{"id":61483,"date":"2024-02-28T07:42:59","date_gmt":"2024-02-28T07:42:59","guid":{"rendered":"https:\/\/medsname.com\/t-bact-ointment-2\/"},"modified":"2026-05-01T10:49:16","modified_gmt":"2026-05-01T10:49:16","slug":"t-bact-ointment-2","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/t-bact-ointment-2\/","title":{"rendered":"T-Bact mast"},"content":{"rendered":"

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\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je T-Bact mast?<\/h3>\n

T-Bact mast<\/strong> obsahuje mupirocin 2% w\/w<\/strong> jako topick\u00e1 mast od GlaxoSmithKline \u2014 antibiotikum unik\u00e1tn\u00ed t\u0159\u00eddy pou\u017e\u00edvan\u00e9 k l\u00e9\u010db\u011b impetiga, sekund\u00e1rn\u00edch infekc\u00ed drobn\u00fdch ran a \u0159ez\u016f, infikovan\u00e9ho ekz\u00e9mu, folikulitidy<\/strong>, a pro dekolonizace nosn\u00edho MRSA<\/strong>. Mechanismus mupirocinu (inhibice bakteri\u00e1ln\u00ed isoleucyl-tRNA syntet\u00e1zy) je unik\u00e1tn\u00ed \u2014 neexistuje zk\u0159\u00ed\u017een\u00e1 rezistence s \u017e\u00e1dnou jinou t\u0159\u00eddou antibiotik. To z n\u011bj \u010din\u00ed cenn\u00fd prost\u0159edek proti multirezistentn\u00edm organism\u016fm v\u010detn\u011b meticilin-rezistentn\u00edho Staphylococcus aureus<\/em> (MRSA)<\/strong>. Aplikujte tenkou vrstvu 2-3kr\u00e1t denn\u011b po dobu maxim\u00e1ln\u011b 7-10 dn\u00ed.<\/strong> Po 10 dnech v\u00fdrazn\u011b roste riziko vzniku rezistence \u2014 mupirocin by NEM\u011aL b\u00fdt pou\u017e\u00edv\u00e1n k dlouhodob\u00e9mu o\u0161et\u0159ov\u00e1n\u00ed ran nebo chronick\u00e9 kolonizaci k\u016f\u017ee bez mikrobiologick\u00e9ho potvrzen\u00ed. Nej\u010dast\u011bj\u0161\u00ed vedlej\u0161\u00ed \u00fa\u010dinky:<\/strong> m\u00edrn\u00e9 p\u00e1len\u00ed, \u0161t\u00edp\u00e1n\u00ed nebo sv\u011bd\u011bn\u00ed v m\u00edst\u011b aplikace. Mupirocin je ur\u010den pouze pro ko\u017en\u00ed pou\u017eit\u00ed<\/strong> \u2014 neaplikujte na sliznice, do o\u010d\u00ed nebo nepou\u017e\u00edvejte ko\u017en\u00ed formuli v nose (pro dekolonizaci MRSA existuje samostatn\u00e1 nosn\u00ed forma mupirocinu).<\/p>\n<\/div>\n

\nCo z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n

\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n

Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n

Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n

Co je T-Bact mast?<\/h2>\n

T-Bact mast je lok\u00e1ln\u00ed mupirocin 2% w\/w<\/strong> mast od spole\u010dnosti GlaxoSmithKline, dod\u00e1van\u00e1 v tub\u011b o hmotnosti 5 g. Mupirocin (d\u0159\u00edve zn\u00e1m\u00fd jako pseudomonov\u00e1 kyselina A) byl p\u016fvodn\u011b izolov\u00e1n z Pseudomonas fluorescens<\/em> v roce 1971 a do klinick\u00e9ho pou\u017eit\u00ed byl uveden v roce 1985. Mezin\u00e1rodn\u011b je zna\u010den jako Bactroban (GSK), Centany (Medimetriks), Eismycin, Mupirox, Mupiderm, Foban<\/strong>, a mnoho generick\u00fdch verz\u00ed.<\/p>\n

Jak mupirocin funguje?<\/h2>\n

Mupirocin m\u00e1 unik\u00e1tn\u00ed mechanismus \u00fa\u010dinku<\/strong> nesd\u00edlen\u00e1 \u017e\u00e1dnou jinou t\u0159\u00eddou antibiotik:<\/p>\n

    \n
  • Inhibuje bakteri\u00e1ln\u00ed isoleucyl-tRNA syntet\u00e1zu (IleRS)<\/strong> \u2014 enzym, kter\u00fd nab\u00edj\u00ed tRNA isoleucinem pro synt\u00e9zu protein\u016f. Bez funk\u010dn\u00ed IleRS se bakteri\u00e1ln\u00ed synt\u00e9za protein\u016f zastav\u00ed a bu\u0148ka odum\u00edr\u00e1.<\/li>\n
  • Selektivn\u00ed pro bakteri\u00e1ln\u00ed IleRS<\/strong> \u2014 sav\u010d\u00ed IleRS je strukturn\u011b odli\u0161n\u00e1 a nen\u00ed ovlivn\u011bna v klinick\u00fdch d\u00e1vk\u00e1ch, co\u017e d\u00e1v\u00e1 mupirocinu v\u00fdbornou bezpe\u010dnostn\u00ed rezervu.<\/li>\n
  • Baktericidn\u00ed v terapeutick\u00fdch koncentrac\u00edch<\/strong> proti citliv\u00fdm grampozitivn\u00edm bakteri\u00edm (Staphylococcus aureus<\/em> v\u010detn\u011b MRSA, Streptococcus pyogenes<\/em>) a n\u011bkter\u00fdm gramnegativn\u00edm. Omezen\u00e1 aktivita proti anaerob\u016fm a gramnegativn\u00edm enterobakteri\u00edm.<\/li>\n
  • \u017d\u00e1dn\u00e1 zk\u0159\u00ed\u017een\u00e1 rezistence<\/strong> s beta-laktamy, makrolidy, fluorochinolony, tetracykliny, glykopeptidy nebo jakoukoli jinou t\u0159\u00eddou antibiotik \u2014 to je velk\u00e1 klinick\u00e1 p\u0159ednost mupirocinu proti MRSA.<\/li>\n<\/ul>\n

    Mupirocin je rychle inaktivov\u00e1n v s\u00e9ru (polo\u010das <30 min) a m\u00e1 minim\u00e1ln\u00ed syst\u00e9movou absorpci z neporu\u0161en\u00e9 k\u016f\u017ee \u2014 je to \u010dist\u011b topick\u00e9 antibiotikum. Viditeln\u00e9 zlep\u0161en\u00ed ko\u017en\u00ed infekce obvykle za\u010d\u00edn\u00e1 b\u011bhem 2-3 dn\u016f; \u00fapln\u00e9 vyl\u00e9\u010den\u00ed b\u011bhem 7-10 denn\u00edho l\u00e9\u010debn\u00e9ho cyklu.<\/p>\n

    Kdy se pou\u017e\u00edv\u00e1 mast T-Bact<\/h2>\n

    Schv\u00e1len\u00e9 indikace:<\/strong><\/p>\n

      \n
    • Impetigo<\/strong> (zp\u016fsoben\u00e9ho Staphylococcus aureus<\/em> nebo Streptococcus pyogenes<\/em>) \u2014 prvn\u00ed volba topick\u00e9ho antibiotika pro omezenou formu impetiga<\/li>\n
    • Sekund\u00e1rn\u00ed infekce drobn\u00fdch poran\u011bn\u00ed, \u0159ezn\u00fdch ran, od\u011brek, tr\u017en\u00fdch ran a pop\u00e1lenin<\/strong><\/li>\n
    • Infikovan\u00e9 dermat\u00f3zy<\/strong> \u2014 sekund\u00e1rn\u011b infikovan\u00fd ekz\u00e9m, kontaktn\u00ed dermatitida<\/li>\n
    • Folikulitida (bakteri\u00e1ln\u00ed)<\/strong><\/li>\n
    • Furunkul\u00f3za<\/strong> (nekomplikovan\u00e9 v\u0159edy)<\/li>\n<\/ul>\n

      Mimoindika\u010dn\u00ed \/ specializovan\u00e9 pou\u017eit\u00ed:<\/strong><\/p>\n

        \n
      • Dekolonizace nosu p\u0159i MRSA \/ MSSA<\/strong> \u2014 pomoc\u00ed speci\u00e1ln\u00ed 2% nosn\u00ed masti (NE tato ko\u017en\u00ed forma), 2\u20133\u00d7 denn\u011b po dobu 5 dn\u016f. Standardn\u00ed p\u0159edopera\u010dn\u00ed protokol u kardi\u00e1ln\u00edch, ortopedick\u00fdch a dal\u0161\u00edch vysoce rizikov\u00fdch v\u00fdkon\u016f.<\/li>\n
      • Prevence recidivuj\u00edc\u00ed furunkul\u00f3zy<\/strong> \u2014 naz\u00e1ln\u00ed dekolonizace + intermitentn\u00ed aplikace na kolonizovan\u00e9 ko\u017en\u00ed oblasti<\/li>\n
      • Kontrola v\u00fdskytu<\/strong> ve zdravotnick\u00fdch za\u0159\u00edzen\u00edch (JIP novorozenc\u016f, dialyza\u010dn\u00ed jednotky)<\/li>\n<\/ul>\n

        Mupirocin nen\u00ed vhodn\u00fd NEN\u00cd<\/strong> pro: hlubok\u00e9 abscesy (vy\u017eaduj\u00ed chirurgickou dren\u00e1\u017e), celulitidu (vy\u017eaduje syst\u00e9mov\u00e1 antibiotika), erysipel, infikovan\u00e9 diabetick\u00e9 v\u0159edy (polybakteri\u00e1ln\u00ed, vy\u017eaduj\u00ed syst\u00e9movou + kultiva\u010dn\u011b vedenou terapii) nebo pl\u00eds\u0148ov\u00e9\/vir\u00e1ln\u00ed ko\u017en\u00ed infekce.<\/p>\n

        D\u00e1vkov\u00e1n\u00ed masti T-Bact a zp\u016fsob aplikace<\/h2>\n
          \n
        1. Umyjte si ruce<\/strong> p\u0159ed a po aplikaci.<\/li>\n
        2. Jemn\u011b o\u010dist\u011bte posti\u017een\u00e9 m\u00edsto<\/strong> m\u00fddlem a vodou; osu\u0161te \u010dist\u00fdm ru\u010dn\u00edkem.<\/li>\n
        3. Naneste mal\u00e9 mno\u017estv\u00ed masti T-Bact<\/strong> (hr\u00e1\u0161ek velikosti hr\u00e1\u0161ku pokryje l\u00e9zi o velikosti 2-3 cm) na infikovanou oblast; jemn\u011b vet\u0159ete.<\/li>\n
        4. V p\u0159\u00edpad\u011b pot\u0159eby p\u0159ekryjte steriln\u00edm obvazem<\/strong> \u2014 zejm\u00e9na u impetiga na exponovan\u00e9 k\u016f\u017ei (obli\u010dej, ruce), aby se zabr\u00e1nilo p\u0159enosu a sn\u00ed\u017eila autoinokulace.<\/li>\n
        5. Aplikujte 2-3kr\u00e1t denn\u011b po dobu a\u017e 7-10 dn\u00ed<\/strong>.<\/li>\n
        6. Pokud nedojde ke zlep\u0161en\u00ed po 3-5 dnech, nav\u0161tivte l\u00e9ka\u0159e \u2014 infekce m\u016f\u017ee b\u00fdt zp\u016fsobena mupirocin-rezistentn\u00edm organismem, m\u016f\u017ee j\u00edt o odli\u0161n\u00fd mikrobiologick\u00fd proces (pl\u00eds\u0148ov\u00fd, virov\u00fd) nebo m\u016f\u017ee b\u00fdt nutn\u00e1 syst\u00e9mov\u00e1 antibiotick\u00e1 l\u00e9\u010dba.<\/li>\n
        7. Nepou\u017e\u00edvejte d\u00e9le ne\u017e 10 dn\u00ed<\/strong> \u2014 riziko vzniku rezistence prudce stoup\u00e1. Pokud je probl\u00e9mem chronick\u00e1 kolonizace, proberte s l\u00e9ka\u0159em dlouhodob\u011bj\u0161\u00ed strategie dekolonizace (st\u0159\u00edd\u00e1n\u00ed antiseptik, behavior\u00e1ln\u00ed opat\u0159en\u00ed).<\/li>\n<\/ol>\n

          D\u011bti:<\/strong> bezpe\u010dn\u00e9 od 2 m\u011bs\u00edc\u016f v\u011bku pod l\u00e9ka\u0159sk\u00fdm dohledem. Stejn\u00fd d\u00e1vkovac\u00ed re\u017eim.<\/p>\n

          T\u011bhotenstv\u00ed:<\/strong> minim\u00e1ln\u00ed syst\u00e9mov\u00e1 absorpce; obecn\u011b pova\u017eov\u00e1no za bezpe\u010dn\u00e9. Kojen\u00ed:<\/strong> nenaplikujte na bradavky bez odborn\u00e9ho poradenstv\u00ed.<\/p>\n

          Rezistence na MRSA a spr\u00e1vn\u00e9 pou\u017e\u00edv\u00e1n\u00ed<\/h2>\n

          Mupirocin je jedn\u00edm z m\u00e1la topick\u00fdch antibiotik se spolehlivou \u00fa\u010dinnost\u00ed proti meticilin-rezistentn\u00edho Staphylococcus aureus<\/em> (MRSA)<\/strong> \u2014 v\u010detn\u011b komunitn\u00edch (CA-MRSA) a nemocni\u010dn\u00edch (HA-MRSA) kmen\u016f. To jej \u010din\u00ed cenn\u00fdm, ale tak\u00e9 n\u00e1chyln\u00fdm k rezistenci zp\u016fsoben\u00e9 nespr\u00e1vn\u00fdm pou\u017e\u00edv\u00e1n\u00edm.<\/p>\n

          Rezistence na mupirocin se vyskytuje ve dvou form\u00e1ch:<\/strong><\/p>\n

            \n
          • N\u00edzk\u00e1 \u00farove\u0148 rezistence<\/strong> (MIC 8-256 \u03bcg\/mL) \u2014 zp\u016fsoben\u00e1 chromozom\u00e1ln\u00edmi bodov\u00fdmi mutacemi v IleRS. L\u00e9\u010dba m\u016f\u017ee st\u00e1le usp\u011bt, ale s vy\u0161\u0161\u00ed m\u00edrou ne\u00fasp\u011bchu.<\/li>\n
          • Vysok\u00e1 \u00farove\u0148 rezistence<\/strong> (MIC >512 \u03bcg\/mL) \u2014 zp\u016fsoben\u00e1 z\u00edskan\u00fdm plasmidem nesouc\u00edm gen mupA<\/em> k\u00f3duj\u00edc\u00ed alternativn\u00ed IleRS. L\u00e9\u010dba obvykle sel\u017ee. Prevalence vysok\u00e9 \u00farovn\u011b rezistence vzrostla z <1 % v 90. letech na 5\u201325 % v n\u011bkter\u00fdch nemocni\u010dn\u00edch za\u0159\u00edzen\u00edch.<\/li>\n<\/ul>\n

            Z\u00e1sady spr\u00e1vn\u00e9ho pou\u017e\u00edv\u00e1n\u00ed mupirocinu:<\/strong><\/p>\n

              \n
            • Pou\u017e\u00edvejte pouze v p\u0159\u00edpad\u011b skute\u010dn\u00e9 indikace topick\u00e9ho antibiotika \u2014 nikoli pro rutinn\u00ed profylaxi ka\u017ed\u00e9ho \u0159ezu nebo od\u011brky<\/li>\n
            • Omezte ka\u017edou l\u00e9\u010debnou k\u00faru na maxim\u00e1ln\u011b 7-10 dn\u00ed<\/li>\n
            • Nepou\u017e\u00edvejte jako dlouhodob\u00fd obvaz na r\u00e1ny<\/li>\n
            • Vyhra\u010fte pro potvrzen\u00e9 nebo siln\u011b podez\u0159el\u00e9 stafylokokov\u00e9 infekce<\/li>\n
            • Pro dekolonizaci MRSA dodr\u017eujte institucion\u00e1ln\u00ed protokoly \u2014 nikoli dlouhodob\u00e9 samostatn\u00e9 k\u00fary<\/li>\n<\/ul>\n

              Vedlej\u0161\u00ed \u00fa\u010dinky<\/h2>\n
                \n
              • \u010cast\u00e9 (m\u00edrn\u00e9):<\/strong> p\u00e1len\u00ed, \u0161t\u00edp\u00e1n\u00ed, sv\u011bd\u011bn\u00ed v m\u00edst\u011b aplikace (\u010dasto souvisej\u00edc\u00ed s polyethylenglykolovou b\u00e1z\u00ed)<\/li>\n
              • M\u00e9n\u011b \u010dast\u00e9:<\/strong> such\u00e1 poko\u017eka, kontaktn\u00ed dermatitida, eryt\u00e9m<\/li>\n
              • Vz\u00e1cn\u00e9:<\/strong> alergick\u00e1 kontaktn\u00ed dermatitida, generalizovan\u00e9 hypersenzitivn\u00ed reakce<\/li>\n
              • Velmi vz\u00e1cn\u011b:<\/strong> Stevens-Johnson\u016fv syndrom, syst\u00e9mov\u00e1 toxicita p\u0159i rozs\u00e1hl\u00e9m pou\u017eit\u00ed na velk\u00fdch ploch\u00e1ch (polyethylenglykolov\u00e9 nosi\u010de mohou b\u00fdt absorbov\u00e1ny p\u0159es rozs\u00e1hle po\u0161kozenou k\u016f\u017ei)<\/li>\n<\/ul>\n

                Kontraindikace a varov\u00e1n\u00ed<\/h2>\n
                  \n
                • P\u0159ecitliv\u011blost na mupirocin nebo jakoukoli pomocnou l\u00e1tku (v\u010detn\u011b polyethylenglykolu)<\/li>\n
                • Aplikace na sliznice (o\u010di, \u00fasta, vagina, mo\u010dov\u00e1 trubice)<\/li>\n
                • Pou\u017eit\u00ed ko\u017en\u00ed formy v nosn\u00ed dutin\u011b (m\u00edsto toho pou\u017eijte speci\u00e1ln\u00ed nosn\u00ed formu mupirocinu)<\/li>\n
                • Aplikace na rozs\u00e1hl\u00e9 plochy po\u0161kozen\u00e9 nebo pop\u00e1len\u00e9 k\u016f\u017ee (mo\u017en\u00e1 syst\u00e9mov\u00e1 absorpce polyethylenglykolov\u00e9 b\u00e1ze u pacient\u016f s ren\u00e1ln\u00edm posti\u017een\u00edm)<\/li>\n
                • T\u011b\u017ek\u00e9 ren\u00e1ln\u00ed posti\u017een\u00ed (relativn\u00ed kontraindikace pro rozs\u00e1hl\u00e9 pou\u017eit\u00ed kv\u016fli obav\u00e1m z akumulace PEG)<\/li>\n<\/ul>\n

                  Interakce s l\u00e9\u010divy<\/h2>\n

                  Topick\u00fd mupirocin m\u00e1 minim\u00e1ln\u00ed syst\u00e9movou absorpci a \u017e\u00e1dn\u00e9 klinicky v\u00fdznamn\u00e9 l\u00e9kov\u00e9 interakce. M\u00edstn\u00ed interakce, kter\u00e9 je t\u0159eba zvl\u00e1dnout:<\/p>\n