头孢噻肟所致药品不良反应文献分析

目的分析头孢噻肟所致药品不良反应(ADR)的特点,促进临床安全用药。方法检索万方数据库1998年至2019年有关文献资料,按患者的年龄、性别、给药途径、原患疾病、发生时间、预后等进行统计与分析。结果头孢噻肟所致ADR在11岁以内的少年儿童中发生较多(20.12%);静脉滴注(91.72%)是主要给药方式;ADR累及系统/器官多为全身性反应(53.85%)、皮肤及其附件损害(11.83%)、中枢及外周神经系统损害(8.28%);过敏性休克(42.60%)为主要表现形式;ADR发生时间多为用药后30 min内(56.21%),过敏性休克多发生于用药10 min内(77.78%)。5例(2.96%,男3例、女2例)死亡,包括过敏性休克4例和急性喉头水肿1例。ADR与头孢噻肟的使用"肯定有关"10例(5.92%),"很可能有关"155例(91.72%),"可能有关"4例(2.37%)。结论临床应重视头孢噻肟导致的ADR,尤其是过敏性休克等严重ADR,鼓励、推广及规范头孢菌素类药物的皮肤过敏试验工作,以确保用药安全。

Literature Analysis on the Adverse Drug Reactions Caused by Cefotaxime

Objective To analyze the characteristics of adverse drug reactions(ADRs)caused by cefotaxime,and to promote clinical safe medication.Methods The literature about ADRs caused by cefotaxime from 1998 to 2019 in the Wanfang database were searched and analyzed according to the patients’age,gender,route of administration and primary disease,the onset time and prognosis of ADRs.Results ADRs caused by cepotaxime often occurred in pediatric and teenagers under 11 years(20.12%),the intravenous drip(91.72%)was the main way of administration route,the systemic reaction(53.85%),skin and its accessories damage(11.83%),central and peripheral nervous system damage(8.28%)were main clinical symptoms of ADR,the anaphylactic shock(42.60%)was the main clinical manifestation.The onset of ADRs was usually within 30 min after administration(56.21%),and the onset of anaphylactic shock was usually within 10 min after administration(77.78%).Five cases(2.96%,three cases of male and two cases of female)died,including four cases of anaphylactic shock and one case of acute laryngeal edema.ADRs were related to the use of cefotaxime,of which ten cases(5.92%)were definitely related,one hundred and fifty-five cases(91.72%)were probably likely related and four cases(2.37%)were likely related.Conclusion We should pay more attention to the ADRs caused by cepotaxime,especially severe ADRs such as anaphylactic shock,and the skin allergy test of cephalosporins should be encouraged,promoted and standardized to ensure medication safety.