Clinical analysis of hypersensitivity reactions induced by antimicrobial drugs in neonates
10.3760/cma.j.issn.1008-5734.2020.01.006
- VernacularTitle:新生儿抗菌药物过敏反应病例临床分析
- Author:
Yongxian JIANG
1
;
Gen LI
;
Yulan WANG
;
Bo WU
;
Han WANG
;
Ling ZHU
Author Information
1. 电子科技大学医学院附属妇女儿童医院/成都市妇女儿童中心医院药学部 611731
- Publication Type:Journal Article
- Keywords:
Infant, newborn;
Anti-bacterial agents;
Drug hypersensitivity;
Adverse drug reaction reporting systems;
Retrospective types studies
- From:
Adverse Drug Reactions Journal
2020;22(1):25-31
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the occurrence and clinical characteristics of hypersensitivity reactions induced by antimicrobial drugs in neonates.Methods:The reports of hypersensitivity reactions induced by antimicrobial drugs in Neonatology Department of Chengdu Women′s and Children′s Central Hospital from January 1, 2015 to December 31, 2017 were collected. According to the basic information of children provided by the reports, the electronic medical records of the children were collected from the hospital information system and the data of application, occurrence, treatments, and outcomes of hypersensitivity reactions were recorded. The clinical manifestations, types, and severity of hypersensitivity reactions were evaluated by 3 pharmacists according to relevant standards. From the hospital information system, the total number of outpatients and inpatients in Department of Neonatology in the same period was counted, the usage of antimicrobial drugs was recorded, and the incidence of hypersensitivity reactions due to antimicrobial agents was caculated.Results:A total of 73 reports of hypersensitivity reactions to antimicrobial drugs in Department of Neonatology were entered, involving 73 newborn infants; there were 21 146 infants using anti-microbial agents at the same time, so the incidence of antimicrobial hypersensitivity reactions was 0.35%. Among the 73 children, 34 were male and 39 were female; the ages on visit or admission to the hospital was (14±7) days; 69 (94.52%) were given injections of antimicrobial agents and 4 (5.48%) were given oral preparations. A total of 20 antimicrobial agents of 7 categories were used; the top 3 were cephalosporins (32 infants, 43.84%), penicillins (21 infants, 28.77%), and cephamycins (6 infants s, 8.22%). The top 3 drugs with higher incidence of hypersensitivity reactions were levofloxacin hydrochloride injection (2/4), erythromycin lactobionate for injection [1.29% (4/311)], and vancomycin hydrochloride for injection [1.07% (4/374)]. Among the 73 infants, 4 (5.48%) had immediate hypersensitivity reactions, of which 3 were severe (including 1 with anaphylactic shock, 1 with dyspnea, and 1 with severe anaphylactic reaction) cases; 69 (94.52%) had nonimmediate hypersensitivity reactions, mainly manifested as rash, digestive system symptoms, and fever, of which 6 were severe cases (including 3 infants with hepatobiliary system injury, 2 with neutropenia, and 1 with severe drug eruption). After discontinuation of suspected drugs and/or antiallergic and symptomatic treatments, 71 of 73 newborns recovered (97.26%) and 2 (2.74%) improved.Conclusions:The incidence of hypersensitivity reactions induced by antimicrobial drugs in newborns in Chengdu Women′s and Children′s Central Hospital was 0.35%. The clinical types of hypersensitivity reactions induced by antimicrobial drugs in neonates were mainly nonimmediate types, most of them were general hypersensitivity reactions, but the immediate drug hypersensitivity reactions were mostly severe hypersensitivity reactions.
