Abstract
Background
Few studies have investigated the incidence of anaphylaxis induced by individual or structurally similar cephalosporins. The aims of the study were to assess the incidence of cephalosporin-induced anaphylaxis and evaluate the clinical efficacy of screening skin tests.
Methods
In this retrospective cohort study, we obtained information on total cephalosporin use and cephalosporin-induced anaphylaxis in intravenous cephalosporin recipients in 12 general hospitals between 2013 and 2015. Cephalosporins were divided into four groups according to similar side-chain structures. The incidence of cephalosporin-induced anaphylaxis was assessed for each cephalosporin, cephalosporin generation and side-chain group. To verify the efficacy of screening intradermal tests (IDT) with cephalosporin, the 12 hospitals were assigned to the intervention or control group depending on whether they performed screening IDT before the administration of cephalosporins.
Results
We identified 76 cases of cephalosporin-induced anaphylaxis with 1,123,345 exposures to intravenous cephalosporins (6.8 per 100,000 exposures) and the incidence of fatal anaphylaxis by cephalosporin was 0.1 cases per 100,000 exposures. The highest incidences of anaphylaxis occurred in the ceftizoxime (13.0 cases per 100,000 exposures) and side-chain group 1 (cefepime, cefotaxime, ceftizoxime, ceftriaxone and cefuroxime; 9.3 per 100,000). There was no case of anaphylaxis induced by cefoxitin, cefmetazole, cefminox and cefotiam. The clinical effectiveness of routine screening IDT was not significant (p = 0.06).
Conclusions
The incidence of cephalosporin-induced anaphylaxis differed according to individual drugs and side-chain structure. Although screening IDT showed no clinical efficacy in general, it may be useful for certain cephalosporins.
This article is protected by copyright. All rights reserved.
http://ift.tt/2tnI7mA
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου