u00e1c ch\u1ebf ph\u1ea5m ch\u1ee9a omeprazol l\u00e0m gi\u1ea3m nh\u1eb9 n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh C<sub>max<\/sub>, v\u00e0 di\u1ec7n t\u00edch d\u01b0\u1edbi \u0111\u01b0\u1eddng cong AUC c\u1ee7a ciprofloxacin.<\/p>\n<p><strong><em>\u1ea2nh h\u01b0\u1edfng c\u1ee7a ciprofloxacin \u0111\u1ebfn c\u00e1c thu\u1ed1c kh\u00e1c<\/em><\/strong><\/p>\n<p><em>Tizanidin<\/em><\/p>\n<p>Kh\u00f4ng \u0111\u01b0\u1ee3c d\u00f9ng tizanidin c\u00f9ng v\u1edbi ciprofloxacin (xem m\u1ee5c CH\u1ed0NG CH\u1ec8 \u0110\u1ecaNH). Trong m\u1ed9t nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng tr\u00ean ng\u01b0\u1eddi t\u00ecnh nguy\u1ec7n kh\u1ecfe m\u1ea1nh, n\u1ed3ng \u0111\u1ed9 tizanidin trong huy\u1ebft thanh t\u0103ng l\u00ean (C<sub>max<\/sub>\u00a0t\u0103ng: 7 l\u1ea7n, dao \u0111\u1ed9ng t\u1eeb 4 \u0111\u1ebfn 21 l\u1ea7n; AUC t\u0103ng: 10 l\u1ea7n, dao \u0111\u1ed9ng t\u1eeb 6 \u0111\u1ebfn 24 l\u1ea7n) khi d\u00f9ng \u0111\u1ed3ng th\u1eddi v\u1edbi ciprofloxacin. N\u1ed3ng \u0111\u1ed9 tizanidin trong huy\u1ebft t\u01b0\u01a1ng t\u0103ng li\u00ean quan \u0111\u1ebfn t\u00e1c d\u1ee5ng h\u1ea1 huy\u1ebft \u00e1p v\u00e0 an th\u1ea7n.<\/p>\n<p><em>Methotrexat<\/em><\/p>\n<p>S\u1ef1 v\u1eadn chuy\u1ec3n methotrexat qua \u1ed1ng th\u1eadn c\u00f3 th\u1ebf b\u1ecb \u1ee9c ch\u1ebf khi d\u00f9ng thu\u1ed1c \u0111\u1ed3ng th\u1eddi v\u1edbi ciprofloxacin d\u1eabn \u0111\u1ebfn l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 methotrexat trong huy\u1ebft t\u01b0\u01a1ng v\u00e0 c\u00f3 nguy c\u01a1 l\u00e0m t\u0103ng \u0111\u1ed9c t\u00ednh c\u1ee7a methotrexat. Khuy\u1ebfn c\u00e1o kh\u00f4ng s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi methotrexat v\u00e0 ciprofloxacin (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG)<\/p>\n<p><em>Theophyllin<\/em><\/p>\n<p>S\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi ciprofloxacin v\u00e0 theophylin c\u00f3 th\u1ec3 l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 theophylin kh\u00f4ng mong mu\u1ed1n trong huy\u1ebft thanh. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a theophyllin m\u00e0 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 n\u00e0y hi\u1ebfm khi \u0111e d\u1ecda \u0111\u1ebfn t\u00ednh m\u1ea1ng ho\u1eb7c g\u00e2y t\u1eed vong. Trong khi ph\u1ed1i h\u1ee3p, n\u00ean ki\u1ec3m tra n\u1ed3ng \u0111\u1ed9 theophyllin trong huy\u1ebft thanh v\u00e0 gi\u1ea3m li\u1ec1u theophylin n\u1ebfu c\u1ea7n thi\u1ebft (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG).<\/p>\n<p><em>C\u00e1c d\u1eabn ch\u1ea5t xanthin kh\u00e1c<\/em><\/p>\n<p>Khi d\u00f9ng \u0111\u1ed3ng th\u1eddi ciprofloxacin v\u1edbi cafein ho\u1eb7c pentoxifyllin (oxpentlfyllin), \u0111\u00e3 c\u00f3 b\u00e1o c\u00e1o v\u1ec1 vi\u1ec7c n\u1ed3ng \u0111\u1ed9 c\u00e1c d\u1eabn ch\u1ea5t xanthin n\u00e0y t\u0103ng l\u00ean trong huy\u1ebft thanh.<\/p>\n<p><em>Phenytoin<\/em><\/p>\n<p>D\u00f9ng \u0111\u1ed3ng th\u1eddi ciprofloxacin v\u00e0 phenytoin c\u00f3 th\u1ec3 l\u00e0m t\u0103ng ho\u1eb7c gi\u1ea3m n\u1ed3ng \u0111\u1ed9 phenytoin trong huy\u1ebft thanh do \u0111\u00f3 vi\u1ec7c theo d\u00f5i n\u1ed3ng \u0111\u1ed9 thu\u1ed1c \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o.<\/p>\n<p><em>Cyclosporin<\/em><\/p>\n<p>S\u1ef1 t\u0103ng tho\u00e1ng qua n\u1ed5ng \u0111\u1ed9 creatinin trong huy\u1ebft thanh \u0111\u00e3 \u0111\u01b0\u1ee3c quan s\u00e1t th\u1ea5y khi d\u00f9ng \u0111\u1ed3ng th\u1eddi ciprofloxacin v\u1edbi c\u00e1c thu\u1ed1c ch\u1ee9a cyclosporin. Do \u0111\u00f3, c\u1ea7n th\u01b0\u1eddng xuy\u00ean (2 l\u1ea7n m\u1ed9t tu\u1ea7n) ki\u1ec3m so\u00e1t n\u1ed3ng \u0111\u1ed9 creatinin huy\u1ebft thanh tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y.<\/p>\n<p><em>C\u00e1c thu\u1ed1c kh\u00e1ng vitamin K<\/em><\/p>\n<p>S\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi ciprofloxacin v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1ng vitamin K c\u00f3 th\u1ec3 l\u00e0m t\u0103ng t\u00e1c d\u1ee5ng ch\u1ed1ng \u0111\u00f4ng m\u00e1u c\u1ee7a c\u00e1c thu\u1ed1c n\u00e0y. Nguy c\u01a1 c\u00f3 th\u1ec3 thay \u0111\u1ed5i v\u1edbi c\u00e1c nhi\u1ec5m khu\u1ea9n s\u1eb5n c\u00f3, tu\u1ed5i v\u00e0 t\u00ecnh tr\u1ea1ng to\u00e0n th\u00e2n c\u1ee7a b\u1ec7nh nh\u00e2n n\u00ean vai tr\u00f2 c\u1ee7a ciprofloxacin trong vi\u1ec7c l\u00e0m t\u0103ng INR (ch\u1ec9 s\u1ed1 b\u00ecnh th\u01b0\u1eddng h\u00f3a qu\u1ed1c t\u1ebf) l\u00e0 kh\u00f3 \u0111\u00e1nh gi\u00e1. N\u00ean th\u01b0\u1eddng xuy\u00ean theo d\u00f5i INR trong v\u00e0 sau th\u1eddi gian ng\u1eafn d\u00f9ng ciprofloxacin v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1ng vitamin K (nh\u01b0 warfarin, acenocoumarol, phenprocoumon hay fluindion).<\/p>\n<p><em>Duloxetin<\/em><\/p>\n<p>C\u00e1c nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng \u0111\u00e3 ch\u1ee9ng minh s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi duloxetin v\u00e0 c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf m\u1ea1nh Isoenzym CYP450 1A2 nh\u01b0 fluvoxamin c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn l\u00e0m t\u0103ng n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh (C<sub>max)<\/sub>\u00a0v\u00e0 di\u1ec7n t\u00edch d\u01b0\u1edbi \u0111\u01b0\u1eddng cong (AUC) c\u1ee7a duloxetin. M\u1eb7c d\u00f9 ch\u01b0a c\u00f3 c\u00e1c d\u1eef li\u1ec7u l\u00e2m s\u00e0ng v\u1ec1 kh\u1ea3 n\u0103ng t\u01b0\u01a1ng t\u00e1c c\u1ee7a thu\u1ed1c v\u1edbi ciprofloxacin, c\u00e1c t\u00e1c d\u1ee5ng t\u01b0\u01a1ng t\u1ef1 c\u0169ng c\u00f3 th\u1ec3 x\u1ea3y ra khi d\u00f9ng \u0111\u1ed3ng th\u1eddi hai thu\u1ed1c n\u00e0y (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG).<\/p>\n<p><em>Ropinirol<\/em><\/p>\n<p>M\u1ed9t nghi\u00ean c\u1ee9u l\u00e2m s\u00e0ng \u0111\u00e3 ch\u1ec9 ra r\u1eb1ng s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi ropinirol v\u1edbi ciprofloxacin, m\u1ed9t ch\u1ea5t \u1ee9c ch\u1ebf trung b\u00ecnh Isoenzym CYP4501A2, l\u00e0m t\u0103ng 60% n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh (C<sub>max<\/sub>) v\u00e0 84% di\u1ec7n t\u00edch d\u01b0\u1edbi \u0111\u01b0\u1eddng cong (AUC) c\u1ee7a ropinirol. Theo d\u00f5i c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a ropinirol v\u00e0 \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u th\u00edch h\u1ee3p \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o trong v\u00e0 sau m\u1ed9t th\u1eddi gian ng\u1eafn d\u00f9ng c\u00f9ng ciprofloxacin (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG).<\/p>\n<p><em>Lidocain<\/em><\/p>\n<p>\u0110\u00e3 c\u00f3 ch\u1ee9ng minh tr\u00ean ng\u01b0\u1eddi t\u00ecnh nguy\u1ec7n kh\u1ecfe m\u1ea1nh khi d\u00f9ng \u0111\u1ed3ng th\u1eddi c\u00e1c thu\u1ed1c ch\u1ee9a lidocain v\u1edbi ciprofloxacin, m\u1ed9t ch\u1ea5t \u1ee9c ch\u1ebf trung b\u00ecnh isoenzym CYP450 1A2, l\u00e0m gi\u1ea3m 22% \u0111\u1ed9 thanh th\u1ea3i c\u1ee7a lidocain \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch. M\u1eb7c d\u00f9 lidocain \u0111\u01b0\u1ee3c dung n\u1ea1p t\u1ed1t, t\u01b0\u01a1ng t\u00e1c c\u00f3 th\u1ec3 x\u1ea3y ra v\u1edbi ciprofloxacin li\u00ean quan \u0111\u1ebfn c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n khi d\u00f9ng \u0111\u1ed3ng th\u1eddi hai thu\u1ed1c n\u00e0y.<\/p>\n<p><em>Clozapin<\/em><\/p>\n<p>Sau 7 ng\u00e0y d\u00f9ng \u0111\u1ed3ng th\u1eddi ciprofloxacin 250mg v\u1edbi clozapin, n\u1ed3ng \u0111\u1ed9 clozapin v\u00e0 N-desmethy clozapin trong huy\u1ebft thanh t\u0103ng t\u01b0\u01a1ng \u1ee9ng l\u00e0 29% v\u00e0 31%. Theo d\u00f5i tr\u00ean l\u00e2m s\u00e0ng v\u00e0 \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u clozapin th\u00edch h\u1ee3p trong v\u00e0 th\u1eddi gian ng\u1eafn sau khi d\u00f9ng thu\u1ed1c c\u00f9ng ciprofloxacin \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o (xem m\u1ee5c C\u1ea2NH B\u00c1O \u0110\u1eb6C BI\u1ec6T V\u00c0 TH\u1eacN TR\u1eccNG KHI S\u1eec D\u1ee4NG).<\/p>\n<p><em>Sildenafil<\/em><\/p>\n<p>N\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh (C<sub>max<\/sub>) v\u00e0 di\u1ec7n t\u00edch d\u01b0\u1edbi \u0111\u01b0\u1eddng cong (AUC) c\u1ee7a sildenafil tr\u00ean ng\u01b0\u1eddi t\u00ecnh nguy\u1ec7n kh\u1ecfe m\u1ea1nh t\u0103ng kho\u1ea3ng hai l\u1ea7n sau khi u\u1ed1ng sildenafil li\u1ec1u 50mg c\u00f9ng v\u1edbi 500mg ciprofloxacin. Do \u0111\u00f3 c\u1ea7n th\u1eadn tr\u1ecdng khi k\u00ea \u0111\u01a1n ciprofloxacin c\u00f9ng v\u1edbi sildenafil, c\u1ea7n c\u00e2n nh\u1eafc nguy c\u01a1 v\u00e0 l\u1ee3i \u00edch c\u1ee7a s\u1ef1 k\u1ebft h\u1ee3p n\u00e0y.<\/p>\n<p><strong><em>D\u00f9ng Serviflox 500 \u0111\u1ed3ng th\u1eddi v\u1edbi th\u1ee9c \u0103n v\u00e0 \u0111\u1ed3 u\u1ed1ng<\/em><\/strong><\/p>\n<p>Tr\u1eeb khi d\u00f9ng Serviflox 500 \u0111\u1ed3ng th\u1eddi v\u1edbi b\u1eefa \u0103n, kh\u00f4ng n\u00ean \u0103n ho\u1eb7c u\u1ed1ng c\u00e1c s\u1ea3n ph\u1ea9m t\u1eeb s\u1eefa (nh\u01b0 s\u1eefa ho\u1eb7c s\u1eefa chua) ho\u1eb7c v\u1edbi th\u1ee9c u\u1ed1ng t\u0103ng c\u01b0\u1eddng canxi do ch\u00fang l\u00e0m \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 h\u1ea5p thu c\u1ee7a Serviflox 500.<\/p>\n<p><strong>4.9 Qu\u00e1 li\u1ec1u v\u00e0 x\u1eed tr\u00ed:<\/strong><\/p>\n<p>\u0110\u00e3 c\u00f3 b\u00e1o c\u00e1o v\u1ec3 qu\u00e1 li\u1ec1u 12g d\u1eabn \u0111\u1ebfn c\u00e1c tri\u1ec7u ch\u00fang ng\u1ed9 \u0111\u1ed9c nh\u1eb9. Qu\u00e1 li\u1ec1u 16g \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o l\u00e0 g\u00e2y suy th\u1eadn c\u1ea5p.<\/p>\n<p>C\u00e1c tri\u1ec7u ch\u00fang qu\u00e1 li\u1ec1u bao g\u1ed3m ch\u00f3ng m\u1eb7t run r\u1ea9y, \u0111au \u0111\u1ea7u, m\u1ec7t m\u1ecfi, co gi\u1eadt, \u1ea3o gi\u00e1c l\u00fa l\u1eabn, \u0111au b\u1ee5ng, suy gan v\u00e0 th\u1eadn c\u0169ng nh\u01b0 c\u00f3 tinh th\u1ec3 ni\u1ec7u v\u00ec ti\u1ec3u ra m\u00e1u. \u0110\u1ed9c t\u00ednh tr\u00ean th\u1eadn c\u00f3 th\u1ec3 h\u1ed3i ph\u1ee5c. Ngo\u00e0i c\u00e1c bi\u1ec7n ph\u00e1p c\u1ea5p c\u1ee9u th\u01b0\u1eddng qui, khuy\u1ebfn c\u00e1o n\u00ean theo d\u00f5i ch\u1ee9c n\u0103ng th\u1eadn, bao g\u1ed3m \u0111o pH ni\u1ec7u &amp; acid h\u00f3a n\u01b0\u1edbc ti\u1ec3u, n\u1ebfu c\u1ea7n thi\u1ebft, \u0111\u1ec3 tr\u00e1nh c\u00f3 tinh th\u1ec3 ni\u1ec7u. B\u1ec7nh nh\u00e2n n\u00ean duy tr\u00ec \u0111\u1ee7 l\u01b0\u1ee3ng n\u01b0\u1edbc u\u1ed1ng v\u00e0o. V\u1ec1 m\u1eb7t l\u00fd thuy\u1ebft, canxi v\u00e0 magnesi c\u00f3 ch\u1ee9a antacids c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m s\u1ef1 h\u1ea5p thu c\u1ee7a ciprofloxacin khi qu\u00e1 li\u1ec1u.<\/p>\n<p>Ch\u1ec9 m\u1ed9t l\u01b0\u1ee3ng nh\u1ecf ciprofloxacin (&lt; 10%) \u0111\u01b0\u1ee3c \u0111\u00e0o th\u1ea3i b\u1eb1ng th\u1eafm t\u00e1ch m\u00e1u ho\u1eb7c ph\u00fac m\u1ea1c.<\/p>\n<p>C\u1ea7n \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng khi b\u1ecb qu\u00e1 li\u1ec1u. N\u00ean th\u1ef1c hi\u1ec7n \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 v\u00ec c\u00f3 kh\u1ea3 n\u0103ng k\u00e9o d\u00e0i kho\u1ea3ng QT.<\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>5. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c :<\/strong><\/p>\n<p><strong>5.1. D\u01b0\u1ee3c l\u1ef1c h\u1ecdc:<\/strong><\/p>\n<p>Nh\u00f3m \u0111i\u1ec1u tr\u1ecb d\u01b0\u1ee3c l\u00fd: Fluoroquinolone. M\u00e3 ATC: J01MA02<\/p>\n<p><em>C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng<\/em><\/p>\n<p>Ciprofloxacin l\u00e0 m\u1ed9t kh\u00e1ng sinh kh\u00e1ng khu\u1ea9n thu\u1ed9c nh\u00f3m fluoroquinolone, t\u00e1c d\u1ee5ng di\u1ec7t khu\u1ea9n c\u1ee7a ciprofloxacin l\u00e0 do \u1ee9c ch\u1ebf c\u1ea3 2 lo\u1ea1i men topolsomerase II (DNA-gyrase) v\u00e0 topoisomerase IV, qui \u0111\u1ecbnh s\u1ef1 sao ch\u00e9p DNA, s\u1ef1 phi\u00ean m\u00e3, s\u1eeda ch\u1eefa &amp; t\u00e1i t\u1ed5 h\u1ee3p.<\/p>\n<p><em>M\u1ed1i t\u01b0\u01a1ng quan gi\u1eefa d\u01b0\u1ee3c \u0111\u1ed9ng &amp; d\u01b0\u1ee3c l\u1ef1c h\u1ecdc<\/em><\/p>\n<p>Hi\u1ec7u l\u1ef1c c\u1ee7a thu\u1ed1c ch\u1ee7 y\u1ebfu ph\u1ee5 thu\u1ed9c v\u00e0o t\u1ef7 l\u1ec7 gi\u1eefa n\u1ed3ng \u0111\u1ed9 thu\u1ed1c c\u1ef1c \u0111\u1ea1i trong huy\u1ebft thanh (C<sub>max<\/sub>) v\u00ec n\u1ed3ng \u0111\u1ed9 \u1ee9c ch\u1ebf t\u1ed1i thi\u1ec3u (MIC) c\u1ee7a ciprofloxacin \u0111\u1ed1i v\u1edbi vi khu\u1ea9n g\u00e2y b\u1ec7nh v\u00e0 t\u1ef7 l\u1ec7 gi\u0169a di\u1ec7n t\u00edch d\u01b0\u1edbi \u0111\u01b0\u1eddng cong n\u1ed3ng \u0111\u1ed9 (AUC) v\u00e0 MIC.<\/p>\n<p><em>C\u01a1 ch\u1ebf \u0111\u1ec1 kh\u00e1ng thu\u1ed1c:<\/em><\/p>\n<p>S\u1ef1 \u0111\u1ec1 kh\u00e1ng in-vitro c\u1ee7a ciprofloxacin c\u00f3 th\u1ec3 m\u1eafc ph\u1ea3i th\u00f4ng qua m\u1ed9t qu\u00e1 tr\u00ecnh b\u1eadc thang b\u1eb1ng c\u00e1ch g\u00e2y bi\u1ebfn \u0111\u1ed5i \u0111i\u1ec3m \u0111\u00edch \u1edf c\u1ea3 2 men DNA gyrase v\u00e0 topoisomerase IV. M\u1ee9c \u0111\u1ed9 \u0111\u1ec1 kh\u00e1ng ch\u00e9o gi\u1eefa ciprofloxacin v\u00e0 c\u00e1c kh\u00e1ng sinh fluoroquinolone kh\u00e1c cho k\u1ebft qu\u1ea3 kh\u00e1c nhau. \u0110\u1ed9t bi\u1ebfn \u0111\u01a1n gen c\u00f3 th\u1ec3 kh\u00f4ng \u0111\u01b0a \u0111\u1ebfn \u0111\u1ec1 kh\u00e1ng tr\u00ean l\u00e2m s\u00e0ng, nh\u01b0ng \u0111\u1ed9t bi\u1ebfn \u0111a gen th\u01b0\u1eddng g\u00e2y ra \u0111\u1ec1 kh\u00e1ng tr\u00ean l\u00e2m s\u00e0ng v\u1edbi nhi\u1ec1u ho\u1eb7c t\u1ea5t c\u1ea3 c\u00e1c ho\u1ea1t ch\u1ea5t trong nh\u00f3m.<\/p>\n<p>C\u01a1 ch\u1ebf \u0111\u1ec1 kh\u00e1ng v\u1edbi \u0111\u1eb7c t\u00ednh th\u1ea5m v\u00e0\/ho\u1eb7c b\u01a1m t\u1ed1ng xu\u1ea5t ho\u1ea1t ch\u1ea5t c\u00f3 th\u1ec3 c\u00f3 t\u00e1c d\u1ee5ng kh\u00e1c nhau l\u00ean t\u00ednh nh\u1ea1y c\u1ea3m v\u1edbi c\u00e1c fluoroquinolone, \u0111i\u1ec1u n\u00e0y ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u1eb7c t\u00ednh l\u00fd h\u00f3a c\u1ee7a c\u00e1c ch\u1ea5t kh\u00e1c nhau trong nh\u00f3m v\u00e0 \u00e1i l\u1ef1c \u0111\u1ed1i v\u1edbi h\u1ec7 chuy\u00ean ch\u1edf cho nh\u1eefng ch\u1ea5t n\u00e0y. T\u1ea5t c\u1ea3 c\u00e1c c\u01a1 ch\u1ebf \u0111\u1ec1 kh\u00e1ng in-vitro th\u01b0\u1eddng \u0111\u01b0\u1ee3c quan s\u00e1t trong c\u00e1c ph\u00e2n l\u1eadp tr\u00ean l\u00e2m s\u00e0ng. Nh\u1eefng c\u01a1 ch\u1ebf \u0111\u1ec1 kh\u00e1ng l\u00e0m b\u1ea5t ho\u1ea1t c\u00e1c kh\u00e1ng sinh kh\u00e1c nh\u01b0 c\u00e1c h\u00e0ng r\u00e0o th\u1ea5m (ph\u1ed5 bi\u1ebfn \u1edf Pseudomonas aeruginosa) v\u00ec c\u01a1 ch\u1ebf t\u1ed1ng xu\u1ea5t c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u00ednh nh\u1ea1y c\u1ea3m \u0111\u1ed1i v\u1edbi ciprofloxacin. \u0110\u1ec1 kh\u00e1ng qua trung gian plasmid \u0111\u01b0\u1ecdc m\u00e3 h\u00f3a b\u1edfi gen qnr c\u0169ng \u0111\u01b0\u1ecdc b\u00e1o c\u00e1o.<\/p>\n<p><em>Ph\u1ed5 kh\u00e1ng khu\u1ea9n:<\/em><\/p>\n<p>N\u1ed3ng \u0111\u1ed9 ng\u01b0\u1ee1ng ph\u00e2n bi\u1ec7t c\u00e1c ch\u1ee7ng nh\u1ea1y c\u1ea3m t\u1eeb c\u00e1c ch\u1ee7ng nh\u1ea1y c\u1ea3m trung gian v\u00e0 sau \u0111\u00f3 l\u00e0 t\u1eeb c\u00e1c ch\u1ee7ng \u0111\u1ec1 kh\u00e1ng.<\/p>\n<p>C\u00e1c khuy\u1ebfn c\u00e1o c\u1ee7a EUCAST (Th\u1eed nghi\u1ec7m c\u1ee7a \u1ee6y ban Ch\u00e2u \u00c2u v\u00ec t\u00ednh nh\u1ea1y c\u1ea3m kh\u00e1ng khu\u1ea9n)<\/p>\n<table>\n<tbody>\n<tr>\n<td><strong>Ch\u1ee7ng vi khu\u1ea9n<\/strong><\/td>\n<td><strong>Nh\u1ea1y c\u1ea3m<\/strong><\/td>\n<td><strong>\u0110\u1ec1 kh\u00e1ng<\/strong><\/td>\n<\/tr>\n<tr>\n<td>Enterobacteria<\/td>\n<td>S &lt; 0,5mg\/L<\/td>\n<td>R &gt; 1mg\/l<\/td>\n<\/tr>\n<tr>\n<td>Pseudomonas<\/td>\n<td>S &lt; 0,5mg\/L<\/td>\n<td>R &gt; 1mg\/L<\/td>\n<\/tr>\n<tr>\n<td>Acinetobacter<\/td>\n<td>S &lt; 1mg\/L<\/td>\n<td>R &gt; 1 mg\/L<\/td>\n<\/tr>\n<tr>\n<td>Staphylococcus spp.<sup>1<\/sup><\/td>\n<td>S &lt; 1mg\/L<\/td>\n<td>R &gt; 1mg\/L<\/td>\n<\/tr>\n<tr>\n<td>Haemophilus influenzae v\u00e0 Moraxellacatarrhalis<\/td>\n<td>S &lt; 0,5mg\/l<\/td>\n<td>R &gt; 0,5mg\/L<\/td>\n<\/tr>\n<tr>\n<td>Neisseria gonorrhceae<\/td>\n<td>S &lt; 0,03mg\/L<\/td>\n<td>R &gt; 0,06mg\/L<\/td>\n<\/tr>\n<tr>\n<td>Neisseria meningitidis<\/td>\n<td>S &lt; 0,03mg\/L<\/td>\n<td>R &gt; 0,06mg\/L<\/td>\n<\/tr>\n<tr>\n<td>N\u1ed3ng \u0111\u1ed9 ng\u01b0\u1ee1ng kh\u00f4ng li\u00ean quan \u0111\u1ebfn lo\u00e0i* (Non-spedes-related breakpoints)<\/td>\n<td>S &lt; 0,5mg\/L<\/td>\n<td>R &gt; 1mg\/L<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><sup>1<\/sup>\u00a0Staphylococcus spp. &#8211; n\u1ed3ng \u0111\u1ed9 ng\u01b0\u1ee1ng \u0111\u1ed1i v\u1edbi ciprofloxacin li\u00ean quan \u0111\u1ebfn vi\u1ec7c \u0111i\u1ec1u tr\u1ecb li\u1ec1u cao.<\/p>\n<p>* N\u1ed3ng \u0111\u1ed9 ng\u01b0\u1ee1ng kh\u00f4ng li\u00ean quan \u0111\u1ebfn lo\u00e0i \u0111\u01b0\u1ee3c quy\u1ebft \u0111\u1ecbnh ch\u1ee7 y\u1ebfu d\u1ef1a v\u00e0o c\u00e1c d\u1eef li\u1ec7u d\u01b0\u1ee3c \u0111\u1ed9ng\/d\u01b0\u1ee3c l\u1ef1c v\u00e0 kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o s\u1ef1 ph\u00e2n b\u1ed1 MIC c\u1ee7a nh\u1eefng lo\u00e0i \u0111\u1eb7c tr\u01b0ng. N\u00f3 ch\u1ec9 d\u00f9ng cho nh\u1eefng lo\u00e0i kh\u00f4ng c\u00f3 n\u1ed3ng \u0111\u1ed9 ng\u01b0\u1ee1ng \u0111\u1eb7c tr\u01b0ng v\u00e0 kh\u00f4ng d\u00f9ng cho nh\u1eefng lo\u00e0i m\u00e0 c\u00e1c th\u1eed nghi\u1ec7m v\u1ec1 t\u00ednh nh\u1ea1y c\u1ea3m kh\u00f4ng \u0111\u01b0a ra \u0111\u01b0\u1ee3c n\u1ed3ng \u0111\u1ed9 ng\u01b0\u1ee1ng \u0111\u1eb7c tr\u01b0ng.<\/p>\n<p>T\u1ef7 l\u1ec7 v\u1ec1 s\u1ef1 \u0111\u1ec1 kh\u00e1ng m\u1eafc ph\u1ea3i c\u00f3 th\u1ec3 kh\u00e1c nhau v\u1ec1 m\u1eb7t \u0111\u1ecba l\u00fd v\u00e0 th\u1eddi gian \u0111\u1ed1i v\u1edbi c\u00e1c lo\u00e0i vi khu\u1ea9n ch\u1ecdn l\u1ecdc v\u00e0 th\u00f4ng tin v\u1ec1 s\u1ef1 \u0111\u1ec1 kh\u00e1ng \u1edf \u0111\u1ecba ph\u01b0\u01a1ng l\u00e0 c\u1ea7n thi\u1ebft, \u0111\u1eb7c bi\u1ec7t khi \u0111ang \u0111i\u1ec1u tr\u1ecb c\u00e1c nhi\u1ec5m khu\u1ea9n n\u1eb7ng. N\u1ebfu c\u1ea7n thi\u1ebft, n\u00ean h\u1ecfi l\u1eddi khuy\u00ean c\u1ee7a c\u00e1c chuy\u00ean gia b\u1edfi v\u00ec t\u1ef7 l\u1ec7 \u0111\u1ec3 kh\u00e1ng \u1edf \u0111\u1ecba ph\u01b0\u01a1ng l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 h\u1eefu d\u1ee5ng, \u00edt nh\u1ea5t l\u00e0 \u0111\u1ed1i v\u1edbi m\u1ed9t s\u1ed1 lo\u1ea1i nhi\u1ec5m khu\u1ea9n \u0111\u00e1ng ng\u1edd.<\/p>\n<p>C\u00c1C CH\u1ee6NG NH\u1ea0Y C\u1ea2M PH\u1ed0 BI\u1ebeN<\/p>\n<p>Vi khu\u1ea9n Gram d\u01b0\u01a1ng hi\u1ebfu kh\u00ed<\/p>\n<p><em>Bacillus anthracis (1)<\/em><\/p>\n<p>Vi khu\u1ea9n Gram \u00e2m hi\u1ebfu kh\u00ed<\/p>\n<p><em>Aeromonas spp.<\/em><\/p>\n<p><em>Brucella spp.<\/em><\/p>\n<p><em>Citrobacter koseri<\/em><\/p>\n<p><em>Erancisella tularensis<\/em><\/p>\n<p><em>Haemophilus ducreyi<\/em><\/p>\n<p><em>Haemophilus influenzae<sup>*<\/sup><\/em><\/p>\n<p><em>Legionella spp.<\/em><\/p>\n<p><em>Moraxella catarrhalis<sup>*<\/sup><\/em><\/p>\n<p><em>Neisseria meningitidis<\/em><\/p>\n<p><em>Pasteurella spp.<\/em><\/p>\n<p><em>Salmonella spp.<sup>*<\/sup><\/em><\/p>\n<p><em>Shigella spp.<sup>*<\/sup><\/em><\/p>\n<p><em>Vibrio spp.<\/em><\/p>\n<p><em>Yersinia pestis<\/em><\/p>\n<p>Vi khu\u1ea9n k\u1ecb kh\u00ed<\/p>\n<p><em>Mobiluncus<\/em><\/p>\n<p>C\u00e1c vi khu\u1ea9n kh\u00e1c<\/p>\n<p><em>Chlamydia trachomatis($)<\/em><\/p>\n<p><em>Chlamydia pneumoniae ($) <\/em><\/p>\n<p><em>Mycoplasma hominis ($)<\/em><\/p>\n<p><em>Mycoplasma pneumoniae ($)<\/em><\/p>\n<p>C\u00c1C CH\u1ee6NG VI KHU\u1ea8N \u0110\u00c3 KH\u00c1NG<\/p>\n<p>Vi khu\u1ea9n Gram d\u01b0\u01a1ng hi\u1ebfu kh\u00ed<\/p>\n<p><em>Enterococcus faecalis ($)<\/em><\/p>\n<p><em>Staphylococcus spp.* (2)<\/em><\/p>\n<p>Vi khu\u1ea9n Gram \u00e2m hi\u1ebfu kh\u00ed<\/p>\n<p><em>Acinetobacter baumannii<sup>+<\/sup><\/em><\/p>\n<p><em>Burkholderia cepacia<sup>+*<\/sup><\/em><\/p>\n<p><em>Campylobacter spp.<sup>+*<\/sup><\/em><\/p>\n<p><em>Citrobacter freundii<sup>*<\/sup><\/em><\/p>\n<p><em>Enterobacteria aerogenes<\/em><\/p>\n<p><em>Enterobacteria cloacae<sup>*<\/sup><\/em><\/p>\n<p><em>Escherichia coli*<\/em><\/p>\n<p><em>Klebsiella oxytoca<\/em><\/p>\n<p><em>Klebsiella pneumonia<sup>*<\/sup><\/em><\/p>\n<p><em>Morganella morganii<sup>*<\/sup><\/em><\/p>\n<p><em>Neisseria gonorrhoeae<sup>*<\/sup><\/em><\/p>\n<p><em>Proteus mirabilis<sup>*<\/sup><\/em><\/p>\n<p><em>Proteus vulgaris<sup>*<\/sup><\/em><\/p>\n<p><em>Providencia spp.<\/em><\/p>\n<p><em>Pseudomonas aeruginosa<sup>*<\/sup><\/em><\/p>\n<p><em>Pseudomonas fluorescens<\/em><\/p>\n<p><em>Serratia marcescens<sup>*<\/sup><\/em><\/p>\n<p>Vi khu\u1ea9n k\u1ecb kh\u00ed<\/p>\n<p><em>Peptostreptococcus spp.<\/em><\/p>\n<p><em>Propionibacterium acnes<\/em><\/p>\n<p>C\u00d3 TH\u1ec2 KH\u00c1NG THU\u1ed0C \u1ede NH\u1eeeNG CH\u1ee6NG SAU<\/p>\n<p>Vi khu\u1ea9n Gram d\u01b0\u01a1ng hi\u1ebfu kh\u00ed<\/p>\n<p><em>Actinomyces<\/em><\/p>\n<p><em>Enteroccus faecium<\/em><\/p>\n<p><em>Listeria monocytogenes<\/em><\/p>\n<p>Vi khu\u1ea9n Gram \u00e2m hi\u1ebfu kh\u00ed<\/p>\n<p><em>Stenotrophomonas maltophilia<\/em><\/p>\n<p>Vi khu\u1ea9n k\u1ef5 kh\u00ed<\/p>\n<p>Tr\u1eeb danh s\u00e1ch tr\u00ean ra<\/p>\n<p>Vi khu\u1ea9n kh\u00e1c<\/p>\n<p><em>Mycoplasma genitalium<\/em><\/p>\n<p><em>Ureaplasma urealitycum<\/em><\/p>\n<p>* Hi\u1ec7u qu\u1ea3 l\u00e2m s\u00e0ng \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh tr\u00ean c\u00e1c ch\u1ee7ng nh\u1ea1y c\u1ea3m l\u00e0 b\u1eb1ng ch\u1ee9ng cho c\u00e1c chi \u0111\u1ecbnh tr\u00ean l\u00e2m s\u00e0ng<\/p>\n<p><sup>+<\/sup>\u00a0T\u1ef7 l\u1ec7 kh\u00e1ng &gt;= 50% trong m\u1ed9t n\u01b0\u1edbc ho\u1eb7c nhi\u1ec1u h\u01a1n trong c\u1ed9ng \u0111\u1ed3ng ch\u00e2u \u00c2u<\/p>\n<p>($): \u0110\u1ed9 nh\u1ea1y c\u1ea3m trung gian t\u1ef1 nhi\u00ean trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 c\u01a1 ch\u1ebf \u0111\u1ec1 kh\u00e1ng m\u1eafc ph\u1ea3i<\/p>\n<p>(1): C\u00e1c nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n tr\u00ean \u0111\u1ed9ng v\u1eadt th\u00ed nghi\u1ec7m g\u00e2y nhi\u1ec5m khu\u1ea9n b\u1eb1ng c\u00e1ch cho h\u00edt b\u00e0o t\u1eed tr\u1ef1c khu\u1ea9n than (Bacillus anthracis); c\u00e1c nghi\u00ean c\u1ee9u n\u00e0y cho th\u1ea5y t\u00e1c d\u1ee5ng kh\u00e1ng sinh b\u1eaft \u0111\u1ea7u sau khi ph\u01a1i nhi\u1ec5m \u0111\u1ec3 tr\u00e1nh s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a b\u1ec7nh n\u1ebfu qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb l\u00e0m gi\u1ea3m \u0111\u01b0\u1ee3c s\u1ed1 l\u01b0\u1ee3ng b\u00e0o t\u1eed trong c\u01a1 th\u1ec3 xu\u1ed1ng d\u01b0\u1edbi m\u1ee9c li\u1ec1u g\u00e2y nhi\u1ec5m. Khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng tr\u00ean ng\u01b0\u1eddi ch\u1ee7 y\u1ebfu d\u1ef1a tr\u00ean \u0111\u1ed9 nh\u1ea1y c\u1ea3m in vitro v\u00e0 tr\u00ean c\u00e1c d\u1eef li\u1ec7u tr\u00ean \u0111\u1ed9ng v\u1eadt th\u00ed nghi\u1ec7m k\u1ebft h\u1ee3p v\u1edbi c\u00e1c d\u1eef li\u1ec7u h\u1ea1n ch\u1ebf tr\u00ean ng\u01b0\u1eddi. Kho\u1ea3ng th\u1eddi gian \u0111i\u1ec1u tr\u1ecb 2 th\u00e1ng tr\u00ean ng\u01b0\u1eddi l\u1edbn v\u1edbi ciprofloxacin \u0111\u01b0\u1eddng u\u1ed1ng v\u1edbi m\u1ee9c li\u1ec1u 500mg hai l\u1ea7n trong ng\u00e0y \u0111\u01b0\u1ee3c xem l\u00e0 c\u00f3 hi\u1ec7u qu\u1ea3 \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh than tr\u00ean ng\u01b0\u1eddi. B\u00e1c s\u0129 \u0111i\u1ec1u tr\u1ecb n\u00ean tham kh\u1ea3o c\u00e1c h\u01b0\u1edbng d\u1eabn \u0111\u00f3ng thu\u1eadn qu\u1ed1c gia v\u00e0\/ho\u1eb7c qu\u1ed1c t\u1ebf trong \u0111i\u1ec1u tr\u1ecb b\u1ec7nh than.<\/p>\n<p>(2): S.aureus kh\u00e1ng methicillin th\u01b0\u1eddng kh\u00e1ng fluoroquinolon. T\u1ef7 l\u1ec7 kh\u00e1ng methicillin kho\u1ea3ng 20 \u0111\u1ebfn 50% trong s\u1ed1 c\u00e1c ch\u1ee7ng t\u1ee5 c\u1ea7u vi th\u01b0\u1eddng cao h\u01a1n \u1edf c\u00e1c ch\u1ee7ng ph\u00e2n l\u1eadp t\u1ea1i b\u1ec7nh vi\u1ec7n.<\/p>\n<p><strong><em>C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng: <\/em><\/strong><\/p>\n<p>Ciprofloxacin l\u00e0 thu\u1ed1c kh\u00e1ng sinh b\u00e1n t\u1ed5ng h\u1ee3p, c\u00f3 ph\u1ed5 kh\u00e1ng khu\u1ea9n r\u1ed9ng, thu\u1ed9c nh\u00f3m quinolon, c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 c\u00e1c ch\u1ea5t \u1ee9c ch\u1ebf DNA girase. Do \u1ee9c ch\u1ebf enzym DNA girase, n\u00ean thu\u1ed1c ng\u0103n s\u1ef1 sao ch\u00e9p c\u1ee7a chromosom khi\u1ebfn cho vi khu\u1ea9n kh\u00f4ng sinh s\u1ea3n \u0111\u01b0\u1ee3c nhanh ch\u00f3ng. Ciprofloxacin c\u00f3 t\u00e1c d\u1ee5ng t\u1ed1t v\u1edbi c\u00e1c vi khu\u1ea9n kh\u00e1ng l\u1ea1i kh\u00e1ng sinh thu\u1ed9c c\u00e1c nh\u00f3m kh\u00e1c (aminoglycosid, cephalosporin, tetracyclin, penicilin&#8230;) v\u00e0 \u0111\u01b0\u1ee3c coi l\u00e0 m\u1ed9t trong nh\u1eefng thu\u1ed1c c\u00f3 t\u00e1c d\u1ee5ng m\u1ea1nh nh\u1ea5t trong nh\u00f3m fluoroquinolon.<\/p>\n<p><a href=\"https:\/\/youtu.be\/ap4wL2Om1bA\"><strong>[XEM T\u1ea0I \u0110\u00c2Y]<\/strong><\/a><\/p>\n<p><strong>5.2. D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc:<\/strong><\/p>\n<p><em>H\u1ea5p thu:<\/em><\/p>\n<p>Ciprofloxacin \u0111\u01b0\u1ee3c h\u1ea5p thu nhanh v\u00e0 r\u1ed9ng kh\u1eafp, ch\u1ee7 y\u1ebfu t\u1eeb ru\u1ed9t non v\u00e0 \u0111\u1ea1t \u0111\u1ebfn n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh trong huy\u1ebft t\u01b0\u01a1ng 1 &#8211; 2 gi\u1edf sau khi u\u1ed1ng 1 li\u1ec1u duy nh\u1ea5t c\u00e1c vi\u00ean ciprofloxacin 250mg, 500mg, v\u00e0 750mg, Li\u1ec1u duy nh\u1ea5t 100 &#8211; 750mg t\u1ea1o ra n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh trong huy\u1ebft t\u01b0\u01a1ng (Cmax trong kho\u1ea3ng 0,56 v\u00e0 3,7mg\/L. N\u1ed3ng \u0111\u1ed9 trong huy\u1ebft tu\u01a1ng t\u0103ng m\u1ed9t c\u00e1ch t\u1ef7 l\u1ec7 v\u1edbi li\u1ec1u l\u00ean \u0111\u1ebfn 1000mg. Sinh kh\u1ea3 d\u1ee5ng tuy\u1ec7t \u0111\u1ed1i c\u1ee7a ciprofloxacin x\u1ea5p x\u1ec9 70 &#8211; 80%.<\/p>\n<p>Li\u1ec1u u\u1ed1ng 500mg m\u1ed7i 12 gi\u1edd cho di\u1ec7n t\u00edch d\u01b0\u1edbi \u0111\u01b0\u1eddng cong n\u1ed3ng \u0111\u1ed9 theo th\u1eddi gian (AUC) t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi vi\u1ec7c ti\u00eam truy\u1ec1n t\u0129nh m\u1ea1ch 400mg ciprofloxacin trong 60 ph\u00fat m\u1ed7i 12 gi\u1edd.<\/p>\n<p><em>Ph\u00e2n b\u1ed1:<\/em><\/p>\n<p>Kh\u1ea3 n\u0103ng g\u1eafn k\u1ebft c\u1ee7a protein v\u1edbi ciprofloxacin th\u1ea5p (20 &#8211; 30%). Ciprofloxacin hi\u1ec7n di\u1ec7n trong m\u00e1u ph\u1ea7n l\u1edbn \u1edf d\u1ea1ng kh\u00f4ng ion h\u00f3a v\u00e0 c\u00f3 th\u1ec3 t\u00edch ph\u00e2n b\u1ed1 \u1edf tr\u1ea1ng th\u00e1i h\u1eb1ng \u0111\u1ecbnh 2 &#8211; 3 L\/kg th\u1ec3 tr\u1ecdng. Ciprofloxacin \u0111\u1ea1t n\u1ed3ng \u0111\u1ed9 cao trong c\u00e1c m\u00f4 kh\u00e1c nhau nh\u01b0 ph\u1ed5i (trong d\u1ecbch bi\u1ec3u m\u00f4, c\u00e1c \u0111\u1ea1i th\u1ef1c b\u00e0o ph\u1ebf nang, m\u00f4 sinh thi\u1ebft), c\u00e1c xoang, nh\u1eefng sang th\u01b0\u01a1ng b\u1ecb vi\u00eam (d\u1ecbch ti\u1ebft b\u00f3ng n\u01b0\u1edbc), v\u00e0 \u0111\u01b0\u1eddng ni\u1ec7u &#8211; sinh d\u1ee5c (n\u01b0\u1edbc ti\u1ec3u, tuy\u1ebfn ti\u1ec1n li\u1ec7t, m\u00e0ng d\u1ea1 con), nh\u1eefng n\u01a1i m\u00e0 n\u1ed3ng \u0111\u1ed9 thu\u1ed1c to\u00e0n ph\u1ea7n cao h\u01a1n n\u1ed3ng \u0111\u1ed9 trong huy\u1ebft t\u01b0\u01a1ng.<\/p>\n<p><em>Chuy\u1ec3n h\u00f3a:<\/em><\/p>\n<p>B\u1ed1n ch\u1ea5t chuy\u1ec3n h\u00f3a c\u00f3 n\u1ed3ng \u0111\u1ed9 th\u1ea5p \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh l\u00e0: desethyleneciprofloxacin (M 1), sulphociprofloxacin (M 2), oxociprofloxacin (M 3) v\u00e0 formylciprofloxacin (M 4). C\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a n\u00e0y cho th\u1ea5y c\u00f3 ho\u1ea1t t\u00ednh kh\u00e1ng khu\u1ea9n in vitro nh\u01b0ng v\u1edbi m\u1ee9c \u0111\u1ed9 th\u1ea5p h\u01a1n ho\u1ea1t ch\u1ea5t g\u1ed1c.<\/p>\n<p>Ciprofloxacin l\u00e0 m\u1ed9t ch\u1ea5t \u1ee9c ch\u1ebf trung b\u00ecnh iso &#8211; enzyme CYP 4501A2.<\/p>\n<p><em>Th\u1ea3i tr\u1eeb:<\/em><\/p>\n<p>Ciprofloxacin \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft ph\u1ea7n l\u1edbn \u1edf d\u1ea1ng kh\u00f4ng \u0111\u1ed5i qua th\u1eadn v\u00e0 v\u1edbi l\u01b0\u1ee3ng \u00edt h\u01a1n qua ph\u00e2n. N\u1eeda \u0111\u1eddi th\u1ea3i tr\u1eeb trong huy\u1ebft t\u01b0\u01a1ng \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 ch\u1ee9c n\u0103ng th\u1eadn b\u00ecnh th\u01b0\u1eddng x\u1ea5p x\u1ec9 4 &#8211; 7 gi\u1edd.<\/p>\n<table>\n<tbody>\n<tr>\n<td rowspan=\"2\">S\u1ef1 b\u00e0i ti\u1ebft c\u1ee7a Ciprofloxacin (% li\u1ec1u)<\/td>\n<td colspan=\"2\">\u0110\u01b0\u1eddng u\u1ed1ng<\/td>\n<\/tr>\n<tr>\n<td>Qua n\u01b0\u1edbc ti\u1ec3u<\/td>\n<td>Qua ph\u00e2n<\/td>\n<\/tr>\n<tr>\n<td>Ciprofloxacin<\/td>\n<td>44,7<\/td>\n<td>25,0<\/td>\n<\/tr>\n<tr>\n<td>C\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a (M1 &#8211; M4)<\/td>\n<td>11,3<\/td>\n<td>7,5<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>\u0110\u1ed9 thanh th\u1ea3i th\u1eadn trong kho\u1ea3ng 180 &#8211; 300mL\/kg\/gi\u1edd v\u00e0 \u0111\u1ed9 thanh th\u1ea3i to\u00e0n ph\u1ea7n c\u00f9a c\u01a1 th\u1ec3 trong kho\u1ea3ng 480 &#8211; 600mL\/kg\/gi\u1edd. Ciprofloxacin \u0111\u01b0\u1ee3c \u0111\u00e0o th\u1ea3i nh\u1edd l\u1ecdc \u1edf c\u1ea7u th\u1eadn v\u00e0 b\u00e0i ti\u1ebft \u1edf \u1ed1ng th\u1eadn. Suy th\u1eadn n\u1eb7ng d\u1eabn \u0111\u1ebfn l\u00e0m t\u0103ng th\u1eddi gian b\u00e1n th\u1ea3i c\u1ee7a ciprofloxacin l\u00ean 12 gi\u1edd.<\/p>\n<p>\u0110\u1ed9 thanh th\u1ea3i ngo\u00e0i th\u1eadn c\u1ee7a ciprofloxacin ch\u1ee7 y\u1ebfu l\u00e0 do s\u1ef1 b\u00e0i ti\u1ebft qua ru\u1ed9t v\u00e0 s\u1ef1 trao \u0111\u1ed5i ch\u1ea5t 1% li\u1ec1u \u0111\u01b0\u1ee3c b\u00e0i ti\u1ebft qua \u0111\u01b0\u1eddng m\u1eadt. Ciprofloxacin xu\u1ea5t hi\u1ec7n trong m\u1eadt v\u1edbi n\u1ed3ng \u0111\u1ed9 cao.<\/p>\n<p><em>B\u1ec7nh nhi:<\/em><\/p>\n<p>C\u00e1c d\u1eef li\u1ec7u v\u1ec1 d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc tr\u00ean b\u1ec7nh nhi c\u00f2n h\u1ea1n ch\u1ebf.<\/p>\n<p>Trong m\u1ed9t nghi\u00ean c\u1ee9u \u1edf tr\u1ebb em, C<sub>max\u00a0<\/sub>v\u00e0 AUC kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u1ed9 tu\u1ed5i (tr\u00ean 1 tu\u1ed5i). Kh\u00f4ng quan s\u00e1t th\u1ea5y s\u1ef1 t\u0103ng \u0111\u00e1ng k\u1ec3 n\u00e0o v\u1ec1 C<sub>max<\/sub>\u00a0v\u00e0 AUC sau khi u\u1ed1ng \u0111a li\u1ec1u (10mg\/kg, 3 l\u1ea7n\/ng\u00e0y).<\/p>\n<p>Trong 10 tr\u1ebb b\u1ecb nhi\u1ec5m khu\u1ea9n n\u1eb7ng, C<sub>max<\/sub>\u00a0l\u00e0 6,1mg\/L (bi\u1ebfn thi\u00ean t\u1eeb 4,6 &#8211; 8,3mg\/L) sau khi ti\u00eam truy\u1ec1n t\u0129nh m\u1ea1ch 1 gi\u1edd 10mg\/kg \u1edf nh\u1eefng tr\u1ebb d\u01b0\u1edbi 1 tu\u1ed5i so v\u1edbi 7,2mg\/L (bi\u1ebfn thi\u00ean t\u1eeb 4,7 &#8211; 11,8mg\/L) \u0111\u1ed1i v\u1edbi b\u00e9 t\u1eeb 1 \u0111\u1ebfn 5 tu\u1ed5i. Gi\u00e1 tr\u1ecb AUC l\u00e0 17,4mg.gi\u1edd\/L (bi\u1ebfn thi\u00ean t\u1eeb 11,8 &#8211; 32,0mg.gi\u1edd\/L) v\u00e0 16,5mg.gi\u1edd\/L (bi\u1ebfn thi\u00ean t\u1eeb 11,0 &#8211; 23,8 mg.gi\u1edd\/L) \u1edf nh\u1eefng nh\u00f3m tu\u1ed5i t\u01b0\u01a1ng \u1ee9ng.<\/p>\n<p>Nh\u1eefng g\u00ed\u00e1 tr\u1ecb n\u00e0y n\u1eb1m trong kho\u1ea3ng li\u1ec1u \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u0111\u1ed1i v\u1edbi ng\u01b0\u1eddi l\u1edbn. D\u1ef1a v\u00e0o ph\u00e2n t\u00edch d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc qu\u1ea7n th\u1ec3 c\u1ee7a nh\u1eefng b\u1ec7nh nhi b\u1ecb c\u00e1c b\u1ec7nh nhi\u1ec5m khu\u1ea9n kh\u00e1c nhau, th\u1eddi gian b\u00e1n th\u1ea3i trung b\u00ecnh u\u1edbc t\u00ednh \u1edf tr\u1ebb em x\u1ea5p x\u1ec9 4 &#8211; 5 gi\u1edd v\u00e0 sinh kh\u1ea3 d\u1ee5ng c\u1ee7a d\u1ea1ng h\u1ed7n d\u1ecbch u\u1ed1ng bi\u1ebfn thi\u00ean t\u1eeb 50 \u0111\u1ebfn 80%.<\/p>\n<p><strong>5.3 Gi\u1ea3i th\u00edch: <\/strong><\/p>\n<p>Ch\u01b0a c\u00f3 th\u00f4ng tin. \u0110ang c\u1eadp nh\u1eadt.<\/p>\n<p><strong>5.4 Thay th\u1ebf thu\u1ed1c : <\/strong><\/p>\n<p>Ch\u01b0a c\u00f3 th\u00f4ng tin. \u0110ang c\u1eadp nh\u1eadt.<\/p>\n<p><strong><em>*L\u01b0u \u00fd:<\/em><\/strong><\/p>\n<p><strong><em>C\u00e1c th\u00f4ng tin v\u1ec1 thu\u1ed1c tr\u00ean Pharmog.com ch\u1ec9 mang t\u00ednh ch\u1ea5t tham kh\u1ea3o &#8211; Khi d\u00f9ng thu\u1ed1c c\u1ea7n tuy\u1ec7t \u0111\u1ed1i tu\u00e2n theo theo h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u00e1c s\u0129 <\/em><\/strong><\/p>\n<p><strong><em>Ch\u00fang t\u00f4i kh\u00f4ng ch\u1ecbu tr\u00e1ch nhi\u1ec7m v\u1ec1 b\u1ea5t c\u1ee9 h\u1eadu qu\u1ea3 n\u00e0o x\u1ea3y ra do t\u1ef1 \u00fd d\u00f9ng thu\u1ed1c d\u1ef1a theo c\u00e1c th\u00f4ng tin tr\u00ean Pharmog.com<\/em><\/strong><\/p>\n<p><script src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js?client=ca-pub-5528370293090692\" async=\"\" crossorigin=\"anonymous\"><\/script><ins class=\"adsbygoogle\" style=\"display: block; text-align: center;\" data-ad-layout=\"in-article\" data-ad-format=\"fluid\" data-ad-client=\"ca-pub-5528370293090692\" data-ad-slot=\"8909623906\"><\/ins><script> (adsbygoogle = window.adsbygoogle || []).push({}); <\/script><\/p>\n<p><strong>6. Ph\u1ea7n th\u00f4ng tin k\u00e8m theo c\u1ee7a thu\u1ed1c:<\/strong><\/p>\n<p><strong>6.1. Danh m\u1ee5c t\u00e1 d\u01b0\u1ee3c:<\/strong><\/p>\n<p>T\u00e1 d\u01b0\u1ee3c: Cellulose vi tinh th\u1ec3, tinh b\u1ed9t b\u1eafp, crospovidone, Silicon dioxit, magnesi stearat, Hydroxypropyl methylcellulose, Polyethylene glycol 8000, Talc, Titani dioxit (E171).<\/p>\n<p><strong>6.2. T\u01b0\u01a1ng k\u1ef5 :<\/strong><\/p>\n<p>Kh\u00f4ng \u00e1p d\u1ee5ng<\/p>\n<p><strong>6.3. B\u1ea3o qu\u1ea3n: <\/strong><\/p>\n<p>N\u01a1i kh\u00f4, tr\u00e1nh \u00e1nh s\u00e1ng, nhi\u1ec7t \u0111\u1ed9 d\u01b0\u1edbi 30\u00b0C.<\/p>\n<p><strong>6.4. Th\u00f4ng tin kh\u00e1c :<\/strong><\/p>\n<p><em>L\u1eddi khuy\u00ean v\u00ec gi\u00e1o d\u1ee5c y khoa<\/em><\/p>\n<p>Thu\u1ed1c kh\u00e1ng sinh \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh nhi\u1ec5m khu\u1ea9n do vi khu\u1ea9n g\u00e2y ra. Thu\u1ed1c kh\u00f4ng c\u00f3 ho\u1ea1t t\u00ednh ch\u1ed1ng l\u1ea1i c\u00e1c b\u1ec7nh nhi\u1ec5m khu\u1ea9n do vi-r\u00fat.<\/p>\n<p>N\u1ebfu b\u00e1c s\u0129 ch\u1ec9 \u0111\u1ecbnh cho b\u1ea1n d\u00f9ng kh\u00e1ng sinh, thu\u1ed1c ch\u1ec9 c\u1ea7n thi\u1ebft cho c\u0103n b\u1ec7nh hi\u1ec7n t\u1ea1i c\u00f9a b\u1ea1n. M\u1eb7c d\u00f9 \u0111\u00e2y l\u00e0 thu\u1ed1c kh\u00e1ng sinh, m\u1ed9t s\u1ed1 vi khu\u1ea9n c\u00f3 th\u1ec3 s\u1ed1ng s\u00f3t v\u00e0 ph\u00e1t tri\u1ec3n. Hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y g\u1ecdi l\u00e0 \u0111\u1ec1 kh\u00e1ng: ngh\u0129a l\u00e0 m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p \u0111i\u1ec1u tr\u1ecb v\u1edbi kh\u00e1ng sinh tr\u1edf n\u00ean v\u00f4 hi\u1ec7u.<\/p>\n<p>Vi\u1ec7c l\u1ea1m d\u1ee5ng kh\u00e1ng sinh l\u00e0m t\u0103ng khi n\u0103ng \u0111\u1ec1 kh\u00e1ng. Th\u1eadm ch\u00ed b\u1ea1n c\u00f3 th\u1ec3 \u0111\u00e3 gi\u00fap cho vi khu\u1ea9n tr\u1edf n\u00ean kh\u00e1ng thu\u1ed1c v\u00e0 do \u0111\u00f3 l\u00e0m k\u00e9o d\u00e0i th\u1eddi gian \u0111i\u1ec1u tr\u1ecb ho\u1eb7c l\u00e0m gi\u1ea3m ho\u1ea1t t\u00ednh kh\u00e1ng khu\u1ea9n n\u1ebfu b\u1ea1n kh\u00f4ng tu\u00e2n th\u1ee7: li\u1ec1u, th\u1eddi gian bi\u1ec3u d\u00f9ng thu\u1ed1c v\u00e0 kho\u1ea3ng th\u1eddi gian \u0111i\u1ec1u tr\u1ecb.<\/p>\n<p><em>Do \u0111\u00f3, \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o hi\u1ec7u qu\u1ea3 c\u1ee7a thu\u1ed1c:<\/em><\/p>\n<p>Ch\u1ec9 d\u00f9ng kh\u00e1ng sinh khi c\u00f3 ch\u1ec9 \u0111\u1ecbnh c\u1ee7a b\u00e1c s\u0129<\/p>\n<p>Tu\u00e2n th\u1ee7 ch\u1eb7t ch\u1ebd ch\u1ec9 \u0111\u1ecbnh c\u1ee7a b\u00e1c s\u0129<\/p>\n<p>Kh\u00f4ng \u0111\u01b0\u1ee3c t\u00e1i s\u1eed d\u1ee5ng kh\u00e1ng sinh m\u00e0 kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh c\u00f9a b\u00e1c s\u0129, ngay c\u1ea3 khi d\u00f9ng thu\u1ed1c \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh t\u01b0\u01a1ng t\u1ef1.<\/p>\n<p>Kh\u00f4ng \u0111\u01b0a thu\u1ed1c n\u00e0y cho nh\u1eefng ng\u01b0\u1eddi kh\u00e1c; c\u00f3 th\u1ec3 thu\u1ed1c kh\u00f4ng ph\u00f9 h\u1ee3p v\u1edbi b\u1ec7nh c\u1ee7a h\u1ecd.<\/p>\n<p>Thu\u1ed1c n\u00e0y ch\u1ec9 d\u00f9ng theo \u0111\u01a1n c\u1ee7a b\u00e1c s\u1ef9<\/p>\n<p><strong>6.5 T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/strong><\/p>\n<p>D\u01b0\u1ee3c Th\u01b0 Qu\u1ed1c Gia Vi\u1ec7t Nam<\/p>\n<p>H\u01b0\u1edbng d\u1eabn s\u1eed d\u1ee5ng thu\u1ed1c Ciprofloxacin.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>1. T\u00ean ho\u1ea1t ch\u1ea5t v\u00e0 bi\u1ec7t d\u01b0\u1ee3c: Ho\u1ea1t ch\u1ea5t : Ciprofloxacin Ph\u00e2n lo\u1ea1i: Thu\u1ed1c Kh\u00e1ng sinh nh\u00f3m Quinolon, Fluoroquinolon th\u1ebf h\u1ec7 2 Nh\u00f3m ph\u00e1p l\u00fd: Thu\u1ed1c k\u00ea \u0111\u01a1n ETC \u2013 (Ethical drugs, prescription drugs, Prescription only medicine) M\u00e3 ATC (Anatomical Therapeutic Chemical): J01MA02, S01AE03, S02AA15, S03AA07. Bi\u1ec7t d\u01b0\u1ee3c g\u1ed1c: CIPROBAY Bi\u1ec7t d\u01b0\u1ee3c: Serviflox H\u00e3ng s\u1ea3n [&hellip;]<\/p>\n","protected":false},"author":8612,"featured_media":19840,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[419],"tags":[658],"class_list":["post-19838","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-biet-duoc","tag-ciprofloxacin"],"_links":{"self":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/19838","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/users\/8612"}],"replies":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/comments?post=19838"}],"version-history":[{"count":3,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/19838\/revisions"}],"predecessor-version":[{"id":49629,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/posts\/19838\/revisions\/49629"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media\/19840"}],"wp:attachment":[{"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/media?parent=19838"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/categories?post=19838"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pharmog.com\/wp\/wp-json\/wp\/v2\/tags?post=19838"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}