巴龍黴素
巴龍黴素是一種口服氨基糖苷類抗生素，主要在獸醫學中用於其抗寄生蟲特性，特別是針對**隱孢子蟲 (Cryptosporidium spp.)** 和 **利什曼原蟲 (Leishmania spp.)**。由於其結構與新黴素 (neomycin) 相似，在胃腸道黏膜完整時幾乎不被吸收，從而能在腸道內局部作用於病原體。 > **臨床重點：** 雖然對腸道原蟲有效，但其在貓的使用極具爭議，因為即使沒有明顯的胃腸道潰瘍，也有報告指出會引起嚴重的全身性毒性（包括急性腎損傷、耳毒性和失明）。許多臨床獸醫師傾向於在貓身上使用如阿奇黴素 (azithromycin) 等替代療法。
作用機制: Paromomycin binds to the **30S ribosomal subunit** of susceptible organisms → causes misreading of mRNA → inhibits protein synthesis, leading to cell death. In protozoa such as *Leishmania*, it is believed to target the mitochondria and ribosomes, disrupting cellular respiration and protein synthesis.
各物種劑量
- Treatment of cryptosporidiosis in Camelids (crias) · 50 mg/kg · PO · once per day (assumed) · 5-10 days · Dosing interval not specified in original source, assumed once per day by Plumb.
- Treatment of cryptosporidiosis · 125-165 mg/kg · PO · twice daily · 5 days · Consider using an alternate treatment first (e.g., azithromycin) or paromomycin at an initially reduced dosage level.
- Treatment of cryptosporidiosis · 150 mg/kg · PO · once a day · 5 days · Caution: nephrotoxicity.
- Treatment of cryptosporidiosis · 150 mg/kg · PO · q12-24hr · Until 1 week past clinical resolution of diarrhea · If the cat is responding to the first 7 days of therapy and toxicity has not been noted.
- Treatment of cryptosporidiosis · 125-165 mg/kg · PO · twice daily · 5 days
- Treatment of cryptosporidiosis · 150 mg/kg · PO · once a day · 5 days · Caution: nephrotoxicity.
- Treatment of cryptosporidiosis · 300-800 mg/kg · PO · q24-48h · 7-14 days or as needed
劑量為合格獸醫專業人員的臨床參考。請務必對照最新藥品仿單及個別病患確認。
給藥途徑
禁忌症
- Known hypersensitivity to paromomycin
- Ileus or intestinal obstruction
- Gastrointestinal ulceration
- Presence of blood in the stool (indicates mucosal breakdown and risk of systemic absorption)
不良反應
- Nausea
- Vomiting
- Diarrhea
- Inappetence
- Nonsusceptible bacterial or fungal overgrowth
- Nephrotoxicity (if systemically absorbed)
- Ototoxicity (if systemically absorbed)
- Pancreatitis (if systemically absorbed)
- Blindness (reported in cats)
藥物相互作用
- Digoxin · Paromomycin may reduce digoxin absorption
- Methotrexate · Paromomycin may reduce methotrexate absorption
監測
- Clinical efficacy (resolution of diarrhea, negative fecal tests)
- Gastrointestinal adverse effects
- Renal function (especially if used in cats or if GI ulceration is suspected)
過量
Because paromomycin is not absorbed orally, acute overdose adverse effects should be limited to **gastrointestinal distress** (nausea, vomiting, diarrhea) in patients with an intact GI system. **Chronic overdoses** or administration in patients with compromised GI mucosa may lead to severe systemic toxicity, including nephrotoxicity, ototoxicity, and pancreatitis.
VetSheet 藥物參考供持牌獸醫專業人員作臨床決策輔助之用,不能取代專業判斷或廠方最新藥品說明書。