Izivivinyo zemitholampilo
Ukukhethwa kwezidakamizwa ze-antifungal emakethe kuncane, futhi kunemikhawulo lapho i-NHS ingayinquma. Izinhlobo eziningi zesikhunta ziye zashintsha ukumelana nemithi eminingi, futhi imiphumela emibi enzima isho ukuthi ezinye iziguli azikwazi ukubekezelela imithi ethile, ngakho-ke kunesidingo esikhulu sama-antifungal amasha, kusukela emakilasini amasha angakathintwa ukumelana nemithi.
Ukuthi imithi emisha igunyazwa kanjani
Ukuthola umuthi omusha ugunyazwe kuyinqubo ende futhi ebizayo evamise ukudlula ezigabeni ezilandelayo:
| Ucwaningo oluyisisekelo | Ukufunda ngalesi sifo nokubheka okuhlosiwe kwamangqamuzana emithini emisha ezosetshenziswa ngokumelene nayo. |
|---|---|
| Ukutholwa kwezidakamizwa | Ukuhlola imitapo yolwazi yamakhemikhali, noma ukulungisa izakhiwo zezinhlanganisela ezithembisayo. |
| Izifundo zangaphambi komtholampilo | Ukuhlola ukuthi umuthi omusha ongase ube namandla usebenza kahle kangakanani kushubhu lokuhlola noma imodeli yezilwane. |
| Isicelo sokuqala izilingo zabantu | |
| Isigaba 0 kanye ne | Ukuhlola umuthi kumavolontiya anempilo, ukubona ukuthi kwenzekani emuthini ngaphakathi emzimbeni - ukuthi umunca kahle kangakanani emgudwini wegazi, usatshalaliswa ezicutshini ezifanele (isb. amaphaphu), ugaywa umzimba futhi ukhishwe ngomchamo/indle. Lokhu kusiza abacwaningi banqume ukuthi yiluphi uhla lwemithamo okufanele balusebenzise ocwaningweni. |
| Phase II | Ukuhlola umuthi ezigulini ezingamakhulu amaningana ezinalesi simo, ukubona ukuthi yisiphi isithako esisebenza kahle kakhulu futhi uthole umbono wanoma yimiphi imiphumela emibi evamile. |
| Isigaba III | Ukuhlola umuthi ezigulini ezingamakhulu ambalwa kuya ezinkulungwaneni ezimbalwa ezinalesi simo, ukukala ngokunembile ukuthi umuthi uphatha kahle kangakanani lesi sifo nokuthi ukhiqiza kangaki umphumela oseceleni ngamunye. |
| Isicelo sokugunyazwa kwezidakamizwa | Ukufaka isicelo ku-EMA (Europe) noma isikhungo esilawula imithi eqondene nezwe elithile njenge-FDA (US) ukuze uthole imvume yokuqala ukuthengisa umuthi. |
| Ukuhlola okuhle | Ukunquma ukuthi umuthi unenzuzo ngokwanele yini ukuwenza ube nezindleko ze-NHS |
| Ukugunyazwa/ukuxhaswa ngezimali | Uma i-NICE ingawutusi umuthi osetshenziswa njengenjwayelo (okuye kwaba njalo kuma-antifungal amaningi), udokotela usengakwazi ukusinikeza isiguli uma i-CCG yangakubo ivuma ukusixhasa ngezimali. I-NAC iwuchwepheshe be-CCG enenkululeko eyengeziwe yokunikeza imithi ethile elwa nesikhunta, futhi amanye amayunithi okufakelwa angase anikeze i-antifungal prophylaxis. |
| Isigaba IV | Kwaziwa nangokuthi yi-post-marketing. Ukuhlola ukuthi umuthi usebenza ngendlela elindelekile yini esimeni 'somhlaba wangempela'. |
Funda kabanzi mayelana nenqubo yokugunyaza: Ijenali Yezemithi or U-Van Norman (2016)
I-CCG = Iqembu Lokugunyazwa Kwezokwelapha
Yimiphi imithi emisha esivivinyweni okwamanje ye-aspergillosis?
Imithi emisha ivamise ukugunyazwa i-aspergillosis ehlaselayo ngaphambi kwe-CPA/ABPA.
- I-Olorofim iyinoveli ye-antifungal evela ekilasini elisha ngokuphelele lezidakamizwa (ama-orotomide). Ithuthukiswa ngu I-F2G Ltd, okuyinkampani eshintshashintshayo abeluleki bayo abahlanganisa uSolwazi Denning. I-Olorofim isidlule ocwaningweni oluhlukahlukene lweSigaba I, izivivinyo zeSigaba II futhi muva nje (Mashi 2022) ingenele uhlolo lweSigaba sesi-III ukubona ukuthi lusebenza kahle kangakanani ezigulini ezingama-225 ezinezifo zokukhunta ezihlaselayo.
- Rezafungin iwuhlobo lomuthi we-echinocandin, lezi zisebenza ngokuvimbela izakhi zodonga lwamaseli okukhunta ezibalulekile ku-homeostasis. Ithuthukiswa ukuze igcine ukuphepha kwamanye ama-echinocandin ngenkathi inezakhiwo eziqinile ze-pharmokinetic. Okwamanje isesigabeni sesi-III sezivivinyo.
- Ibrexafuningerp ingeyokuqala ekilasini elisha lama-antifungal abizwa nge-Triterpenoids. I-Ibrexafungerp isebenza ngendlela efanayo ne-echinocandins, kodwa inesakhiwo esihluke ngokuphelele, iyenza izinze futhi isho ukuthi inganikezwa ngomlomo. Kunezilingo ezimbili eziqhubekayo zesigaba sesi-3 ze-ibrexafungerp. Olunye ucwaningo lwe-FURI olubandakanya ababambiqhaza abangama-200 abanezifo ezihlaselayo kanye/noma ezinzima zokukhunta.
- I-Fosmanogepix yi afokokuqala kwe-antifungal enomusa evimbela ukukhiqizwa kwenhlanganisela ebalulekile ebalulekile ekwakhiweni kodonga lwamaseli kanye nokuzilawula. Isanda kuphothula uhlolo lwesigaba II esibandakanya ababambiqhaza abangama-21.
- I-Oteseconazole ingeyokuqala kwama-ejenti e-tetrazole ambalwa aklanywe ngomgomo wokukhetha okukhulu, imiphumela emibi embalwa, nokusebenza okuthuthukisiwe uma kuqhathaniswa nama-azole atholakalayo njengamanje. It isesigabeni sesi-3 sokuthuthuka futhi okwamanje ingaphansi kokucatshangelwa kwe-FDA ukuze igunyazwe ukwelapha i-vulvovaginal candidiasis ephindaphindayo.
- I-Encochleated Amphotericin B iwuhlobo lwe-Polyene ebulala isikhunta ngokubopha i-ergosterol esebenza ukugcina ubuqotho be-membrane yeseli. Kodwa-ke, ama-Polyenes nawo asebenzisana ne-cholesterol kulwelwesi lwamaseli omuntu, okusho ukuthi anobuthi obubalulekile. I-Encochleated Amphotericin B yenzelwe ukugwema lobu buthi obubalulekile futhi okwamanje isesigabeni 1 & 2 sokuthuthuka.
- I-ATI-2307 iwuhlobo lwe-Arylamidine evimbela ukusebenza kwe-mitochondrial ku-yeast ngakho-ke ivimbela ukukhula. Iqede ukulingwa kwesigaba sokuqala sesithathu futhi izongena ezilingweni zesigaba II ngo-2022.
Chofoza lapha ukuze uthole imininingwane eyengeziwe ngomuthi ngamunye
Ungalubheka kanjani ulwazi mayelana nokuhlolwa kwe-aspergillosis
Izivivinyo zemitholampilo kufanele zibhaliswe esidlangalaleni ngenxa yezizathu zokuziphatha (ngoba zibandakanya izifundo zabantu). Ungasebenzisa imitholampilo.gov.za ukucinga izivivinyo ongase ufaneleke ukubamba iqhaza kuzo, noma ukuthola imiphumela yezivivinyo ezisanda kuqedwa.
Uma ungakhululekile ngezingozi ezikhona ekuhloleni umuthi omusha, ungavolontiya ekubhaliseni noma kucwaningo lwe-diagnostics/biomarker esikhundleni salokho. Izinhlolo eziningi zibheka ukuthi singayisebenzisa kanjani imithi ekhona ngemithamo emisha noma inhlanganisela entsha, noma emaqenjini ahlukene eziguli isib. I-ATCFI-Itraconazole/voriconazole ezigulini ezine-cystic fibrosis ezinezikhwehlela ezihlala zinemiphumela I-Aspergillus.
