2005～2014年头孢菌素类抗生素致药源性死亡的国内文献分析

目的：汇总近10年国内发表的报道头孢菌素类抗生素致药源性死亡的文献，分析国内头孢菌素类抗生素致药源性死亡的发生情况及特点，为临床用药安全提供科学依据。方法检索中国知网、万方数据和维普网中有关头孢菌素类抗生素致药源性死亡的文献资料，对致死病例的性别、年龄、药品不良反应临床表现及死亡原因等信息进行回顾性分析。结果纳入有效文献55篇，共报道病例76例，男性45例（59．2％）、女性31例（40．8％），男女性别比为1．45∶1；患者年龄0．5～79岁，平均年龄46．9±17．9。患者原发疾病以上呼吸道感染29例（38.2％）、（支）气管炎12例（15.8％）、肺部感染11例（14．5％）等呼吸系统疾病为主，给药方式以静脉滴注为主，有65例（85.5％）。药品不良反应的发生时间主要集中在10 min 以内，有48例（63．2％）；全部药品不良反应患者中发生过敏性休克患者59例（77．6％），用药后休克症状发生时间＜5 min 有46例（78．0％）。第三代头孢菌素的使用率最高，有49例（64.5％）。全部患者药品不良反应的临床表现及死亡原因分布中，过敏性休克占比最多，为59例（77．6％）。结论头孢菌素类抗生素临床应用广泛，所引起的药品不良反应临床表现各异，其中致药源性死亡的最主要原因为过敏性休克，第三代头孢菌素的使用率最高。临床用药过程中，用药前应当详细询问病史、过敏史等，密切观察防止药品不良反应致死病例的发生。

Analysis of literatures about drug-induced death caused by cephalosporins from 2005 to 2014

Objective To analyze literatures about drug -induced death caused by cephalosporins,investigate the char-acteristics of drug -induced deaths by cephalosporins and provide a scientific basis for drug safety.Methods To retrieve lit-eratures related cephalosporins cause drug -induced death in China knowledge Reseurce Integrated Database,Wanfang Data and VIP Network,and retrospectively analysis by sex,age,clinical manifestations of adverse drug reactions and cause of death and other information.Results There were 55 effective documents of 76 cases,45 males (59.2%),31 females (40.8%), and the ratio was 1 .45∶1 ;Patients aged 0.5 to 79 years,the mean age was 46.9 ±17.9.Patients with primary disease 29 cases of upper respiratory tract infection (38.2%),12 cases of tracheitis(bronchitis)(15.8%),lung infection in 11 patients (14.5%), and other respiratory diseases mainly with intravenous administration of Lord,there were 65 cases (85.5%).ADR occurrence time,mainly within 10 min,there were 48 cases (63.2%);59 cases of anaphylactic shock patients (77.6%)occurred in patients of all ADR,shock symptoms occur after administration time <5 minutes,46 patients (78.0%).Highest third -generation cepha-losporin usage,there were 49 cases(64.5%);The most frequently used before 5 cephalosporins were:ceftriaxone,cefazolin,cef-operazone,cefotaxime sodium,cefoperazone -sulbactam.Clinical manifestations of adverse reactions in all patients and cause of death distribution,accounting for up to anaphylactic shock 59 cases (77.6%).Conclusion The clinical application of antibiotics was widespread,the clinical manifestations of ADR were different,and the main cause of the death of drug was allergic shock,and the use of the third generation of the most important was the highest.In the process of clinical medication,the medical history,al-lergic history,etc.,should be closely observed to prevent the occurrence of ADR fatal cases.