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베타-락탐 항생제 알레르기: 일개 지역병원의 실제 임상

Beta-Lactam Allergy: Real Practice in a Regional Hospital

대한내과학회지 2021년 96권 1호 p.42 ~ 47
김혜림, 이재천, 김세진,
소속 상세정보
김혜림 ( Kim Hye-Rim ) - Jeju National University School of Medicine Department of Internal Medicine
이재천 ( Lee Jae-Chun ) - Jeju National University School of Medicine Department of Internal Medicine
김세진 ( Kim Se-Jin ) - Jeju National University School of Medicine Department of Internal Medicine

Abstract


Background/Aims : Beta-lactam (BL) antibiotics are widely prescribed for controlling bacterial infections and relevant culprits of adverse drug reactions (ADRs). BL allergy may vary according to prescription patterns within a given period of time. However, BL allergy in contemporary clinical practice has rarely been a focus of research.

Methods : To investigate the clinical characteristics of BL allergy, subjects with ADRs to medicines, including BL antibiotics, were retrospectively reviewed.

Results : Among the 175 enrolled subjects, BL antibiotics as culprits were confirmed in 79 (45.1%, female 53.2%, age 49 ± 14 years). Among the patients with confirmed BL allergy, only two (2.5%) were diagnosed via a prescription survey completed as part of multi-drug administration. The others were confirmed by serologic tests in 33 patients (41.8%), skin tests in 29 (36.7%), and drug provocation tests in 15 (19.0%). Regarding the symptoms and signs, onset within an hour of taking medicines was common (61 patients, 77.3%). Itchy skin was most common, followed by hives, rash, breathing difficulty, angioedema, and hypotension. Anaphylaxis occurred in 67%, and one-half (50.6%) of patients visited the emergency room. Cefaclor and amoxicillin were common BL culprits. Among others who did not have BL allergy, nonsteroidal anti-inflammatory drugs were found to be common culprits, followed by quinolones.

Conclusions : BL allergy is common among patients who experienced ADRs to medicines including BL antibiotics. For multi-drug administration, a prescription survey hardly helped in confirming BL allergy. Anaphylaxis is common in patients with BL allergy, frequently leading to emergency room visits. Cefaclor and amoxicillin are common culprits.

키워드

약물이상반응; 약물 알레르기; 베타-락탐 항생제; 아나필락시스; 피부시험
Drug hypersensitivity; Beta-lactams; Skin tests; Diagnostic tests; Cephalosporins

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