Manje sekungekho emthethweni ukunikeza imfuyo imithi elwa namagciwane ukuze ithole isisindo
Ngama-1950, abalimi benza ukutholakala kwemidlalo: Imfuyo enempilo eyanikezwa ngama-antibiotics yazuza isisindo. Nakuba isisindo esitholakalayo-cishe amaphesenti amathathu-singase sibonakale singabonakali, embonini emikhulu lapho yonke i-ounce ibalwa, ngisho nokuzuza kwesisindo samakhilogremu ambalwa kwenkomo kungasho amashumi ezinkulungwane zamaRandi.
Ngo-1995, i-FDA ivume ukwengezwa kwemithi elwa namagciwane kumondlo wokudla kwemfuyo namanzi.
Kusukela ngaleso sikhathi, sibone ukwanda okuphawulekayo kokusakazeka kwamagciwane okulwa nezidakamizwa (ukumelana nokulwa namagciwane). Isibonelo, amaphesenti angu-20 kuwo wonke inyama enomhlabathi aqukethe i-salmonella engamelana nezidakamizwa. Abantu abaningi bakhulume lokhu kwanda okukhulu kwe-superbug njengendlela yokucacisa ukuvimbela umkhuba wokunikeza ama-antibiotic emfuyo enempilo. NgoJanuwari 3, 2017, ekugcineni kwaba ngokungemthetho ukuphatha ama-antibiotics ezinkomeni ngenhloso yodwa yokuthola isisindo (ukusetshenziswa okungekho kwelebuli).
Kungani Izilwane Zinikezwa Ama-antibiotics
Nakuba inani eliqondile kunzima ukulinganisa, kulinganiselwa ukuthi phakathi kuka-15 no-17 million amaphilisi ama-antibiotic anikezwa ngemfuyo minyaka yonke. Okunye okulinganiselwe amaphuzu inombolo engama-18 amaphesenti angu-22.7 wezigidi zama-antibiotic akhiqizwa e-United States ngonyaka.
Izilwane zezilwane zinikezwa ama-antibiotics ngezizathu ezine:
- Ukusebenzisa ukwelashwa : ukuphatha izilwane ezigulayo
- I-Metaphylaxis: Uma isilwane esisodwa emhlambini noma emhlambini sigula futhi zonke izilwane zinikezwa ukwelashwa okwesikhashana okuvimbela ukusabalala kwezifo
- I-Prophylaxis: ukuvimbela izifo ukuthi zingabikho emfuyweni
- Ukusebenzisa izifo ezincane : lapho i-antibiotics isetshenziselwa ukuzuza isisindo noma ikhwalithi yenyama enhle emfuyweni
Ngezinye izikhathi abalimi kudingeka banikeze izilwane zabo izidambisigciwane zokwelashwa noma uma ukutheleleka okunzulu kusongela umhlambi kanye nepulazi. Ukuphathwa okunjalo kuyisikhathi esifushane futhi kuhloswe ukulwa nokutheleleka okuvele kuvele noma kusakazeka.
Noma kunjalo, ukusetshenziswa okuqhubekayo kwe-prophylactic noma subtherapeutic yama-antibiotic phakathi kwemfuyo kunzima kakhulu.
Izingozi zokulawulwa kwama-antibiotic emfuyweni
Ngokusetshenziswa kwama-antibiotics emfuyweni, siye sabona i-bump kwinani lama-anti-antibiotic-resistant germs emhlabeni wonke. Isibonelo, nakuba ngabe ukuphika okungajwayelekile, ukuhlushwa kwe-fluoroquinolone kwanda kakhulu ngemva kokuba i-FDA ivumele abalimi ukuba bafake i-fluoroquinolones njenge-Baytril ekudleni kwezilwane nasemanzini. (Okwamanje, umthetho wesifundazwe uvimbela ukusetshenziswa kwe-extralabel ye-Baytril. Ngamanye amazwi, lesi sidakamizwa singasetshenziswa kuphela ukuphatha ukutheleleka ezilwaneni.)
Abacwaningi bakholelwa ukuthi ama-antibiotic anikezwe emfuyweni emazingeni aphansi noma angaphansi kwegazi abulala ezinye izitshalo ezivamile ze-bacteria. Ngokubulala lesi sitshalo esivamile, izilwane zingakwazi ukugaya ukudla kwazo kangako, ukudla okuncane kunesidingo ukuze kubondliwe, futhi kuncibilike kancane. Kodwa-ke, ezinye izitshalo eziphikisana nezidakamizwa ezikwazi ukulwa nezidakamizwa zikwazi ukubhekana nokuhlukunyezwa kwama-antibiotics futhi zenze indlela yazo yokudla. Lapho abantu bedla ukudla okuphekiwe okungalungile, la mabhaktheriya abathinta abantu. Ngaphezu kwalokho, ezinye izifundo zibonisa ukuthi abaphathi balezi zilwane bangenwa yizibhaktheriya ezingamelana nemithi ngokuthinta nje imfuyo.
Ukulwa nokulwa namagciwane kuyinkinga enkulu yempilo yomphakathi. Ngokusho kwabakwa-Landers nababhali-mbumbulu, kukhona "ukuqaphela ngokubanzi ukuthi ukusetshenziswa kwezidakamizwa ezilwaneni ezidlayo kubalulekile ekutheleleni kwezifo ezinamagciwane aphikisana namagciwane."
Ngisho noma ukuphathwa kwamagciwane e-subtherapeutic imfuyo kungase kubangele ukwandisa kwezidakamizwa ze-salmonella, i-E. coli, nokunye okunye kubantu, ubufakazi bokuthi ukukhula kwesibalo sezidakamizwa kuholele ezifweni akunakwenzeka. Ngaphezu kwalokho, ukwandiswa kwamabhaktheriya angagxili izidakamizwa akuyona nje into eyenziwa yimfuyo yokusetshenziswa kwezidakamizwa yedwa.
Ukusetshenziswa kabi kwe-antibiotic nokugqithisa ngokweqile kunomthelela kule nkinga. Kanye nezixwayiso zezindleko ezengeziwe ezibangelwa ukuyeka ukuphathwa kwemithi elwa namagciwane, abakhiqizi bezinyama baphinde bakhulume lezi zizathu kwezinye izingxabano zabo ukuze balondoloze umkhuba.
Yini i-FDA Eyenza Ngokusetshenziswa Kwemithi Yokulwa Namagciwane Emfuyweni?
I-Lobbies inamandla amakhulu. Lokhu kuhlanganiswe neqiniso lokuthi inqubomgomo enkulu yomphakathi isekelwe kumbono wobuchwepheshe nokuvumelana kwenza umgwaqo uguquke isikhathi eside. Kodwa-ke, ngo-2013, isiqondiso se-FDA esihlongozwayo seMboni # 213, noma i-GFI # 213, isisombululo sokuzithandela sokusebenzisa kahle ama-antibiotics emfuyweni. Ngo-December 2016, i-FDA ivuselele lesi siqondiso. Futhi ngo-2016, abakhiqizi bezilwane ezilwa namagciwane bavuma ukushintsha noma ukususa amalebula akhuthaza ukusetshenziswa kwamagciwane omzimba ukuze anciphise imfuyo. Ngenxa yalokho, ukusebenzisa i-off-label ye-antibiotics emfuyo manje sekungekho emthethweni.
Uma ubuka emuva, i-GFI # 213 yakhuthaza abenzi be-antibiotic yezilwane ukuba bashintshe ama-antibiotics kusukela ngaphezulu kwe-counter to counter to the prescription futhi kudingeka ukuba udokotela wezilwane asebenzise lezi zidakamizwa.Ithemba ukuthi ukukhiqiza ama-antibiotics angeke afinyeleleke futhi alawulwe ngokuqinile, abalimi bayolisebenzisa lezi izidakamizwa kuphela ngezifo nokuvimbela izifo.
Ngokuhamba kwesikhathi, u-Elanco no-Zoetis, abakhiqizi ababili bezilwane ezinamandla kakhulu, bavumile ukuhambisana nesiqondiso # 213. Ngaphezu kwalokho, i-Tyson, i-Purdue ne-Foster Farms yonke yavuma ukuvimbela umkhuba wabo wokuhlinzeka ngama-antibiotic ezincane ezinganeni. Phakathi naleso sikhathi, uMcDonald's, uPapeye noWendy's babengafuni ukuthenga inyama kubakhiqizi abasebenzisa ama-antibiotics okusetshenziselwa ukusetshenziselwa izifo ezincane. Ekugcineni, bonke abakhiqizi bemfuyo yemithi elwa namagciwane bayavuma ukukhipha ulwazi oluvela kumalebula okukhuthaza ukusetshenziswa kwama-antibiotics ukuze kutholakale isisindo ezinkomeni. Okokugcina, kufana naseCanada, amazwe aseYurophu, naseNingizimu Korea, lo mkhuba manje awukho emthethweni e-United States.
Ngaphansi
Ukwanda kwemithi yokulwa namagciwane-ikakhulukazi ezinqamuzaneni zethu zokugcina ezifana nama-fluoroquinolones-ngelinye ilanga kusho ukuthi lezi zidakamizwa ngeke zisasebenza. Ngeke sisavikeleka ngemithi yethu! Njengoba izilwane zithatha ama-antibiotiki afanayo esikwenzayo, ukwesaba ukulwa nokulwa namagciwane kuyinto ekhethekile kakhulu. Izilwane ezinjengama-hogs zikhonza njengama-incubators aphelele ekukhethweni nasekuvuseleleni izinkinga ze-bacterial anti-drug resistant. Eqinisweni, lapho lezi zinhlamvu ziqhamuka ezifuyweni, iziqhingi zezinto eziphilayo (ezibizwa ngokuthi i-integrins) zivame ukushintshaniswa okuphikisana nokuphikisana nezidakamizwa eziningi (ezingabodwa). Kuyinto enhle kakhulu ukuthi umkhuba wokunikeza imfuyo yama-antibiotic wokuthola isisindo manje uvinjelwe e-United States.
Imithombo:
Kuehn BM. I-FDA ishukumisela ukuvimbela ukusetshenziswa kwezidakamizwa emfuyweni. I-JAMA. 2014.
Abakwa-Landers, TF, et al. Ukubuyekezwa kokusetshenziswa kwama-antibiotic kuzilwane zokudla: okubhekayo, inqubomgomo, kanye nokwenzeka. Imibiko Yempilo Yomphakathi. 2012; 127: 4-22.
Mathew AG. Ukuphikiswa kwama-Antibiotic kumaBhaktheriya Ahlanganiswa Nezilwane Zokudla: I-United States Inhloso Yokukhiqiza Imfuyo. Ama-Pathogenens and Disease Okudlayo . 2007.
> Ukuvuselelwa kokusetjenziswa kweKhombandlela ye-FDA ye-Industry # 213. NgoDisemba 23, 2016. www.fda.gov.