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Occupational Asthma in Antibiotic Manufacturing Workers: Case Reports and Systematic Review

机译：抗生素制造工人的职业性哮喘：病例报告和系统评价

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Background. The risks of occupational asthma (OA) from antibiotics are uncertain. We report 4 new cases and a systematic review of the literature. Methods. Cases were identified through a specialist clinic, each underwent specific provocation testing (SPT). We subsequently reviewed the published literature. Results. The patients were employed in the manufacture of antibiotics; penicillins were implicated in three cases, in the fourth erythromycin, not previously reported to cause OA. In two, there was evidence of specific IgE sensitisation. At SPT each developed a late asthmatic reaction and increased bronchial hyperresponsiveness. 36 case reports have been previously published, 26 (citing penicillins or cephalosporins). Seven cross-sectional workplace-based surveys found prevalences of 5–8%. Conclusions. OA in antibiotic manufacturers may be more common than is generally recognised. Its pathogenesis remains unclear; immunological tests are of uncertain value and potential cases require confirmation with SPT. Further study of its frequency, mechanisms, and diagnosis is required.
机译：背景。抗生素导致职业性哮喘（OA）的风险尚不确定。我们报告了4个新病例，并对文献进行了系统回顾。方法。通过专科诊所鉴定病例，每个病例都经过特定的激发试验（SPT）。随后，我们回顾了已发表的文献。结果。患者受雇于制造抗生素;在第四例红霉素中，有3例涉及青霉素，以前没有报道可导致OA。在两个案例中，有证据表明存在特定的IgE致敏作用。在SPT时，每个人都会出现晚期哮喘反应并增加支气管高反应性。以前已经发表了36例病例报告，其中26例（引用青霉素或头孢菌素）。七项基于工作场所的横断面调查发现患病率为5–8％。结论。抗生素生产商中的OA可能比普遍公认的更为普遍。其发病机制仍不清楚;免疫学检查的价值不确定，潜在病例需要SPT确认。需要对其频率，机制和诊断进行进一步研究。

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