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Incidence of cephalosporin‐induced anaphylaxis and clinical efficacy of screening intradermal tests with cephalosporins: A large multicenter retrospective cohort study

机译:头孢菌素诱导的过敏性的发病率和筛查头孢菌素皮内检验的临床疗效:大量回顾性队列队列研究

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摘要

Abstract Background Few studies have investigated the incidence of anaphylaxis induced by individual or structurally similar cephalosporins. The aims of the study were to assess the incidence of cephalosporin‐induced anaphylaxis and evaluate the clinical efficacy of screening skin tests. Methods In this retrospective cohort study, we obtained information on total cephalosporin use and cephalosporin‐induced anaphylaxis in intravenous cephalosporin recipients in 12 general hospitals between 2013 and 2015. Cephalosporins were divided into 4 groups according to similar side‐chain structures. The incidence of cephalosporin‐induced anaphylaxis was assessed for each cephalosporin, cephalosporin generation, and side‐chain group. To verify the efficacy of screening intradermal tests ( IDT ) with cephalosporin, the 12 hospitals were assigned to the intervention or control group depending on whether they performed screening IDT before the administration of cephalosporins. Results We identified 76 cases of cephalosporin‐induced anaphylaxis with 1?123?345 exposures to intravenous cephalosporins (6.8 per 100?000 exposures), and the incidence of fatal anaphylaxis by cephalosporin was 0.1 cases per 100?000 exposures. The highest incidences of anaphylaxis occurred in the ceftizoxime (13.0 cases per 100?000 exposures) and side‐chain group 1 (cefepime, cefotaxime, ceftizoxime, ceftriaxone, and cefuroxime; 9.3 per 100?000). There was no case of anaphylaxis induced by cefoxitin, cefmetazole, cefminox, and cefotiam. The clinical effectiveness of routine screening IDT was not significant ( P ?=?.06). Conclusions The incidence of cephalosporin‐induced anaphylaxis differed according to individual drugs and side‐chain structure. Screening IDT showed no clinical efficacy at a population level.
机译:摘要背景少数研究已经研究了个体或结构上类似的头孢菌素诱导的过敏反应的发病率。该研究的目的是评估头孢菌素诱导的过敏性的发病率,并评估筛选皮肤测试的临床疗效。方法在该回顾性队列研究中,我们在2013和2015之间的12个综合医院中获得了总头孢菌素使用和头孢菌素诱导的过敏性的信息。根据类似的侧链结构,Cephalosporins分为4组。对每个头孢菌素,头孢菌素产生和侧链组评估头孢菌素诱导的过敏糖的发病率。为了验证筛选与头孢菌素的皮内检测(IDT)的疗效,将12家医院分配给干预或对照组,这取决于它们是否在施用头孢菌素之前进行IDT进行筛选。结果我们鉴定了76例头孢菌素诱导的过敏性,1〜123〜345曝光给静脉注射头孢菌素(6.8每100 00?000曝光),头孢菌素致命的致命性过敏的发病率为0.1例每100 00 000曝光。过敏的发病率发生在头孢唑肟(每100 000次暴露的13.0例)和侧链组1(头孢噻肟,头孢噻肟,头孢唑肟,头孢曲松和头孢呋辛; 9.3每100?000)。没有Cefoxitin,头孢唑,头孢米蛋白和集团诱导过敏反应的情况。常规筛查IDT的临床疗效不显着(P?= 06)。结论根据个体药物和侧链结构,Cephalosporin诱导的过敏性的发病率不同。筛选IDT在人口水平上显示了临床疗效。

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  • 来源
    《Allergy》 |2018年第9期|共9页
  • 作者单位

    Department of Internal MedicineSMG‐SNU Boramae Medical CenterSeoul Korea;

    Department of Preventive MedicineSeoul National University College of MedicineSeoul Korea;

    Department of Allergy and Clinical ImmunologyUniversity of Ulsan College of MedicineSeoul Korea;

    Department of Internal MedicineGangnam Severance HospitalSeoul Korea;

    Department of Internal MedicineEulji General HospitalSeoul Korea;

    Division of Pulmonary Allergy and Critical Care MedicineBusan Paik HospitalBusan Korea;

    Division of Allergy and ImmunologyYonsei University College of MedicineSeoul Korea;

    Division of Allergy and Respiratory MedicineSoonchunhyang University Seoul HospitalSeoul Korea;

    Department of Internal MedicineDong‐A University College of MedicineBusan Korea;

    Department of Internal MedicineSchool of MedicineDaegu Korea;

    Department of Internal MedicineChung‐Ang University College of MedicineSeoul Korea;

    Department of Allergy and Clinical ImmunologyUniversity of Ulsan College of MedicineSeoul Korea;

    Department of PediatricsNational Health Insurance ServiceGoyang Korea;

    Pediatric Allergy and Respiratory CenterSoonchunhyang University Seoul HospitalSeoul Korea;

    Department of PediatricsEulji General HospitalSeoul Korea;

    Division of Allergy and ImmunologyYonsei University College of MedicineSeoul Korea;

    Drug Safety Monitoring CenterSeoul National University HospitalSeoul Korea;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 医学免疫学;
  • 关键词

    anaphylaxis; cephalosporins; incidence; intradermal tests; mass screening;

    机译:过敏反应;头孢菌素;发病率;皮内测试;质量筛选;

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