β-内酰胺类抗菌药物皮肤过敏试验阴性后过敏反应的临床研究
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摘要
目的 研究β-内酰胺类抗菌药物皮肤过敏试验阴性后过敏反应的规律与特点。方法 回顾性分析2017年1月～2018年10月本院收治的30例β-内酰胺类抗菌药物(主要为头孢类与青霉素类)皮肤过敏试验阴性后过敏反应住院患者,收集其临床资料,评估年龄、药品使用分类、过敏临床反应、过敏反应发生时间与缓解时间等。结果 年龄<1岁出现β-内酰胺类抗菌药物皮肤过敏试验阴性后过敏反应占比高达50.00%,均高于其他年龄段的比例,差异有统计学意义(P<0.05);占比前三药品为美洛西林(33.33%)、哌拉西林他唑巴坦(20.00%)以及头孢哌酮舒巴坦(13.34%);临床表现以瘙痒、风团、皮疹等为主,累及部位不固定;发生时间主要为7～9剂(用药4d后);12h以内缓解共19例(63.33%)。结论 β-内酰胺类抗菌药物皮肤过敏试验阴性后过敏反应易发人群为<1岁,发生时间、发生部位均不固定,要求对患者使用β-内酰胺类抗菌药物过程中需严密监督观察。
Objective To study the regularity and characteristics of allergic reactions after negative skin allergy test of beta lactam antibiotics.Methods A retrospective analysis in January 2017 to October 2018 in our hospital treated 30 cases of beta lactam antimicrobial drugs(mainly for the cephalosporin class) and penicillin skin allergy test negative, hospitalized patients with allergic reaction after the clinical information collection,classification,is used to assess age,drug allergy clinical reaction,allergic reactions happen time and reduce time and so on.Results The proportion of allergic reaction was up to 50.00% after negative skin allergy test of beta lactam antibacterial agents at age <1,both higher than that of other age groups,and the difference was statistically significant(P<0.05).The top three drugs were melocillin(33.33%),piperacillin tazobactam(20.00%)and cefoperazone sulbactam(13.34%).The clinical manifestations were mainly pruritus,anemoderma,and rash,and the affected parts were not fixed.The occurrence time was mainly 7～9 doses(after 4 d).A total of 19 cases(63.33%)were relieved within 12 h.Conclusion The susceptible group of allergic reactions after negative skin allergy test of betaprolactam antibiotics is <1 year old,and the time and place of occurrence are not fixed.Therefore, strict supervision and observation are required during the use of betaprolactam antibiotics in patients.
Objective To study the regularity and characteristics of allergic reactions after negative skin allergy test of beta lactam antibiotics.Methods A retrospective analysis in January 2017 to October 2018 in our hospital treated 30 cases of beta lactam antimicrobial drugs(mainly for the cephalosporin class) and penicillin skin allergy test negative, hospitalized patients with allergic reaction after the clinical information collection,classification,is used to assess age,drug allergy clinical reaction,allergic reactions happen time and reduce time and so on.Results The proportion of allergic reaction was up to 50.00% after negative skin allergy test of beta lactam antibacterial agents at age <1,both higher than that of other age groups,and the difference was statistically significant(P<0.05).The top three drugs were melocillin(33.33%),piperacillin tazobactam(20.00%)and cefoperazone sulbactam(13.34%).The clinical manifestations were mainly pruritus,anemoderma,and rash,and the affected parts were not fixed.The occurrence time was mainly 7～9 doses(after 4 d).A total of 19 cases(63.33%)were relieved within 12 h.Conclusion The susceptible group of allergic reactions after negative skin allergy test of betaprolactam antibiotics is <1 year old,and the time and place of occurrence are not fixed.Therefore, strict supervision and observation are required during the use of betaprolactam antibiotics in patients.
引文
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[2]崔兰卿,吕媛.药物代谢动力学/药物效应动力学理论优化β-内酰胺类抗菌药物抗感染治疗的研究现状[J].中国临床药理学杂志,2018,34(16):2004-2007.
[3]毛孝钢,周华,张媛媛,等.β-内酰胺类抗菌药物致药物热的研究[J].中国现代应用药学,2016,33(06):822-834.
[4]许锦英,盛雪鹤,刘孟雪,等.皖南地区18所公立医院β-内酰胺类抗菌药物皮肤过敏试验现状分析[J]安徽医药,2017,21(05):943-947.
[5]杨茵梅,李坤浪,钟伟章,等.98例β-内酰胺类抗菌药物致不良反应[J].中国医院用药评价与分析,2016,16(07):994-996.
[6]GAETA F,VALLUZZI R L,ALONZI C,et al.Tolerability of aztreonam and carbapenems in patients with IgE-mediated hypersensitivity to penicillins[J].Journal of allergy&clinical imm unology,2015,135(04):972-976.
[7]朱曼,凡超,郭代红,等.军队医院1175例抗感染药物严重药品不良反应/事件报告分析[J].中国药物应用与监测,2015,12(03):163-167.
[8]王云龙.β-内酰胺类抗菌药物皮肤过敏试验阴性后过敏反应22例临床分析[J].中国药业,2016,25(05):68-69.