Clinical characteristics of adverse reactions induced by levofloxacin in the emergency infusion unit: a prospective cohort study
10.3760/cma.j.cn114015-20231117-00812
- VernacularTitle:急诊输液室左氧氟沙星不良反应临床特征的前瞻性队列研究
- Author:
Weiwen HAO
1
;
Lumin WANG
;
Jinsong ZHANG
;
Guiping JIANG
;
Hao SUN
;
Hua JIN
;
Yun CAO
;
Huazhong ZHANG
;
Gannan WANG
;
Qifang SHI
Author Information
1. 南京医科大学第一附属医院急诊医学中心，南京 210029
- Publication Type:Journal Article
- Keywords:
Emergency treatment;
Infusions, intravenous;
Drug-related side effects and adverse reactions;
Levofloxacin;
Prospective studies
- From:
Adverse Drug Reactions Journal
2024;26(6):331-336
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical characteristics of adverse reactions induced by levofloxacin in the emergency infusion unit.Methods:The study was designed as a single center prospective cohort study. Data of adverse drug reaction (ADR) in the Infusion Unit of Emergency Medicine Center of First Affiliated Hospital of Nanjing Medical University was managed, recorded and collected according to the pre-formulated "emergency infusion unit drug adverse reaction management process" and "strengthening the reporting of observational studies in epidemiology (STROBE)". The incidence, severity, clinical characteristics, intervention measures, outcomes, and follow-up of adverse reactions induced by levofloxacin from November 2019 to October 2022 was summarized and analyzed.Results:A total of 426 cases of ADR occurred within the set time period, of which 62 (14.55%) were related to levofloxacin, involving 27 males (43.55%) and 35 females (56.45%) with a median age of 39 years. Among the 62 levofloxacin-related ADRs, 96.77% (60/62) occurred within 2 hours of intravenous infusion of levofloxacin; the severity of 44 (70.97%), 10 (16.13%) and 8 (12.90%) cases of ADRs was classified as grade 1, 2, and 3, respectively, and no grade 4 ADRs occurred. The most common clinical symptoms were skin and mucosa reactions, including rash and itching, followed by cardiovascular system and nervous system manifestations, including hypotension, palpitation, and dizziness. The skin and mucosa manifestations were more common in patients with severity grade 1 ADRs, while the cardiovascular, digestive, respiratory nervous system and systemic manifestations were more common in those with severity grade 2 and 3 ADRs; the differences were statistically significant (all P<0.05). After the occurrence of ADRs, levofloxacin was withdrawn in all the 62 patients, the infusion set was replaced, and infusion of 0.9% sodium chloride injection were used to flush the tube. Additionally, 24 patients (38.71%) were given drug intervention, including epinephrine in 2 patients. After the above intervention, the symptoms of all patients were relieved, with a median response time of 49 minutes. Conclusions:Levofloxacin was one of the common drugs causing ADR in the emergency infusion unit. The clinical manifestations were mainly rashes and itching, most of which were mild in severity. Timely discontinuation of levofloxacin and drug interventions often help get a good prognosis. However, the treatment procedure of severe ADRs remain to be standardized.
