美罗培南与哌拉西林他唑巴坦交叉过敏反应一例并文献分析

发布时间：2017-12-27 18:45

本文关键词：美罗培南与哌拉西林他唑巴坦交叉过敏反应一例并文献分析　出处：《实用药物与临床》2016年01期 　论文类型：期刊论文

【摘要】：目的探讨Ig E介导的青霉素过敏患者能否安全使用碳青霉烯类抗菌药物。方法结合1例美罗培南与哌拉西林他唑巴坦交叉过敏反应的临床案例,检索2015年1月之前国内外研究碳青霉烯类和青霉素类药物交叉过敏反应的文献,共收集到相关文献11篇(2 308例受试者),分别从"研究药品、纳入人群特点、交叉过敏的研究方法、研究结果和结论"等5个方面进行统计和分析。结果亚胺培南与青霉素的交叉过敏反应发生率在0.8%~25%之间,美罗培南与青霉素的交叉过敏反应发生率在0~0.9%之间;交叉过敏反应的主要表现为皮疹、皮肤瘙痒、药物热、喘憋、中性粒细胞减少、面部水肿、呼吸窘迫、关节痛、急性中性粒细胞减少、急性肾功能衰竭和血管内溶血等。结论对于有青霉素过敏史或者皮试阳性的患者,医生应详细询问患者青霉素过敏情况(相关药品、发生时间和类型、严重程度等);确有必要使用碳青霉烯类药物时,应谨慎使用并进行密切监护,必要时进行脱敏治疗或在床旁准备过敏抢救药品和设施。
[Abstract]:Objective to explore the safe use of carbapenem antibiotics in patients with penicillin allergy mediated by Ig E. Methods 1 clinical cases of meropenem and piperacillin / tazobactam cross allergic reaction, retrieval before January 2015 at home and abroad on the carbapenems and penicillins allergic reaction cross references, a total of 11 literatures were collected (2308 subjects), 5 aspects respectively from "research, drug population characteristics, cross research methods, results and conclusion allergy" statistics and analysis. The allergic reactions of imipenem and penicillin cross in the incidence of 0.8%~25% between the allergic reaction of meropenem and penicillin cross ratio between 0~0.9%; mainly cross allergy rash, pruritus, drug fever, wheezing, neutropenia, facial edema, joint pain, acute respiratory distress, neutrophil reduce, acute renal failure and intravascular hemolysis. Conclusion for a history of penicillin allergy or skin test positive patients, doctors should ask patients with penicillin allergy (related to drugs, time of occurrence and severity of type, etc.); it is necessary to use carbapenems, should be cautious and monitor closely, when necessary for desensitization therapy or prepare emergency drugs and allergies the facilities at the bedside.
【作者单位】：北京大学首钢医院药剂科;北京大学药学院;
【分类号】：R969.2
【正文快照】： 1病例资料患者,男,78岁,身高162 cm,体重约45 kg,主因“慢性咳痰喘50年,加重伴精神差1 d”于2015年1月9日入我院肾内科治疗,查体:体温37.1℃,脉搏96次/min,呼吸36次/min,血压110/60 mm Hg;血象:白细胞6.5×109/L、中性粒细胞67.7%;降钙素原0.166μg/L;既往:癫疒间60年,间断发

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