{"id":25106,"date":"2023-04-19T22:02:13","date_gmt":"2023-04-19T15:02:13","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=25106"},"modified":"2023-04-22T13:13:34","modified_gmt":"2023-04-22T06:13:34","slug":"daptomycin-va-linezolid-trong-viem-noi-tam-mac-nhiem-khuan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/daptomycin-va-linezolid-trong-viem-noi-tam-mac-nhiem-khuan\/","title":{"rendered":"Daptomycin v\u00e0 linezolid trong vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n"},"content":{"rendered":"

Daptomycin v\u00e0 linezolid l\u00e0 \u0111\u01b0\u1ee3c d\u00f9ng trong \u0111i\u1ec1u tr\u1ecb vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n.<\/a> C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u0169ng nh\u01b0 c\u00e1c ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng s\u1ebd c\u00f3 trong b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y.<\/strong><\/p>\n

\"Vi\u00eam<\/p>\n

Vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n<\/strong><\/p>\n

1.Daptomycin<\/h2>\n

1.1.L\u1ecbch s\u1eed<\/h3>\n

Daptomycin l\u00e0 kh\u00e1ng sinh nh\u00f3m lipopeptid v\u1edbi t\u00e1c d\u1ee5ng tr\u00ean vi khu\u1ea9n Gram d\u01b0\u01a1ng hi\u1ebfu kh\u00ed c\u0169ng nh\u01b0 k\u1ef5 kh\u00ed c\u00f2n m\u1ea1nh h\u01a1n c\u1ea3 c\u00e1c glycopeptid. Thu\u1ed1c c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb vi khu\u1ea9n Streptomyces roseosporus.
\nSau khi ra \u0111\u1eddi v\u00e0o cu\u1ed1i nh\u1eefng n\u0103m 1980, thu\u1ed1c \u0111\u00e3 th\u1ea5t b\u1ea1i trong th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng \u0111i\u1ec1u tr\u1ecb VNTMNK v\u1edbi li\u1ec1u 2 mg\/kg c\u00f9ng v\u1edbi t\u00e1c d\u1ee5ng ph\u1ee5 b\u1ec7nh l\u00fd c\u01a1 do thu\u1ed1c. Tuy nhi\u00ean, \u0111\u1ebfn n\u0103m 1997 thu\u1ed1c \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n tr\u1edf l\u1ea1i v\u1edbi li\u1ec1u d\u00f9ng th\u00f4ng th\u01b0\u1eddng hi\u1ec7n nay l\u00e0 4-6 mg\/kg v\u00e0 th\u1eadm ch\u00ed c\u00f2n cao h\u01a1n n\u1eefa.<\/p>\n

2.2. D\u01b0\u1ee3c l\u1ef1c h\u1ecdc v\u00e0 d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc<\/h3>\n


\n<\/strong>C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u1ee7a daptomycin t\u1ea5n c\u00f4ng v\u00e0o m\u00e0ng t\u1ebf b\u00e0o vi khu\u1ea9n. Daptomycin g\u1eafn v\u00e0 ch\u00e8n v\u00e0o m\u00e0ng t\u1ebf b\u00e0o, sau \u0111\u00f3 t\u1eadp trung l\u1ea1i th\u00e0nh t\u1eebng \u0111\u00e1m \u0111a ph\u00e2n t\u1eed l\u00e0m thay \u0111\u1ed5i \u0111\u1ed9 u\u1ed1n c\u1ee7a m\u00e0ng, t\u1ea1o th\u00e0nh c\u00e1c l\u1ed7 m\u00e0ng l\u00e0m tho\u00e1t ion. H\u1eadu qu\u1ea3 l\u00e0 s\u1ef1 kh\u1eed c\u1ef1c di\u1ec5n ra nhanh ch\u00f3ng, m\u00e0ng m\u1ea5t \u0111i\u1ec7n th\u1ebf kh\u00f4ng ho\u1ea1t \u0111\u1ed9ng \u0111\u01b0\u1ee3c ch\u1ee9c n\u0103ng t\u1ed5ng h\u1ee3p protein, ADN v\u00e0 ARN d\u1eabn \u0111\u1ebfn ch\u1ebft t\u1ebf b\u00e0o vi khu\u1ea9n. Ph\u1ed5 di\u1ec7t khu\u1ea9n c\u1ee7a daptomycin ch\u1ec9 bao g\u1ed3m c\u00e1c vi khu\u1ea9n Gram d\u01b0\u01a1ng. B\u00ean c\u1ea1nh li\u00ean c\u1ea7u, t\u1ee5 c\u1ea7u (g\u1ed3m c\u1ea3 MRSA), daptomycin c\u00f2n c\u00f3 t\u00e1c d\u1ee5ng v\u1edbi c\u00e1c Enterococcus (g\u1ed3m c\u1ea3 c\u00e1c Enterococcus kh\u00e1ng glycopeptid \u2013 GRE). Thu\u1ed1c g\u1eafn protein t\u1edbi 90-93%. Th\u1eddi gian b\u00e1n th\u1ea3i 8-9h nh\u01b0ng k\u00e9o d\u00e0i t\u1edbi 28h khi suy th\u1eadn. Thu\u1ed1c th\u1ea3i tr\u1eeb qua n\u01b0\u1edbc ti\u1ec3u (78%, ch\u1ee7 y\u1ebfu l\u00e0 d\u01b0\u1edbi d\u1ea1ng thu\u1ed1c ch\u01b0a bi\u1ebfn \u0111\u1ed5i) v\u00e0 ph\u00e2n (5,7%).<\/p>\n

2.3. Ch\u1ec9 \u0111\u1ecbnh, ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, li\u1ec1u d\u00f9ng, c\u00e1ch d\u00f9ng<\/h3>\n


\n<\/strong>Ch\u1ea5t ho\u1ea1t di\u1ec7n (surfactant) ph\u1ed5i l\u00e0m b\u1ea5t ho\u1ea1t daptomycin n\u00ean kh\u00f4ng d\u00f9ng daptomycin n\u1ebfu c\u00f3 vi\u00eam ph\u1ed5i k\u00e8m theo.
\nVNTMNK do t\u1ee5 c\u1ea7u kh\u00e1ng methicillin (l\u1ef1a ch\u1ecdn thay th\u1ebf): 8 \u0111\u1ebfn 10 mg\/kg truy\u1ec1n t\u0129nh m\u1ea1ch m\u1ed9t l\u1ea7n\/24h trong 6 tu\u1ea7n. Nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nghi ng\u1edd MRSA kh\u00e1ng daptomycin c\u00f3 th\u1ec3 ph\u1ed1i h\u1ee3p th\u00eam cotrimoxazol ho\u1eb7c nafcillin.
\nVNTMNK do c\u00e1c Enterococcus kh\u00e1ng penicillin, aminoglycosid v\u00e0 vancomycin: 10 \u0111\u1ebfn 12 mg\/kg truy\u1ec1n t\u0129nh m\u1ea1ch m\u1ed9t l\u1ea7n\/24h, k\u1ebft h\u1ee3p v\u1edbi ampicillin ho\u1eb7c ceftaroline trong \u00edt nh\u1ea5t 6 tu\u1ea7n. V\u1edbi van t\u1ef1 nhi\u00ean c\u00f3 th\u1ec3 d\u00f9ng \u0111\u01a1n tr\u1ecb li\u1ec7u. \u0110i\u1ec1u tr\u1ecb theo kinh nghi\u1ec7m VNTMNK tr\u00ean van t\u1ef1 nhi\u00ean (l\u1ef1a ch\u1ecdn thay th\u1ebf): 6 mg\/kg truy\u1ec1n t\u0129nh m\u1ea1ch c\u00e1ch 24h, k\u1ebft h\u1ee3p v\u1edbi ceftriaxon ho\u1eb7c gentamicin. Ch\u1ec9 d\u00f9ng dung d\u1ecbch mu\u1ed1i \u0111\u1eb3ng tr\u01b0\u01a1ng ho\u1eb7c Ringer lactat \u0111\u1ec3 pha truy\u1ec1n, tr\u00e1nh d\u00f9ng c\u00e1c dung m\u00f4i ch\u1ee9a dextrose. \u0110i\u1ec1u ch\u1ec9nh li\u1ec1u d\u00f9ng khi suy th\u1eadn: N\u1ebfu m\u1ee9c l\u1ecdc c\u1ea7u th\u1eadn d\u01b0\u1edbi 30 mL\/ph\u00fat th\u00ec d\u00f9ng thu\u1ed1c c\u00e1ch 48h.<\/p>\n

2.4. T\u00e1c d\u1ee5ng ph\u1ee5 v\u00e0 x\u1eed tr\u00ed<\/h3>\n

C\u1ea7n theo d\u00f5i CPK h\u1eb1ng tu\u1ea7n. N\u1ebfu CPK t\u0103ng tr\u00ean 10 l\u1ea7n m\u1ee9c b\u00ecnh th\u01b0\u1eddng ho\u1eb7c c\u00f3 tri\u1ec7u ch\u1ee9ng b\u1ec7nh l\u00fd c\u01a1 k\u00e8m theo CPK t\u0103ng tr\u00ean 1000 \u0111\u01a1n v\u1ecb\/l th\u00ec ph\u1ea3i ng\u1eebng daptomycin.
\nTrong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb daptomycin c\u1ea7n ng\u1eebng statin do s\u1eed d\u1ee5ng \u0111\u1ed3ng th\u1eddi v\u1edbi c\u00e1c statin l\u00e0m t\u0103ng nguy c\u01a1 b\u1ec7nh l\u00fd c\u01a1. C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00e1c hay g\u1eb7p l\u00e0 \u0111au \u0111\u1ea7u, bu\u1ed3n n\u00f4n\/n\u00f4n, ti\u00eau ch\u1ea3y, ph\u00e1t ban, s\u1ed1t, vi\u00eam t\u0129nh m\u1ea1ch t\u1ea1i ch\u1ed7, vi\u00eam \u0111\u1ea1i tr\u00e0ng gi\u1ea3 m\u1ea1c, t\u0103ng ur\u00ea. Daptomycin t\u01b0\u01a1ng t\u00e1c v\u1edbi h\u00f3a ch\u1ea5t \u0111o th\u1eddi gian prothrombin d\u1eabn \u0111\u1ebfn k\u1ebft qu\u1ea3 k\u00e9o d\u00e0i gi\u1ea3 t\u1ea1o th\u1eddi gian prothrombin.<\/p>\n

2.5. \u00dd ngh\u0129a l\u00e2m s\u00e0ng<\/h3>\n


\n<\/strong>Vi\u1ec7c kh\u00f4ng s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb vi\u00eam ph\u1ed5i \u0111\u00e3 h\u1ea1n ch\u1ebf r\u1ea5t nhi\u1ec1u vai tr\u00f2 c\u1ee7a daptomycin tr\u00ean l\u00e2m s\u00e0ng. Xu h\u01b0\u1edbng hi\u1ec7n nay kh\u00f4ng d\u00f9ng daptomycin \u0111\u01a1n \u0111\u1ed9c m\u00e0 ch\u00fa \u00fd ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c kh\u00e1ng sinh kh\u00e1c \u0111\u1ec3 tr\u00e1nh ph\u00e1t sinh \u0111\u1ec1 kh\u00e1ng v\u1edbi daptomycin. Nh\u1eefng tr\u01b0\u1eddng h\u1ee3p VNTMNK li\u00ean quan d\u1ee5ng c\u1ee5 \u0111i\u1ec7n t\u1eed c\u1ea5y gh\u00e9p hay g\u1eb7p m\u1ea7m b\u1ec7nh MRSA l\u00e0 ch\u1ec9 \u0111\u1ecbnh c\u00f3 l\u1ebd v\u1eeba t\u1ea7m nh\u1ea5t \u0111\u1ed1i v\u1edbi daptomycin hi\u1ec7n nay.<\/p>\n

2. Linezolid<\/h2>\n


\n<\/strong>2.1. L\u1ecbch s\u1eed<\/h3>\n


\n<\/strong>Linezolid l\u00e0 kh\u00e1ng sinh nh\u00f3m oxazolidinone \u0111\u01b0\u1ee3c kh\u00e1m ph\u00e1 t\u1eeb gi\u1eefa nh\u1eefng n\u0103m 1990 v\u00e0 c\u00f4ng nh\u1eadn s\u1eed d\u1ee5ng tr\u00ean l\u00e2m s\u00e0ng t\u1eeb n\u0103m 2000. Nh\u1eefng thu\u1ed1c oxazolidinone \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n t\u1eeb cu\u1ed1i nh\u1eefng n\u0103m 1980 nh\u01b0ng c\u00f3 nhi\u1ec1u \u0111\u1ed9c t\u00ednh. Linezolid l\u00e0 thu\u1ed1c \u0111\u1ea7u ti\u00ean trong nh\u00f3m qua \u0111\u01b0\u1ee3c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng giai \u0111o\u1ea1n 1 m\u00e0 kh\u00f4ng c\u00f3 \u0111\u1ed9c t\u00ednh g\u00ec \u0111\u00e1ng k\u1ec3. Do m\u1edbi ra \u0111\u1eddi, ch\u01b0a c\u00f3 nhi\u1ec1u tr\u01b0\u1eddng h\u1ee3p \u0111\u1ec1 kh\u00e1ng, c\u1ed9ng th\u00eam ch\u1ec9 \u0111\u1ecbnh nh\u1eb1m v\u00e0o c\u00e1c tr\u01b0\u1eddng h\u1ee3p vi khu\u1ea9n \u0111\u1ec1 kh\u00e1ng c\u00e1c kh\u00e1ng sinh kinh \u0111i\u1ec3n, linezolid \u0111ang \u0111\u01b0\u1ee3c \u01b0a chu\u1ed9ng s\u1eed d\u1ee5ng ng\u00e0y m\u1ed9t r\u1ed9ng r\u00e3i \u0111\u1ebfn m\u1ee9c th\u01b0\u1eddng b\u1ecb b\u1ecf qu\u00ean \u0111\u1ed9c t\u00ednh v\u1ec1 huy\u1ebft h\u1ecdc v\u00e0 th\u1ea7n kinh khi s\u1eed d\u1ee5ng k\u00e9o d\u00e0i.<\/p>\n

2.2. D\u01b0\u1ee3c l\u1ef1c h\u1ecdc v\u00e0 d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc<\/h3>\n

Linezolid g\u1eafn v\u00e0o ARN 23S c\u1ee7a ti\u1ec3u ph\u1ea7n ribosome 50S l\u00e0 n\u01a1i di\u1ec5n ra ho\u1ea1t t\u00ednh peptidyl transferase, t\u1eeb \u0111\u00f3 \u1ee9c ch\u1ebf h\u00ecnh th\u00e0nh ph\u1ee9c h\u1ee3p 70S \u0111\u1ec3 kh\u1edfi \u0111\u1ea7u c\u1ee7a qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p protein c\u1ee7a vi khu\u1ea9n. \u0110\u1ed1i v\u1edbi c\u00e1c Enterococcus v\u00e0 t\u1ee5 c\u1ea7u, linezolid ch\u1ec9 c\u00f3 t\u00e1c d\u1ee5ng k\u00ecm khu\u1ea9n nh\u01b0ng \u0111\u1ed1i v\u1edbi ph\u1ea7n l\u1edbn c\u00e1c ch\u1ee7ng li\u00ean c\u1ea7u th\u00ec n\u00f3 l\u1ea1i c\u00f3 t\u00e1c d\u1ee5ng di\u1ec7t khu\u1ea9n. H\u1ea5p thu nhanh v\u00e0 nhi\u1ec1u qua \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. Sinh kh\u1ea3 d\u1ee5ng \u0111\u01b0\u1eddng u\u1ed1ng \u0111\u1ea1t x\u1ea5p x\u1ec9 100%. Th\u1eddi gian \u0111\u1ea1t n\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh huy\u1ebft thanh sau u\u1ed1ng thu\u1ed1c l\u00e0 1-2h. Thu\u1ed1c g\u1eafn protein 31%. Chuy\u1ec3n h\u00f3a t\u1ed1i thi\u1ec3u \u1edf gan (c\u00f3 th\u1ec3 qua trung gian cytochrome P450) t\u1ea1o ra hai ch\u1ea5t chuy\u1ec3n h\u00f3a kh\u00f4ng ho\u1ea1t t\u00ednh. Th\u1eddi gian b\u00e1n th\u1ea3i 4,9h, \u1edf tr\u1ebb em dao \u0111\u1ed9ng 1,8-5,6h. Th\u1ea3i tr\u1eeb qua n\u01b0\u1edbc ti\u1ec3u (kho\u1ea3ng 30% t\u1ed5ng li\u1ec1u l\u00e0 thu\u1ed1c nguy\u00ean d\u1ea1ng, c\u00f2n kho\u1ea3ng 50% t\u1ed5ng li\u1ec1u l\u00e0 c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a) v\u00e0 ph\u00e2n (kho\u1ea3ng 9% t\u1ed5ng li\u1ec1u l\u00e0 c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a). B\u1ec7nh nh\u00e2n suy th\u1eadn n\u1eb7ng c\u00f3 th\u1ec3 t\u00edch l\u0169y c\u00e1c ch\u1ea5t chuy\u1ec3n h\u00f3a c\u1ee7a linezolid.<\/p>\n

2.3. Ch\u1ec9 \u0111\u1ecbnh, ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, li\u1ec1u d\u00f9ng, c\u00e1ch d\u00f9ng<\/h3>\n


\n<\/strong>VNTMNK do c\u00e1c Enterococcus kh\u00e1ng penicillin, aminoglycosid v\u00e0 vancomycin: 600 mg u\u1ed1ng ho\u1eb7c truy\u1ec1n t\u0129nh m\u1ea1ch m\u1ed7i 12h trong \u00edt nh\u1ea5t 6 tu\u1ea7n. Kh\u00f4ng c\u1ea7n \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u \u1edf b\u1ea5t c\u1ee9 m\u1ee9c l\u1ecdc c\u1ea7u th\u1eadn n\u00e0o.<\/p>\n

2.4. T\u00e1c d\u1ee5ng ph\u1ee5 v\u00e0 x\u1eed tr\u00ed<\/h3>\n


\n<\/strong>Ti\u1ebfp x\u00fac th\u1eddi gian ng\u1eafn: ti\u00eau ch\u1ea3y, bu\u1ed3n n\u00f4n, n\u00f4n, ph\u00e1t ban, t\u0103ng men gan, vi\u00eam \u0111\u1ea1i tr\u00e0ng gi\u1ea3 m\u1ea1c.
\nTi\u1ebfp x\u00fac th\u1eddi gian d\u00e0i tr\u00ean 2 tu\u1ea7n s\u1ebd xu\u1ea5t hi\u1ec7n c\u00e1c bi\u1ec3u hi\u1ec7n c\u1ee7a \u1ee9c ch\u1ebf t\u1ed5ng h\u1ee3p protein c\u1ee7a ty th\u1ec3 c\u00f3 t\u01b0\u01a1ng quan v\u1edbi th\u1eddi gian v\u00e0 li\u1ec1u d\u00f9ng. Tuy nhi\u00ean sau khi ng\u1eebng thu\u1ed1c, t\u1ea5t c\u1ea3 c\u00e1c bi\u1ec3u hi\u1ec7n \u0111\u1ec1u c\u00f3 th\u1ec3 ph\u1ee5c h\u1ed3i ho\u00e0n to\u00e0n.
\n\u1ee8c ch\u1ebf t\u1ee7y x\u01b0\u01a1ng c\u00f3 h\u1ed3i ph\u1ee5c: gi\u1ea3m ti\u1ec3u c\u1ea7u, thi\u1ebfu m\u00e1u, gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh. Hay g\u1eb7p nh\u1ea5t sau khi \u0111i\u1ec1u tr\u1ecb tr\u00ean 2 tu\u1ea7n. Nguy c\u01a1 cao n\u1ebfu c\u00f3 b\u1ec7nh th\u1eadn giai \u0111o\u1ea1n cu\u1ed1i.
\nSau khi \u0111i\u1ec1u tr\u1ecb tr\u00ean 4 tu\u1ea7n c\u00f3 th\u1ec3 b\u1ecb nhi\u1ec5m toan lactic, b\u1ec7nh th\u1ea7n kinh ngo\u1ea1i vi, b\u1ec7nh th\u1ea7n kinh th\u1ecb.
\nLinezolid \u1ee9c ch\u1ebf monoamine oxidase n\u00ean c\u00f3 nguy c\u01a1 xu\u1ea5t hi\u1ec7n h\u1ed9i ch\u1ee9ng serotonin (s\u1ed1t, k\u00edch \u0111\u1ed9ng, thay \u0111\u1ed5i tr\u1ea1ng th\u00e1i tinh th\u1ea7n, run) n\u1ebfu d\u00f9ng cho b\u1ec7nh nh\u00e2n \u0111ang s\u1eed d\u1ee5ng thu\u1ed1c \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu serotonin c\u00f3 ch\u1ecdn l\u1ecdc ho\u1eb7c thu\u1ed1c \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu norepinephrine serotonin.
\nNguy c\u01a1 t\u0103ng huy\u1ebft \u00e1p nghi\u00eam tr\u1ecdng n\u1ebfu d\u00f9ng c\u00f9ng th\u1ee9c \u0103n gi\u00e0u tyramine. C\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00e1c nh\u01b0 l\u01b0\u1ee1i l\u00f4ng \u0111en, vi\u00eam th\u1eadn k\u1ebd c\u1ea5p t\u00ednh, r\u0103ng x\u1ec9n m\u00e0u.<\/p>\n

2.5. \u00dd ngh\u0129a l\u00e2m s\u00e0ng<\/h3>\n


\n<\/strong>N\u00ean s\u1eed d\u1ee5ng linezolid trong \u0111i\u1ec1u tr\u1ecb VNTMNK khi b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi c\u00e1c thu\u1ed1c kh\u00e1ng sinh kh\u00e1c. T\u1ef7 l\u1ec7 t\u00e1i ph\u00e1t cao v\u1edbi \u0111i\u1ec1u tr\u1ecb linezolid khi\u1ebfn cho ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb VNTMNK c\u1ee7a linezolid hi\u1ec7n nay ch\u1ec9 c\u00f2n t\u1eadp trung v\u00e0o c\u00e1c Enterococcus \u0111a kh\u00e1ng kh\u00e1ng sinh.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Daptomycin v\u00e0 linezolid l\u00e0 \u0111\u01b0\u1ee3c d\u00f9ng trong \u0111i\u1ec1u tr\u1ecb vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n. C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng c\u0169ng nh\u01b0 c\u00e1c ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng s\u1ebd c\u00f3 trong b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y. Vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n 1.Daptomycin 1.1.L\u1ecbch s\u1eed Daptomycin l\u00e0 kh\u00e1ng sinh nh\u00f3m lipopeptid v\u1edbi t\u00e1c d\u1ee5ng tr\u00ean vi khu\u1ea9n Gram […]<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[12,33],"tags":[],"yoast_head":"\nDaptomycin v\u00e0 linezolid trong vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n<\/title>\n<meta name=\"description\" content=\"Daptomycin v\u00e0 linezolid trong vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n l\u00e0 v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c d\u00f9ng. B\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y cung c\u1ea5p c\u00e1c th\u00f4ng tin quan tr\u1ecdng\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Daptomycin v\u00e0 linezolid trong vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n\" \/>\n<meta property=\"og:description\" content=\"Daptomycin v\u00e0 linezolid trong vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n l\u00e0 v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c d\u00f9ng. B\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y cung c\u1ea5p c\u00e1c th\u00f4ng tin quan tr\u1ecdng\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/daptomycin-va-linezolid-trong-viem-noi-tam-mac-nhiem-khuan\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-19T15:02:13+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-22T06:13:34+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/16957-endocarditis-278x300.webp\" \/>\n<meta name=\"author\" content=\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"6 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/daptomycin-va-linezolid-trong-viem-noi-tam-mac-nhiem-khuan\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/daptomycin-va-linezolid-trong-viem-noi-tam-mac-nhiem-khuan\/\",\"name\":\"Daptomycin v\u00e0 linezolid trong vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-19T15:02:13+00:00\",\"dateModified\":\"2023-04-22T06:13:34+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629\"},\"description\":\"Daptomycin v\u00e0 linezolid trong vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n l\u00e0 v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c d\u00f9ng. B\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y cung c\u1ea5p c\u00e1c th\u00f4ng tin quan tr\u1ecdng\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/daptomycin-va-linezolid-trong-viem-noi-tam-mac-nhiem-khuan\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/daptomycin-va-linezolid-trong-viem-noi-tam-mac-nhiem-khuan\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/daptomycin-va-linezolid-trong-viem-noi-tam-mac-nhiem-khuan\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Daptomycin v\u00e0 linezolid trong vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n\"}]},{\"@type\":\"WebSite\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/\",\"name\":\"Vinmec\",\"description\":\"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629\",\"name\":\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/2.gravatar.com\/avatar\/50f51f67852bc7e49c0b8b60a1fefe3e?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/2.gravatar.com\/avatar\/50f51f67852bc7e49c0b8b60a1fefe3e?s=96&d=mm&r=g\",\"caption\":\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/viettai304-304gmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Daptomycin v\u00e0 linezolid trong vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n","description":"Daptomycin v\u00e0 linezolid trong vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n l\u00e0 v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c d\u00f9ng. B\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y cung c\u1ea5p c\u00e1c th\u00f4ng tin quan tr\u1ecdng","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"Daptomycin v\u00e0 linezolid trong vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n","og_description":"Daptomycin v\u00e0 linezolid trong vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n l\u00e0 v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c d\u00f9ng. B\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y cung c\u1ea5p c\u00e1c th\u00f4ng tin quan tr\u1ecdng","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/daptomycin-va-linezolid-trong-viem-noi-tam-mac-nhiem-khuan\/","og_site_name":"Vinmec","article_published_time":"2023-04-19T15:02:13+00:00","article_modified_time":"2023-04-22T06:13:34+00:00","og_image":[{"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/16957-endocarditis-278x300.webp"}],"author":"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i","twitter_card":"summary_large_image","twitter_misc":{"Written by":"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i","Est. reading time":"6 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/daptomycin-va-linezolid-trong-viem-noi-tam-mac-nhiem-khuan\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/daptomycin-va-linezolid-trong-viem-noi-tam-mac-nhiem-khuan\/","name":"Daptomycin v\u00e0 linezolid trong vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-19T15:02:13+00:00","dateModified":"2023-04-22T06:13:34+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629"},"description":"Daptomycin v\u00e0 linezolid trong vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n l\u00e0 v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c d\u00f9ng. B\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y cung c\u1ea5p c\u00e1c th\u00f4ng tin quan tr\u1ecdng","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/daptomycin-va-linezolid-trong-viem-noi-tam-mac-nhiem-khuan\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/daptomycin-va-linezolid-trong-viem-noi-tam-mac-nhiem-khuan\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/daptomycin-va-linezolid-trong-viem-noi-tam-mac-nhiem-khuan\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Daptomycin v\u00e0 linezolid trong vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n"}]},{"@type":"WebSite","@id":"http:\/\/noithathoaphat.in\/ctv\/#website","url":"http:\/\/noithathoaphat.in\/ctv\/","name":"Vinmec","description":"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629","name":"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/2.gravatar.com\/avatar\/50f51f67852bc7e49c0b8b60a1fefe3e?s=96&d=mm&r=g","contentUrl":"http:\/\/2.gravatar.com\/avatar\/50f51f67852bc7e49c0b8b60a1fefe3e?s=96&d=mm&r=g","caption":"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/viettai304-304gmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/25106"}],"collection":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=25106"}],"version-history":[{"count":4,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/25106\/revisions"}],"predecessor-version":[{"id":26381,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/25106\/revisions\/26381"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=25106"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=25106"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=25106"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}